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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: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.

Project description:BACKGROUND:Perioperative fluid therapy management is changing due to the incorporation of different fluids, surgical techniques, and minimally invasive monitoring systems. The objective of this study was to explore fluid therapy management during the perioperative period in our country. METHODS:We designed the Fluid Day study as a cross-sectional, multicentre, observational study. The study was performed in 131 Spanish hospitals in February 2019. We included adult patients undergoing general anaesthesia for either elective or non-elective surgery. Demographic variables were recorded, as well as the type and total volume of fluid administered during the perioperative period and the monitorization used. To perform the analysis, patients were categorized by risk group. RESULTS:We recruited 7291 patients, 6314 of which were included in the analysis; 1541 (24.4%) patients underwent high-risk surgery, 1497 (23. 7%) were high risk patients, and 554 (8.7%) were high-risk patients and underwent high-risk surgery; 98% patients received crystalloids (80% balanced solutions); intraoperative colloids were used in 466 patients (7.51%). The hourly intraoperative volume in mL/kg/h and the median [Q1; Q3] administered volume (mL/kg) were, respectively, 6.67 [3.83; 8.17] ml/Kg/h and 13.9 [9.52;5.20] ml/Kg in low-risk patients undergoing low- or intermediate-risk surgery, 6 [4.04; 9.08] ml/Kg/h and 15.7 [10.4;24.5] ml/Kg in high- risk patients undergoing low or intermediate-risk surgery, 6.41 [4.36; 9.33] ml/Kg/h and 20.2 [13.3;32.4] ml/Kg in low-risk patients undergoing high-risk surgery, and 5.46 [3.83; 8.17] ml/Kg/h and 22.7[14.1;40.9] ml/Kg in high-risk patients undergoing high- risk surgery . We used advanced fluid monitoring strategies in 5% of patients in the intraoperative period and in 10% in the postoperative period. CONCLUSIONS:The most widely used fluid was balanced crystalloids. Colloids were used in a small number of patients. Hourly surgery volume tended to be more restrictive in high-risk patients but confirms a high degree of variation in the perioperatively administered volume. Scarce monitorization was observed in fluid therapy management. TRIAL REGISTRATION:Clinical Trials: NCT03630744.

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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