학술논문
Changes in Traumatic Mechanisms of Injury in Southern California Related to COVID-19: Penetrating Trauma as a Second Pandemic
Document Type
Academic Journal
Author
Yeates, Eric O.; Grigorian, Areg; Barrios, Cristobal; Schellenberg, Morgan; Owattanapanich, Natthida; Barmparas, Galinos; Margulies, Daniel; Juillard, Catherine; Garber, Kent; Cryer, Henry; Tilou, Areti; Burruss, Sigrid; Penaloza-Villalobos, Liz; Lin, Ann; Figueras, Ryan; Brenner, Megan; Firek, Christopher; Costantini, Todd; Santorelli, Jarrett; Curry, Terry; Wintz, Diane; Biffl, Walter L.; Schaffer, Kathryn B.; Duncan, Thomas K.; Barbaro, Casey; Diaz, Graal; Johnson, Arianne; Chinn, Justine; Naaseh, Ariana; Leung, Amanda; Grabar, Christina; Nahmias, Jeffry
Source
Journal of Trauma and Acute Care Surgery. Dec 29, 2020
Subject
Language
English
ISSN
2163-0755
Abstract
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 remains 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 (ACS) Level 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 1/1/2020-3/18/2020 (PRE), after SAH from 3/19/2020-6/30/2020 (POST), and a historical control from 3/19/2019-6/30/2019 (CONTROL). POST was compared to both PRE and CONTROL in two separate analyses. RESULTS: Across all time 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 to 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). CONCLUSIONS: 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). LEVEL OF EVIDENCE: IV