Severely injured patients do not disappear in a pandemic: Incidence and characteristics of severe injuries during COVID-19 lockdown in Finland

Abstract

Background and purpose — COVID-19 lockdowns have resulted in noteworthy changes in trauma admissions. We report and compare the incidence and characteristics of severe injuries (New Injury Severity Score [NISS] > 15) during the COVID-19 lockdown in Finland with earlier years. Methods — We retrospectively analyzed incidence rate, injury severity scores, injury patterns, and mechanisms of injury of all severely injured patients (NISS >15) in 4 Finnish hospitals (Tampere University Hospital, Kuopio University Hospital, Central Finland Hospital, Mikkeli Central Hospital) during the 11-week lockdown period (March 16–May 31, 2020) with comparison with a matching time period in earlier years (2016–2018). These 4 hospitals have a combined catchment area of 1,150,000 people or roughly one-fifth of the population of Finland. Results — The incidence rate of severe injuries during the lockdown period was 4.9/10 5 inhabitants (95% CI 3.7–6.4). The incidence rate of severe injuries during years 2016–2018 was 5.1/10 5 inhabitants (CI 3.9–6.5). We could not detect a significant incidence difference between the lockdown period and the 3 previous years (incidence rate difference –0.2 (CI –2.0 to 1.7). The proportion of traffic-related accidents was 55% during the lockdown period and 51% during previous years. There were no detectable differences in injury patterns. During the lockdown period, the mean age of patients was higher (53 years vs. 47 years, p = 0.03) and the rate of severely injured elderly patients (aged 70 or more) was higher (30% vs. 16%). Interpretation — Despite heavy social restrictions, the incidence of severe injuries during the lockdown period was similar to previous years. Notably, a decline in road use and traffic volumes did not reduce the number of severe traffic accidents. Although our data is compatible with a decrease of 2.0 to an increase of 1.7 severely injured patients per 10 5 inhabitants, we conclude that severely injured patients do not disappear even during pandemic and stabile hospital resources are needed to treat these patients.

Impact of the COVID-19 Pandemic on Road Traffic Collision Injury Patterns and Severity in Al-Ain City, United Arab Emirates

“…Systolic blood pressure and respiratory rate were signi cantly worse during the Pandemic in our study, although ISS and GCS were unchanged. Other authors reported signi cant changes both in the anatomical and physiological markers of severity between the two periods [13,14,32]. Our current study has shown that low GCS, higher ISS, and admission to ICU are the most signi cant clinical predictors of mortality among patients who died, similar to our reported previous studies before the pandemics [33][34][35].…”

“…periods [13,14,32]. Our current study has shown that low GCS, higher ISS, and admission to ICU are the most signi cant clinical predictors of mortality among patients who died, similar to our reported previous studies before the pandemics [33][34][35].…”

“…The reported reduction of the incidence of RTCs varied in different studies. Although some studies reported a reduction in the incidence [12][13][14], others found that it did not change [15][16]. Similarly, the incidence of bicycle injuries in other studies varied depending on whether the use of bicycles was encouraged as the preferred mode of exercise/transport during the Pandemic [14,[17][18][19][20].…”

Incidence of pediatric injury visits decreased while trauma surgeries remained stable during the first and second waves of the COVID-19 pandemic in Finland: a register-based study

“…[8][9][10][11][12][13] A previous Finnish study showed that the rate of severely injured patients remained stable during the pandemic. 14 Parallel results were reported when the pandemic also increased referrals to major trauma centers in the pediatric population. 9 A previous study from Finland reported a decrease in incidence of pediatric trauma operations during the lockdown, mostly due to a decreased rate of lower limb trauma operations.…”

Association of the COVID-19 pandemic and dying at home due to ischemic heart disease

“…Non-natural deaths were selected as a comparison group for two reasons. First, while it has been documented that overall emergency department visits have decreased, trauma-related visits for severe injury were less impacted ( Riuttanen et al, 2021 ). Additionally, a study examining the trend of trauma emergency department visits before and during the pandemic found that patients who were treated during the pandemic had higher injury severity scores when compared to patients treated prior to the pandemic ( Ghafil et al, 2021 ).…”