TY - JOUR
T1 - Changes in traumatic mechanisms of injury in Southern California related to COVID-19
T2 - Penetrating trauma as a second pandemic
AU - Yeates, Eric O.
AU - Grigorian, Areg
AU - Barrios, Cristobal
AU - Schellenberg, Morgan
AU - Owattanapanich, Natthida
AU - Barmparas, Galinos
AU - Margulies, Daniel
AU - Juillard, Catherine
AU - Garber, Kent
AU - Cryer, Henry
AU - Tillou, Areti
AU - Burruss, Sigrid
AU - Penaloza-Villalobos, Liz
AU - Lin, Ann
AU - Figueras, Ryan Arthur
AU - Brenner, Megan
AU - Firek, Christopher
AU - Costantini, Todd
AU - Santorelli, Jarrett
AU - Curry, Terry
AU - Wintz, Diane
AU - Biffl, Walter L.
AU - Schaffer, Kathryn B.
AU - Duncan, Thomas K.
AU - Barbaro, Casey
AU - Diaz, Graal
AU - Johnson, Arianne
AU - Chinn, Justine
AU - Naaseh, Ariana
AU - Leung, Amanda
AU - Grabar, Christina
AU - Nahmias, Jeffry
N1 - Publisher Copyright:
Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2021/4
Y1 - 2021/4
N2 - BACKGROUND: The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19, 2020, forcing large-scale behavioral changes and taking an emotional and economic toll. The effects of SAH orders on the trauma population remain unknown. We hypothesized an increase in rates of penetrating trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern California trauma population after the SAH order. METHODS: A multicenter retrospective analysis of all trauma patients presenting to 11 American College of Surgeons levels I and II trauma centers spanning seven counties in California was performed. Demographic data, injury characteristics, clinical data, and outcomes were collected. Patients were divided into three groups based on injury date: before SAH from January 1, 2020, to March 18, 2020 (PRE), after SAH from March 19, 2020, to June 30, 2020 (POST), and a historical control from March 19, 2019, to June 30, 2019 (CONTROL). POST was compared with both PRE and CONTROL in two separate analyses. RESULTS: Across all periods, 20,448 trauma patients were identified (CONTROL, 7,707; PRE, 6,022; POST, 6,719). POST had a significantly increased rate of penetrating trauma (13.0% vs. 10.3%, p < 0.001 and 13.0% vs. 9.9%, p < 0.001) and gunshot wounds (4.5% vs. 2.4%, p = 0.002 and 4.5% vs. 3.7%, p = 0.025) compared with PRE and CONTROL, respectively. POST had a suicide attempt rate of 1.9% and a domestic violence rate of 0.7%, which were similar to PRE (p = 0.478, p = 0.514) and CONTROL (p = 0.160, p = 0.618). CONCLUSION: This multicenter Southern California study demonstrated an increased rate of penetrating trauma and gunshot wounds after the COVID-19 SAH orders but no difference in attempted suicide or domestic violence rates. These findings may provide useful information regarding resource utilization and a target for societal intervention during the current or future pandemic(s).
AB - BACKGROUND: The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19, 2020, forcing large-scale behavioral changes and taking an emotional and economic toll. The effects of SAH orders on the trauma population remain unknown. We hypothesized an increase in rates of penetrating trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern California trauma population after the SAH order. METHODS: A multicenter retrospective analysis of all trauma patients presenting to 11 American College of Surgeons levels I and II trauma centers spanning seven counties in California was performed. Demographic data, injury characteristics, clinical data, and outcomes were collected. Patients were divided into three groups based on injury date: before SAH from January 1, 2020, to March 18, 2020 (PRE), after SAH from March 19, 2020, to June 30, 2020 (POST), and a historical control from March 19, 2019, to June 30, 2019 (CONTROL). POST was compared with both PRE and CONTROL in two separate analyses. RESULTS: Across all periods, 20,448 trauma patients were identified (CONTROL, 7,707; PRE, 6,022; POST, 6,719). POST had a significantly increased rate of penetrating trauma (13.0% vs. 10.3%, p < 0.001 and 13.0% vs. 9.9%, p < 0.001) and gunshot wounds (4.5% vs. 2.4%, p = 0.002 and 4.5% vs. 3.7%, p = 0.025) compared with PRE and CONTROL, respectively. POST had a suicide attempt rate of 1.9% and a domestic violence rate of 0.7%, which were similar to PRE (p = 0.478, p = 0.514) and CONTROL (p = 0.160, p = 0.618). CONCLUSION: This multicenter Southern California study demonstrated an increased rate of penetrating trauma and gunshot wounds after the COVID-19 SAH orders but no difference in attempted suicide or domestic violence rates. These findings may provide useful information regarding resource utilization and a target for societal intervention during the current or future pandemic(s).
KW - COVID-19
KW - firearm violence
KW - penetrating trauma
KW - stay at home
KW - trauma
UR - http://www.scopus.com/inward/record.url?scp=85103306702&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85103306702&partnerID=8YFLogxK
U2 - 10.1097/TA.0000000000003068
DO - 10.1097/TA.0000000000003068
M3 - Article
C2 - 33395031
AN - SCOPUS:85103306702
SN - 2163-0755
VL - 90
SP - 714
EP - 721
JO - Journal of Trauma and Acute Care Surgery
JF - Journal of Trauma and Acute Care Surgery
IS - 4
ER -
