Effects of the COVID-19 lockdown on orthopaedic trauma: a multicentre study across Scotland.

Autor:	MacDonald DRW; Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK., Neilly DW; Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK., Davies PSE; Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, UK., Crome CR; Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, UK., Jamal B; Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, UK., Gill SL; Department of Trauma and Orthopaedics, Queen Elizabeth University Hospital, Glasgow, UK., Jariwala AC; Department of Trauma and Orthopaedics, Ninewells Hospital, Dundee, UK., Stevenson IM; Department of Trauma and Orthopaedics, Aberdeen Royal Infirmary, Aberdeen, UK., Ashcroft GP; Division of Applied Medicine, University of Aberdeen, Aberdeen, UK.
Jazyk:	angličtina
Zdroj:	Bone & joint open [Bone Jt Open] 2020 Sep 08; Vol. 1 (9), pp. 541-548. Date of Electronic Publication: 2020 Sep 08 (Print Publication: 2020).
DOI:	10.1302/2633-1462.19.BJO-2020-0114.R1
Abstrakt:	Aims: The UK government declared a national lockdown on 23 March 2020 to reduce transmission of COVID-19. This study aims to identify the effect of lockdown on the rates, types, mechanisms, and mortality of musculoskeletal trauma across Scotland. Methods: Data for all musculoskeletal trauma requiring operative treatment were collected prospectively from five key orthopaedic units across Scotland during lockdown (23 March 2020 to 28 May 2020). This was compared with data for the same timeframe in 2019 and 2018. Data collected included all cases requiring surgery, injury type, mechanism of injury, and inpatient mortality. Results: A total of 1,315 patients received operative treatment from 23 March 2020 to 28 May 2020 compared with 1,791 in 2019 and 1,719 in 2018. The numbers of all injury types decreased, but the relative frequency of hip fractures increased (36.3% in 2020 vs 30.2% in 2019, p < 0.0001 and 30.7% in 2018, p < 0.0001). Significant increases were seen in the proportion of DIY-related injuries (3.1% in 2020 vs 1.7% in 2019, p = 0.012 and 1.6% in 2018, p < 0.005) and injuries caused by falls (65.6% in 2020 vs 62.6% in 2019, p = 0.082 and 61.9% in 2018, p = 0.047). Significant decreases were seen in the proportion of road traffic collisions (2.6% in 2020 vs 5.4% in 2019, p < 0.0001 and 4.2% in 2018, p = 0.016), occupational injuries (1.8% in 2020 vs 3.0% in 2019, p = 0.025 and 2.3% in 2018, p = 0.012) and infections (6.8% in 2020 vs 7.8% in 2019, p = 0.268 and 10.3% in 2018, p < 0.012). Cycling injuries increased (78 in 2020 vs 64 in 2019 vs 42 in 2018). A significant increase in the proportion of self-harm injuries was seen (1.7% in 2020 vs 1.1% in 2019, p = 0.185 and 0.5% in 2018, p < 0.0001). Mortality of trauma patients was significantly higher in 2020 (5.0%) than in 2019 (2.8%, p = 0.002) and 2018 (1.8%, p < 0.0001). Conclusion: The UK COVID-19 lockdown has resulted in a marked reduction in musculoskeletal trauma patients undergoing surgery in Scotland. There have been significant changes in types and mechanisms of injury and, concerningly, mortality of trauma patients has risen significantly.Cite this article: Bone Joint Open 2020;1-9:541-548. Competing Interests: ICMJE COI statement: B. Jamal reports payment received from Biocomposites for a lecture given in May 2019 on bone infection, which is not related to this article. *SCORE authors Authors as part of the SCottish Orthopaedic Research collaborativE (SCORE), who contributed to data collection, analysis, and production of the manuscript: Amanda Lee, PhD, University of Aberdeen. Gabrielle Scicluna, MRCS(Edin), Queen Elizabeth University Hospital. Taegyeong T. Ha, MBChB, Glasgow Royal Infirmary. Christopher J. Donoghue, MRCS(Ed), Raigmore Hospital. Jeswant Bashyam, MBBS, Aberdeen Royal Infirmary. Thomas S Greensmith, MRCS(Ed), Ninewells Hospital. Alastair Faulkner, MRCS(Ed), Ninewells Hospital. Alasdair Macinnes, MRCS(Ed), Ninewells Hospital. Rachel Pennington, MBChB, Ninewells Hospital. Matthew J Kennedy, MRCS, Queen Elizabeth University Hospital. Luke Guiot, MBChB, Queen Elizabeth University Hospital. Benjamin R.F. Wheelwright, Queen Elizabeth University Hospital. Thomas W. Noteman, MBBCh, Glasgow Royal Infirmary. Collette Harte, MBChB, Glasgow Royal Infirmary. Matthew S. Torkington, FRCS (Orth), Glasgow Royal Infirmary. David E. Boddie, FRCS (Orth), Aberdeen Royal Infirmary. (© 2020 Author(s) et al.)
Databáze:	MEDLINE
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