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Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge

STUDY OBJECTIVE: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening e...

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Autores principales: Prokopakis, Kayla E, Bolotin, Todd, Donley, Chad, Lomasney, Mark, Harter, Jason, Graham, Jack, Chopra, Quincy, Olsen, Steven, Noga, Joseph, Gatchel, Matthew, Paull, Brendan, Greyslak, Victoria, Bradford, Bret, Plummer, Anna, Powell, Carrie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008031/
https://www.ncbi.nlm.nih.gov/pubmed/36915617
http://dx.doi.org/10.2147/OAEM.S379059
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author Prokopakis, Kayla E
Bolotin, Todd
Donley, Chad
Lomasney, Mark
Harter, Jason
Graham, Jack
Chopra, Quincy
Olsen, Steven
Noga, Joseph
Gatchel, Matthew
Paull, Brendan
Greyslak, Victoria
Bradford, Bret
Plummer, Anna
Powell, Carrie
author_facet Prokopakis, Kayla E
Bolotin, Todd
Donley, Chad
Lomasney, Mark
Harter, Jason
Graham, Jack
Chopra, Quincy
Olsen, Steven
Noga, Joseph
Gatchel, Matthew
Paull, Brendan
Greyslak, Victoria
Bradford, Bret
Plummer, Anna
Powell, Carrie
author_sort Prokopakis, Kayla E
collection PubMed
description STUDY OBJECTIVE: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening emergencies using upper extremity injuries as a model for other potentially emergent presentation as compared to pre-pandemic times. We do this using the epidemiology of pre-defined significant upper extremity injuries at our facility as a specific example of what occurred at an urban trauma center. METHODS: We conducted a comparison of two 6-month periods: between March 2019 and August 2019 (prior to COVID-19) and between March 2020 and August 2020 after the onset of the initial COVID-19 wave. We performed a retrospective chart review of patients who presented with upper extremity injury chief complaints using analysis of the electronic medical record at a single urban tertiary care trauma center in the Midwestern United States. We investigated examination findings, imaging, frequency of surgical procedures and final diagnosis. RESULTS: In the 2019 study period, there were 31,157 ED patients, including 429 with upper extremity injuries, of which 108 patients had significant injuries. In the 2020 study period, there were 24,295 patient presentations, of which 118 of 296 upper extremity presentations were significant. We a priori defined significant injury as follows: fractures, dislocations, neurovascular injuries, or need for operative intervention within 24 hours of ED presentation. Specifically, 25.2% of injuries were significant pre-COVID-19 and 39.9% (p < 0.001) during the initial COVID-19 surge. The absolute number and percentage of significant injuries increased from pre-COVID-19 compared to the initial COVID-19 surge despite an overall 22% decrease in total patient volume. CONCLUSION: The incidence of significant upper extremity musculoskeletal injuries increased during the pandemic even though the overall number of ED presentations for upper extremity musculoskeletal injuries decreased.
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spelling pubmed-100080312023-03-12 Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge Prokopakis, Kayla E Bolotin, Todd Donley, Chad Lomasney, Mark Harter, Jason Graham, Jack Chopra, Quincy Olsen, Steven Noga, Joseph Gatchel, Matthew Paull, Brendan Greyslak, Victoria Bradford, Bret Plummer, Anna Powell, Carrie Open Access Emerg Med Original Research STUDY OBJECTIVE: The SARS-CoV-2 (COVID-19) pandemic significantly impacted emergency department volume and acuity. The Delta and Omicron variants contributed to additional surges. We describe the impact that the initial pandemic phase had on frequency and severity of typically non-life-threatening emergencies using upper extremity injuries as a model for other potentially emergent presentation as compared to pre-pandemic times. We do this using the epidemiology of pre-defined significant upper extremity injuries at our facility as a specific example of what occurred at an urban trauma center. METHODS: We conducted a comparison of two 6-month periods: between March 2019 and August 2019 (prior to COVID-19) and between March 2020 and August 2020 after the onset of the initial COVID-19 wave. We performed a retrospective chart review of patients who presented with upper extremity injury chief complaints using analysis of the electronic medical record at a single urban tertiary care trauma center in the Midwestern United States. We investigated examination findings, imaging, frequency of surgical procedures and final diagnosis. RESULTS: In the 2019 study period, there were 31,157 ED patients, including 429 with upper extremity injuries, of which 108 patients had significant injuries. In the 2020 study period, there were 24,295 patient presentations, of which 118 of 296 upper extremity presentations were significant. We a priori defined significant injury as follows: fractures, dislocations, neurovascular injuries, or need for operative intervention within 24 hours of ED presentation. Specifically, 25.2% of injuries were significant pre-COVID-19 and 39.9% (p < 0.001) during the initial COVID-19 surge. The absolute number and percentage of significant injuries increased from pre-COVID-19 compared to the initial COVID-19 surge despite an overall 22% decrease in total patient volume. CONCLUSION: The incidence of significant upper extremity musculoskeletal injuries increased during the pandemic even though the overall number of ED presentations for upper extremity musculoskeletal injuries decreased. Dove 2023-03-07 /pmc/articles/PMC10008031/ /pubmed/36915617 http://dx.doi.org/10.2147/OAEM.S379059 Text en © 2023 Prokopakis et al. https://creativecommons.org/licenses/by-nc/3.0/This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/ (https://creativecommons.org/licenses/by-nc/3.0/) ). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Original Research
Prokopakis, Kayla E
Bolotin, Todd
Donley, Chad
Lomasney, Mark
Harter, Jason
Graham, Jack
Chopra, Quincy
Olsen, Steven
Noga, Joseph
Gatchel, Matthew
Paull, Brendan
Greyslak, Victoria
Bradford, Bret
Plummer, Anna
Powell, Carrie
Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title_full Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title_fullStr Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title_full_unstemmed Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title_short Upper Extremity Musculoskeletal Injuries Presenting to an Emergency Department Before and During the Initial COVID-19 Pandemic Surge
title_sort upper extremity musculoskeletal injuries presenting to an emergency department before and during the initial covid-19 pandemic surge
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10008031/
https://www.ncbi.nlm.nih.gov/pubmed/36915617
http://dx.doi.org/10.2147/OAEM.S379059
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