Seasonal Variation of Trauma in Western Massachusetts: Fact or Folklore?

Nahmias, Jeffry; Poola, Shiva; Doben, Andrew R.; Garb, Jane; Gross, R

doi:10.1136/tsaco-2017-000120

Cited by 21 publications

(27 citation statements)

References 12 publications

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“…This may be related to the lack of opportunity to engage in activities usually associated with injury, such as; excessive consumption of alcohol, interpersonal violence and RTCs [ 22 , 23 ]. The scale of change, by as much as 68% reduction in the early phase of the lockdown, is unprecedented and differed significantly from the seasonal variations (which ranges from 10 to 20%) previously reported [ 5 – 7 ]. Profound differences in the demographics of the two matched periods were observed.…”

Section: Discussioncontrasting

confidence: 57%

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The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

Moody

Adiamah

Anis³

et al. 2021

Eur J Trauma Emerg Surg

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Background The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of “lockdown measures” and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma. Methods This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020–18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019–20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher’s exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality. Results A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (p < 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables. Conclusion Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.

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Section: Discussioncontrasting

confidence: 57%

“…[22,23]. The scale of change, by as much as 68% reduction in the early phase of the lockdown, is unprecedented and differed significantly from the seasonal variations (which ranges from 10 to 20%) previously reported [5][6][7]. Profound differences in the demographics of the two matched periods were observed.…”

Section: Discussionmentioning

confidence: 83%

The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

Moody

Adiamah

Anis³

et al. 2021

Eur J Trauma Emerg Surg

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“…As previously reported, trauma admissions show seasonal differences with a mid-year peak and the “trauma season” spanning from April to November [ 22 ]. Although falls and motor vehicle accidents were reported to be more frequent in the winter season [ 23 ], trauma numbers in March/April were comparable to those in February/March in ordinary years without a pandemic [ 24 ]. This allows the assumption that lower orthopedic trauma cases during the PRE compared to the CTRL period, may have been caused by people already being more cautious during the early months of the COVID-19 pandemic, although a shutdown was not yet in place.…”

Section: Discussionmentioning

confidence: 99%

Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany

et al. 2021

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Background The COVID-19 pandemic led to the implementation of drastic shutdown measures worldwide. While quarantine, self-isolation and shutdown laws helped to effectively contain and control the spread of SARS-CoV-2, the impact of COVID-19 shutdowns on trauma care in emergency departments (EDs) remains elusive. Methods All ED patient records from the 35-day COVID-19 shutdown (SHUTDOWN) period were retrospectively compared to a calendar-matched control period in 2019 (CTRL) as well as to a pre (PRE)- and post (POST)-shutdown period in an academic Level I Trauma Center in Berlin, Germany. Total patient and orthopedic trauma cases and contacts as well as trauma causes and injury patterns were evaluated during respective periods regarding absolute numbers, incidence rate ratios (IRRs) and risk ratios (RRs). Findings Daily total patient cases (SHUTDOWN vs. CTRL, 106.94 vs. 167.54) and orthopedic trauma cases (SHUTDOWN vs. CTRL, 30.91 vs. 52.06) decreased during the SHUTDOWN compared to the CTRL period with IRRs of 0.64 and 0.59. While absolute numbers decreased for most trauma causes during the SHUTDOWN period, we observed increased incidence proportions of household injuries and bicycle accidents with RRs of 1.31 and 1.68 respectively. An RR of 2.41 was observed for injuries due to domestic violence. We further recorded increased incidence proportions of acute and regular substance abuse during the SHUTDOWN period with RRs of 1.63 and 3.22, respectively. Conclusions While we observed a relevant decrease in total patient cases, relative proportions of specific trauma causes and injury patterns increased during the COVID-19 shutdown in Berlin, Germany. As government programs offered prompt financial aid during the pandemic to individuals and businesses, additional social support may be considered for vulnerable domestic environments.

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“…However, more injuries were found in the months of July and August, which was described as Summer in the Northern Meteorological Seasons and Rainy Season in Bangladeshi Seasons. Earlier, a study from adult trauma cases in the USA described significant seasonal variations of mechanism of injury and reported that falls were significantly more during winter and RTAs were more during fall and winter than spring (Nahmias et al, 2017). The South Indian study reported that majority of injuries in children occurred during the most active part of the day (6 am-5 pm) and about half of their patients presented during the afternoon shift (3 pm-10 pm) (Paul et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Epidemiological characteristics of child injury in a tertiary paediatric surgical centre in Bangladesh

Chowdhury

Sadia

Khan

et al. 2020

Asian J. Med. Biol. Res

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While high income countries (HICs) have reduced the mortality from child injury, it is increasing in the low- and middle-income countries (LMICs). However, injury registry and reporting are inconsistent and not well developed in the LMICs. This study aims at describing the epidemiology of child injury in a tertiary paediatric surgical centre in Bangladesh. We retrospectively analysed all patients of injury between 0 and 12 years of age admitted in the Department of Paediatric Surgery, Chattogram Medical College Hospital during January 2017 to June 2020. Analysis was done for the hospital prevalence, age and sex distribution, seasonal variations, mechanism of injury, site of involvement, and mortality from injury. There were a total of 538 patients and male to female ratio was 2.01:1. Hospital prevalence was 6.71%. Mean age was 6.60 ± 3.32 years. School age children were affected more (51.7%); and “6-10 years” age group had the highest number injuries (251 patients, 46.65%). The most common mechanisms of injuries were road-traffic accident (RTA, 35.32%), followed by fall (26.39%) and „stab or cut injury‟ (20.63%). Males experienced more abdominal injuries and females had more perineal injuries (P=0.00). RTA was the commonest mechanism in males (37.05%) and falls were the commonest mechanism in females (32.96%). „Stab or cut injury‟ was the commonest mechanism in infants and toddlers, and RTA was commonest among pre-school and school age children. There were no significant seasonal variations (P=0.09). There were 5.76% intentional injuries. Mortality was 2.60% and major causes of mortality were RTA and animal assaults. Injuries were more prevalent during the mid-childhood with an overall increasing trend with age. Mechanism of injury and site of involvement were different among different age groups and between sexes. Asian J. Med. Biol. Res. September 2020, 6(3): 577-586

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Seasonal Variation of Trauma in Western Massachusetts: Fact or Folklore?

Cited by 21 publications

References 12 publications

The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

Impact of the COVID-19 shutdown on orthopedic trauma numbers and patterns in an academic Level I Trauma Center in Berlin, Germany

Epidemiological characteristics of child injury in a tertiary paediatric surgical centre in Bangladesh

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