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Impact of the COVID-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study.

ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic has led to the worldwide implementation of unprecedented public protection measures. On the 17th of March, the French government announced a lockdown of the population for 8 weeks. This monocentric study assessed the impact of this lockdown on the musculoskeletal injuries treated at the emergency department as well as the surgical indications. We carried out a retrospective study in the Emergency Department and the Surgery Department of Nantes University Hospital from 18 February to 11 May 2020. We collected data pertaining to the demographics, the mechanism, the type, the severity, and inter-hospital transfer for musculoskeletal injuries from our institution. We compared the 4-week pre-lockdown period and the 8-week lockdown period divided into two 4-week periods: early lockdown and late lockdown. There was a 52.1% decrease in musculoskeletal injuries among patients presenting to the Emergency Department between the pre-lockdown and the lockdown period (weekly incidence: 415.3?±?44.2 vs. 198.5?±?46.0, respectively, p??16) between the pre-lockdown and the early lockdown period (2 (1.1%) vs. 7 (7.2%), respectively, p?=?.010) as well as between the pre-lockdown and the late lockdown period (2 (1.1%) vs. 10 (8.3%), respectively, p?=?.004). We observed a significant increase in the weekly emergency department patient admissions between the early and the late lockdown period (161.5?±?22.9, 235.5?±?27.7, respectively, p?=?.028). A pronounced decrease in the incidence of musculoskeletal injuries was observed secondary to the lockdown measures, with emergency department patient admissions being halved and surgical indications being reduced by a third. The increase in musculoskeletal injuries during the late confinement period and the higher incidence of severe trauma highlights the importance of maintaining a functional trauma center organization with an inter-hospital transfer policy in case of a COVID-19s wave lockdown.

SUBMITTER: Crenn V

PROVIDER: S-EPMC7775434 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Impact of the COVID-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study.

Crenn V V El Kinani M M Pietu G G Leteve M M Persigant M M Toanen C C Varenne Y Y Goffinet N N Buffenoir K K Javaudin F F Montassier E E

Scientific reports 20201231 1

The coronavirus disease 2019 (COVID-19) pandemic has led to the worldwide implementation of unprecedented public protection measures. On the 17th of March, the French government announced a lockdown of the population for 8 weeks. This monocentric study assessed the impact of this lockdown on the musculoskeletal injuries treated at the emergency department as well as the surgical indications. We carried out a retrospective study in the Emergency Department and the Surgery Department of Nantes Uni ...[more]

PMID: 33384443

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Project description:BackgroundsSplenic injury accounts for 40% of all injuries after blunt abdominal trauma. Blunt splenic injury in hemodynamically unstable patients is preferably treated by splenectomy. Nowadays hemodynamically stable patients with low grade splenic injuries are mostly treated by non-operative management (NOM). However no consensus exists about the management of high grade splenic injuries in hemodynamically stable patients. Therefore the aim of this study was to analyze patients with high grade splenic injuries in our institution.MethodsWe retrospectively included all patients with a splenic injury presented to our level I trauma center during the 5-year period from January 1, 2012, until December 31, 2017. Baseline characteristics, data regarding complications and mortality were collected from the electronic patient registry. Patients were grouped based on splenic injury and the treatment they received.ResultsA total of 123 patients were included, of which 93 (75.6%) were male with a median age of 31 (24-52) and a median injury severity score of 27 (17-34). High grade injuries (n = 28) consisted of 20 Grade IV injuries and 8 grade V injuries. Splenectomy was required in 15/28 (53.6%) patients, of whom all remained hemodynamically unstable after resuscitation, including all grade V injuries. A total of 13 patients with high grade injuries were treated with spleen preserving therapy. Seven of these patients received angio-embolization. One patient went for laparotomy and the spleen was treated with a hemostatic agent. Secondary hemorrhage was present in 3 of these patients (initial treatment: 1 embolization/ 2 observational), resulting in a success rate of 76.9%. There is no mortality seen in patient with high grade splenic injuries.ConclusionNon-operative treatment in high grade splenic injuries is a safe treatment modality in hemodynamically stable patients. Hemodynamic status and peroperative bleeding, not injury severity or splenic injury grade were the drivers for surgical management by splenectomy. This selected cohort of patients must be closely monitored to prevent adverse outcomes from secondary delayed bleeding in case of non-operative management.

Project description:BackgroundPrevious literature suggests the use of smartphones and tablet devices may result in various postural and musculoskeletal disorders, predominantly of the neck and upper extremities. However, factors that contribute to the symptoms have not been adequately explored.MethodsThis study aimed to investigate the prevalence and patterns (e.g. types, sites and temporal distributions) of musculoskeletal symptoms among adult smartphone and tablet device users. It also investigated device usage in terms of usage time, postures adopted during use, operational methods and purposes of device use in order to explain the symptom occurrences. Participants from eastern states of Australia retrospectively reported device usage and symptoms in the preceding two-week period, via an online survey. Data was analysed using Chi-square [χ2] analysis to determine the relationships between categorical variables; Mann-Whitney U tests to compare two groups (e.g. smartphone-only users versus tablet users) where dependant variables were ordinal; independent samples t-tests if dependent variables were continuous and approximated a normal distribution; and Spearman's correlation analysis to assess the relationships between pairs of continuous or ordinal variables.ResultsOf the 207 participants, 59.9% reported musculoskeletal symptoms during or after device use; for 64.5% of these, symptoms began within the first 30 min (mostly between 15 and 30 min) of commencing usage. No statistically significant differences were observed between smartphone-only users and tablet device users in proportions reporting symptoms during device use (χ2 = .350, N = 207, p = .554). The most prevalent symptom was stiffness. The most prevalent symptom occurred in the neck (18.1% in smartphone-only users and 19.3% in tablet device users). Tablet users who were 18-24 year-old and used their device for more than 30 min in each usage session more often experienced symptoms (82.4% prevalence) than those who used a device for 30 min or less (52.2%) (χ2 = 4.723, N = 63, p = .030).ConclusionThese findings suggest that user age, duration and frequency of usage, and type of device are important factors to consider in the formation of evidence-based guidelines to reduce experiences of musculoskeletal symptoms among smartphone and tablet device users. If usage was capped at < 15 min, the majority of smartphone and tablet device users would avoid symptoms.

Dataset Information

Impact of the COVID-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study.

Publications

Impact of the COVID-19 lockdown period on adult musculoskeletal injuries and surgical management: a retrospective monocentric study.

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