Choi Yunhyung, Lee Duk Hee
Department of Emergency Medicine, College of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea.
Healthcare (Basel). 2023 May 19;11(10):1483. doi: 10.3390/healthcare11101483.
The coronavirus disease 2019 (COVID-19) pandemic has obviously caused a remarkable change in patients' emergency department (ED) visits; however, data from multicenter studies are lacking. We aimed to present a comprehensive analysis of injury-related ED visits in Republic of Korea before and during the COVID-19 pandemic.
Data from 23 tertiary hospitals based on Emergency Department-based Injury In-depth Surveillance were used for this retrospective cross-sectional study. A total of 541,515 ED visits (age ≥ 20 years) between 1 January 2018 and 31 December 2020 were included, and the trend of injuries related to motor vehicular accidents, falls, self-harm and suicide, assault, and poisoning were compared between the pre-COVID-19 time period and during the COVID-19 pandemic.
In the first year of the COVID-19 period, a decline in the number of ED visits was observed (41,275, 21%) compared to the previous year. Injuries caused by motor vehicles (36,332 in 2019 vs. 27,144 in 2020), falls and slips (61,286 in 2019 vs. 49,156 in 2020), assaults (10,528 in 2019 vs. 8067 in 2020), and poisonings (7859 in 2019 vs. 7167 in 2020) decreased, whereas self-harm and suicide (8917 in 2019 vs. 8911 in 2020) remained unchanged. The hospitalization (16.6% in 2019 vs. 18.8% in 2020) and ED mortality rate (0.6% in 2019 vs. 0.8% in 2020) also increased.
The COVID-19 pandemic led to a decline in the overall number of trauma patients seeking medical care; however, the proportion of patients requiring hospitalization or intensive care unit admission increased, indicating more severe injuries among those who did seek care. Suicide attempt rates remained unchanged, highlighting the need for targeted care and support for vulnerable patients. During the pandemic, EDs had to continue to provide care to patients with medical emergencies unrelated to COVID-19, which requires a delicate and adaptable approach to ED operations. To manage the increased stress and workload caused by the pandemic, increased resources and support for healthcare workers were needed.
2019年冠状病毒病（COVID-19）大流行明显导致了患者急诊就诊情况的显著变化；然而，缺乏多中心研究的数据。我们旨在对韩国COVID-19大流行之前和期间与伤害相关的急诊就诊情况进行全面分析。
本回顾性横断面研究使用了基于急诊科伤害深度监测的23家三级医院的数据。纳入了2018年1月1日至2020年12月31日期间共541,515次急诊就诊（年龄≥20岁），并比较了COVID-19之前时期和COVID-19大流行期间与机动车事故、跌倒、自残与自杀、袭击和中毒相关的伤害趋势。
在COVID-19时期的第一年，与上一年相比，急诊就诊次数有所下降（41,275次，下降21%）。机动车造成的伤害（2019年为36,332例，2020年为27,144例）、跌倒和滑倒（2019年为61,286例，2020年为49,156例）、袭击（2019年为10,528例，2020年为8067例）和中毒（2019年为7859例，2020年为7167例）有所减少，而自残与自杀（2019年为8917例，2020年为8911例）保持不变。住院率（2019年为16.6%，2020年为18.8%）和急诊死亡率（2019年为0.6%，2020年为0.8%）也有所上升。
COVID-19大流行导致寻求医疗救治的创伤患者总数下降；然而，需要住院治疗或入住重症监护病房的患者比例增加，这表明在寻求治疗的患者中伤情更严重。自杀未遂率保持不变，这突出表明需要针对弱势患者提供有针对性的护理和支持。在大流行期间，急诊科必须继续为与COVID-19无关的医疗紧急情况患者提供护理，这需要对急诊科运营采取细致且适应性强的方法。为应对大流行造成的压力和工作量增加，需要为医护人员增加资源和支持。
