通过新冠疫情期间急诊科就诊的踝关节骨折情况：国家电子伤害监测系统分析
Emergency Department Visits for Ankle Fractures Through COVID-19: An Analysis of the National Electronic Injury Surveillance System.
作者信息
Mo Kevin, Gupta Arjun, Singh Priya, Malan Samuel, McDaniel Claire, Thompson John M, Aiyer Amiethab
机构信息
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, USA.
出版信息
Foot Ankle Orthop. 2022 Sep 3;7(3):24730114221119188. doi: 10.1177/24730114221119188. eCollection 2022 Jul.
BACKGROUND
Societal changes that occurred during the COVID-19 pandemic may have altered the epidemiology of ankle fractures. The aim of this study was to assess trends in emergency department visits for ankle fractures from 2019 to 2020 in the United States.
METHODS
The National Electronic Injury Surveillance System (NEISS) database is a sample of hospitals in the United States stratified and weighted based on emergency department (ED) size, which was used to generate national estimates (NEs). The NEISS database was queried for patients who sustained an ankle fracture. Patients before COVID-19 (BC) (July 2019-December 2019) were compared to those during COVID-19 (DC) (July 2020-December 2020).
RESULTS
This study assessed 3350 (NE: 131,672) patients. Of these, 1683 (NE: 67,292) patients presented BC and 1667 (NE: 64,380) DC, representing a 4% decrease. The rate of alcohol-related ankle fractures increased (1.9% BC vs 2.6% DC; < .001). The fraction of ankle fractures at school (3% BC vs 0.7% DC; < .001) and during sports (19% BC vs 14% DC; < .001) decreased. ED visits for ankle fracture leading to hospitalization marginally increased (23% BC vs 24% DC). The top 3 ankle fracture causes during COVID-19 were stairs (NE: 18,026, 28%), floors (ie, falling on floor) (NE: 4635, 7.2%), and skateboards (NE: 2832, 4.40%). The 3 largest increases in ankle fracture causes during COVID-19 were skateboards (+2.80%), floors (+1.10%), and powered scooters (+0.80%).
CONCLUSION
There was a decrease in ankle fractures during the COVID-19 pandemic compared to the year before. Alcohol-related fractures increased as did fractures resulting in hospitalization. Ankle fractures caused by skateboards, powered scooters, and mopeds increased during COVID-19, whereas fewer occurred in school or during sports, consistent with restrictions to group activities. These findings may aid in proper health care budgeting in times of national and global crises.
LEVEL OF EVIDENCE
Level III, retrospective comparative study.
背景
2019冠状病毒病大流行期间发生的社会变化可能改变了踝关节骨折的流行病学特征。本研究的目的是评估2019年至2020年美国急诊科踝关节骨折就诊趋势。
方法
国家电子伤害监测系统（NEISS）数据库是美国医院的一个样本，根据急诊科规模进行分层和加权，用于生成全国估计数（NE）。在NEISS数据库中查询踝关节骨折患者。将2019年冠状病毒病之前（BC）（2019年7月至2019年12月）的患者与2019年冠状病毒病期间（DC）（2020年7月至2020年12月）的患者进行比较。
结果
本研究评估了3350例（NE：131,672例）患者。其中，1683例（NE：67,292例）患者在BC期就诊，1667例（NE：64,380例）患者在DC期就诊，下降了4%。酒精相关踝关节骨折的发生率有所增加（BC期为1.9%，DC期为2.6%；P<0.001）。在学校发生的踝关节骨折比例（BC期为3%，DC期为0.7%；P<0.001）和在运动期间发生的比例（BC期为19%，DC期为14%；P<0.001）均下降。因踝关节骨折导致住院的急诊科就诊人数略有增加（BC期为23%，DC期为24%）。2019年冠状病毒病期间踝关节骨折的前三大原因是楼梯（NE：18,026例，28%）、地板（即摔倒在地板上）（NE：4635例，7.2%）和滑板（NE：2832例，4.40%）。2019年冠状病毒病期间踝关节骨折原因增加幅度最大的三个是滑板（+2.80%）、地板（+1.10%）和电动滑板车（+0.80%）。
结论
与前一年相比，2019年冠状病毒病大流行期间踝关节骨折有所减少。酒精相关骨折以及导致住院的骨折有所增加。2019年冠状病毒病期间，滑板、电动滑板车和轻便摩托车导致的踝关节骨折有所增加，而在学校或运动期间发生的骨折较少，这与团体活动限制一致。这些发现可能有助于在国家和全球危机时期进行适当的医疗保健预算。
证据水平
三级，回顾性比较研究。
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