The Impact of the COVID-19 Shelter-in-Place Order on Traumatic Brain Injuries in San Francisco, California

被引:0
|
作者
Madhok, Debbie Y. [1 ,2 ]
Nardone, Anthony [1 ,3 ]
Caceres, Elizabeth Urrutia [4 ]
Wong, Angela H. K. [1 ]
Zhang, Li [5 ]
Rodriguez, Robert M. [1 ]
机构
[1] Univ Calif San Francisco, Dept Emergency Med, 1001 Potrero Ave,Bldg 5,Suite 6A, San Francisco, CA 94110 USA
[2] Univ Calif San Francisco, Dept Neurol, San Francisco, CA 94110 USA
[3] Univ Calif San Francisco, Sch Med, San Francisco, CA 94110 USA
[4] San Francisco State Univ, San Francisco, CA USA
[5] Univ Calif San Francisco, Dept Med & Epidemiol & Biostat, San Francisco, CA 94110 USA
来源
JOURNAL OF EMERGENCY MEDICINE | 2023年 / 65卷 / 06期
关键词
traumatic brain injury; cycling injuries; trauma; concussion; COVID-19; ADMISSIONS; DECREASE;
D O I
10.1016/j.jemermed.2023.07.002
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: In response to the COVID-19 pandemic, San Francisco, California issued a shelter-in-place (SIP) order in March 2020, during which emergency physicians noted a drop in trauma cases, as well as a change in traditional mechanisms of trauma. Objectives: Our objective was to determine the epidemiology of traumatic brain injury (TBI) pre- and post-COVID-19 SIP. Methods: We reviewed the electronic medical record of the only trauma center in the city of San Francisco, to determine the number of and characteristics of patients with a diagnosis of head injury presenting to the emergency department between December 16, 2019 and June 16, 2020. Using chi-squared and Fisher's exact tests when appropriate, we compared pre- and post- COVID-19 lockdown epidemiology. Results: There were 1246 TBI-related visits during the 6-month study period. Bi-weekly TBI cases decreased by 36.64% 2 weeks after the COVID-19 SIP and then increased to near baseline levels by June 2020. TBI patients during SIP were older (mean age: 53.3 years pre-SIP vs. 58.2 post-SIP; p < 0.001), more likely to be male (odds ratio 1.43, 95% confidence interval 1.14-1.81), and less likely to be 17 or younger (8.9% vs. 0.5%, pre- to post-SIP respectively, p = 0.003). Patients were less likely to be Hispanic (27.2% vs. 21.7% pre- to post-SIP, respectively, p = 0.029). The proportion of TBI visits attributable to cycling accidents increased (14.1% to 52.7%, p < 0.001), whereas those attributable to pedestrians involved in road traffic accidents decreased (37.2% to 12.7%, p = 0.003). Conclusions: Understanding the changing epidemiology of TBI during the COVID-19 pandemic can aid in immediate and future disaster resource planning.(c) 2023 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND li-cense ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
引用
收藏
页码:E479 / E486
页数:8
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