East Midlands Major Trauma Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
Eur J Trauma Emerg Surg. 2022 Aug;48(4):2831-2839. doi: 10.1007/s00068-022-01964-5. Epub 2022 May 18.
To compare patterns and mechanisms of injuries during and after the UK Nationwide lockdown during the COVID-19 pandemic.
This prospective cohort study included all major trauma admissions during the 10-week period of the nationwide lockdown (09/03/2020-18/05/2020), compared with admissions in the 10-weeks following the full lifting of lockdown restrictions (04/07/20-12/09/2020). Differences in the volume, spectrum and mechanism of injuries presenting during and post-lockdown were compared using Fisher's exact and Chi-squared tests as appropriate. The associated risk of 30-day mortality was examined using univariable and multivariable logistic regression.
A total of 692 major trauma admissions were included in this analysis. Of these, 237 patients were admitted during the lockdown and 455 patients were admitted post-lockdown. This represented a twofold increase in trauma admission between the two periods. Characteristically, both cohorts had a higher proportion of male patients (73.84% male during lockdown and 72.5% male post-lockdown). There was a noted shift in age groups between both cohorts with an overall more elderly population during lockdown (p = 0.0292), There was a significant difference in mechanisms of injury between the two cohorts. The 3-commonest mechanisms during the lockdown period were: Road traffic accidents (RTA)-31.22%, Falls of less than 2 m-26.58%, and falls greater than 2 m causing 22.78% of major trauma admissions. However, in the post-lockdown period RTAs represented 46.15% of all trauma admissions with falls greater than 2 m causing 17.80% and falls less than 2 m causing 15.16% of major trauma injuries. With falls in the elderly associated with an increased risk of mortality. In terms of absolute numbers, there was a twofold increase in major trauma injuries due to stabbings and shootings, rising from 25 admitted patients during the lockdown to 53 admitted patients post-lockdown.
The lifting of lockdown restrictions resulted in a twofold increase in major trauma admissions that was also associated with significant changes in both the demographic and patterns of injuries with RTA's contributing almost half of all injury presentations.
This study was classed as a service evaluation and registered with the local audit department, registration number: 20-177C.
比较 COVID-19 大流行期间英国全国封锁期间和之后的受伤模式和机制。
本前瞻性队列研究纳入了全国封锁期间（2020 年 3 月 9 日至 5 月 18 日）的所有主要创伤入院病例，并与封锁限制完全解除后的 10 周（2020 年 7 月 4 日至 9 月 12 日）进行比较。使用 Fisher 精确检验和卡方检验比较封锁期间和之后入院的受伤量、范围和机制的差异。使用单变量和多变量逻辑回归检查 30 天死亡率的相关风险。
本分析共纳入 692 例主要创伤入院病例。其中，237 例患者在封锁期间入院，455 例患者在封锁后入院。这表明两个时期的创伤入院人数增加了两倍。两个队列均以男性患者居多（封锁期间为 73.84%，封锁后为 72.5%）。两个队列之间的年龄组存在明显变化，封锁期间老年人口比例总体较高（p=0.0292）。两个队列的受伤机制存在显著差异。封锁期间最常见的三种机制是：道路交通意外（RTA）-31.22%、2 米以下跌倒-26.58%、2 米以上跌倒导致 22.78%的主要创伤入院。然而，在封锁后期间，RTA 占所有创伤入院的 46.15%，2 米以上跌倒导致 17.80%，2 米以下跌倒导致 15.16%的主要创伤损伤。老年人跌倒与死亡率增加有关。就绝对数字而言，刺伤和枪击导致的主要创伤伤害增加了两倍，从封锁期间的 25 名入院患者增加到封锁后的 53 名入院患者。
封锁限制的解除导致主要创伤入院人数增加了两倍，受伤人数和受伤模式也发生了显著变化，道路交通意外几乎占所有受伤人数的一半。
本研究被归类为服务评估，并在当地审计部门注册，注册号为 20-177C。
