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2020年新冠疫情对日本严重创伤的流行病学、治疗及预后的影响:一项基于全国登记处的回顾性观察研究

Impact of the COVID-19 pandemic on epidemiology, treatment, and outcome of major trauma in Japan in 2020: a retrospective observational nationwide registry-based study.

作者信息

Ojima Masahiro, Ishida Kenichiro, Katayama Yusuke, Hirose Tomoya, Nakao Shunichiro, Tachino Jotaro, Noda Tomohiro, Umemura Yutaka, Kiguchi Takeyuki, Kiyohara Kosuke, Matsuyama Tasuku, Kitamura Tetsuhisa, Oda Jun, Ohnishi Mitsuo

机构信息

Department of Acute Medicine and Critical Care Medical Center National Hospital Organization Osaka National Hospital Osaka Japan.

Department of Traumatology and Acute Critical Medicine Osaka University Graduate School of Medicine Suita Japan.

出版信息

Acute Med Surg. 2023 Jan 18;10(1):e817. doi: 10.1002/ams2.817. eCollection 2023 Jan-Dec.

Abstract

AIM

The nationwide impact of the coronavirus disease (COVID-19) pandemic on major trauma in Japan is unknown. The nationwide registry-based data of the Japanese Trauma Data Bank were analyzed to elucidate the impact of COVID-19 on the epidemiology, treatment, and outcomes of major trauma patients.

METHODS

Among patients transported directly from the injury site by ambulance with an Injury Severity Score of ≥16, we compared patients managed from April to December in 2019 to those managed from April to December in 2020.

RESULTS

In total, 9792 patients were included in this study (2019,  = 5194; 2020,  = 4598). There were no significant differences in age or sex, but there were significant differences between 2019 and 2020 in the rates of "self-injury (suicide)", "motor vehicle accident", "fall from height", "fall down", and "fall to the ground", which are factors associated with patient age. Injury severity in 2019 and 2020 did not differ to a statistically significant extent, but the rate of major spinal injury increased. The time of prehospital care significantly increased in 2020 compared to 2019. There was no noticeable change in hospital treatment or in-hospital mortality between 2019 and 2020.

CONCLUSION

This study suggests that the COVID-19 pandemic might have altered the injuries of major trauma; however, medical services for major trauma were well supplied in Japan in 2020.

摘要

目的

冠状病毒病(COVID-19)大流行对日本严重创伤的全国性影响尚不清楚。对日本创伤数据库基于全国登记的数据进行分析,以阐明COVID-19对严重创伤患者的流行病学、治疗及结局的影响。

方法

在通过救护车直接从受伤现场转运的损伤严重度评分≥16的患者中,我们比较了2019年4月至12月期间收治的患者与2020年4月至12月期间收治的患者。

结果

本研究共纳入9792例患者(2019年,n = 5194;2020年,n = 4598)。年龄和性别方面无显著差异,但2019年和2020年在“自我伤害(自杀)”“机动车事故”“高处坠落”“摔倒”及“跌倒在地”的发生率上存在显著差异,这些都是与患者年龄相关的因素。2019年和2020年的损伤严重程度在统计学上无显著差异,但严重脊柱损伤的发生率有所增加。与2019年相比,2020年的院前护理时间显著增加。2019年和2020年之间,医院治疗或住院死亡率没有明显变化。

结论

本研究表明,COVID-19大流行可能改变了严重创伤的损伤情况;然而,2020年日本为严重创伤提供了充足的医疗服务。

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