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Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden

BACKGROUND: Public health measures were instituted to reduce COVID-19 spread. A decrease in total emergency department volume followed, but the impact on injury is unknown. With lockdown and social distancing potentially increasing domicile discord, we hypothesized that intentional injury increased...

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Autores principales: Abdallah, Hatem O., Zhao, Cindy, Kaufman, Elinore, Hatchimonji, Justin, Swendiman, Robert A., Kaplan, Lewis J., Seamon, Mark, Schwab, C. William, Pascual, Jose L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: by the American College of Surgeons. Published by Elsevier Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645281/
https://www.ncbi.nlm.nih.gov/pubmed/33166665
http://dx.doi.org/10.1016/j.jamcollsurg.2020.09.028
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author Abdallah, Hatem O.
Zhao, Cindy
Kaufman, Elinore
Hatchimonji, Justin
Swendiman, Robert A.
Kaplan, Lewis J.
Seamon, Mark
Schwab, C. William
Pascual, Jose L.
author_facet Abdallah, Hatem O.
Zhao, Cindy
Kaufman, Elinore
Hatchimonji, Justin
Swendiman, Robert A.
Kaplan, Lewis J.
Seamon, Mark
Schwab, C. William
Pascual, Jose L.
author_sort Abdallah, Hatem O.
collection PubMed
description BACKGROUND: Public health measures were instituted to reduce COVID-19 spread. A decrease in total emergency department volume followed, but the impact on injury is unknown. With lockdown and social distancing potentially increasing domicile discord, we hypothesized that intentional injury increased during COVID-19, driven primarily by an increase in penetrating trauma. STUDY DESIGN: A retrospective review of acute adult patient care in an urban Level I trauma center assessed injury patterns. Presenting patient characteristics and diagnoses from 6 weeks pre to 10 weeks post statewide stay-at-home orders (March 16, 2020) were compared, as well as with 2015-2019. Subsets were defined by intentionality (intentional vs nonintentional) and mechanism of injury (blunt vs penetrating). Fisher exact and Wilcoxon tests were used to compare proportions and means. RESULTS: There were 357 trauma patients that presented pre stay-at-home order and 480 that presented post stay-at-home order. Pre and post groups demonstrated differences in sex (35.6% vs 27.9% female; p = 0.02), age (47.4 ± 22.1 years vs 42 ± 20.3 years; p = 0.009), and race (1.4% vs 2.3% Asian; 63.3% vs 68.3% Black; 30.5% vs 22.3% White; and 4.8% vs 7.1% other; p = 0.03). Post stay-at-home order mechanism of injury revealed more intentional injury (p = 0.0008). Decreases in nonintentional trauma after adoption of social isolation paralleled declines in daily emergency department visits. Compared with earlier years, 2020 demonstrated a significantly greater proportion of intentional violent injury during the peripandemic months, especially from firearms. CONCLUSIONS: Unprecedented social isolation policies to address COVID-19 were associated with increased intentional injury, especially gun violence. Meanwhile, emergency department and nonintentional trauma visits decreased. Pandemic-related public health measures should embrace intentional injury prevention and management strategies.
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spelling pubmed-76452812020-11-06 Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden Abdallah, Hatem O. Zhao, Cindy Kaufman, Elinore Hatchimonji, Justin Swendiman, Robert A. Kaplan, Lewis J. Seamon, Mark Schwab, C. William Pascual, Jose L. J Am Coll Surg Original Scientific Article BACKGROUND: Public health measures were instituted to reduce COVID-19 spread. A decrease in total emergency department volume followed, but the impact on injury is unknown. With lockdown and social distancing potentially increasing domicile discord, we hypothesized that intentional injury increased during COVID-19, driven primarily by an increase in penetrating trauma. STUDY DESIGN: A retrospective review of acute adult patient care in an urban Level I trauma center assessed injury patterns. Presenting patient characteristics and diagnoses from 6 weeks pre to 10 weeks post statewide stay-at-home orders (March 16, 2020) were compared, as well as with 2015-2019. Subsets were defined by intentionality (intentional vs nonintentional) and mechanism of injury (blunt vs penetrating). Fisher exact and Wilcoxon tests were used to compare proportions and means. RESULTS: There were 357 trauma patients that presented pre stay-at-home order and 480 that presented post stay-at-home order. Pre and post groups demonstrated differences in sex (35.6% vs 27.9% female; p = 0.02), age (47.4 ± 22.1 years vs 42 ± 20.3 years; p = 0.009), and race (1.4% vs 2.3% Asian; 63.3% vs 68.3% Black; 30.5% vs 22.3% White; and 4.8% vs 7.1% other; p = 0.03). Post stay-at-home order mechanism of injury revealed more intentional injury (p = 0.0008). Decreases in nonintentional trauma after adoption of social isolation paralleled declines in daily emergency department visits. Compared with earlier years, 2020 demonstrated a significantly greater proportion of intentional violent injury during the peripandemic months, especially from firearms. CONCLUSIONS: Unprecedented social isolation policies to address COVID-19 were associated with increased intentional injury, especially gun violence. Meanwhile, emergency department and nonintentional trauma visits decreased. Pandemic-related public health measures should embrace intentional injury prevention and management strategies. by the American College of Surgeons. Published by Elsevier Inc. 2021-02 2020-11-06 /pmc/articles/PMC7645281/ /pubmed/33166665 http://dx.doi.org/10.1016/j.jamcollsurg.2020.09.028 Text en © 2020 by the American College of Surgeons. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Original Scientific Article
Abdallah, Hatem O.
Zhao, Cindy
Kaufman, Elinore
Hatchimonji, Justin
Swendiman, Robert A.
Kaplan, Lewis J.
Seamon, Mark
Schwab, C. William
Pascual, Jose L.
Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title_full Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title_fullStr Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title_full_unstemmed Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title_short Increased Firearm Injury During the COVID-19 Pandemic: A Hidden Urban Burden
title_sort increased firearm injury during the covid-19 pandemic: a hidden urban burden
topic Original Scientific Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7645281/
https://www.ncbi.nlm.nih.gov/pubmed/33166665
http://dx.doi.org/10.1016/j.jamcollsurg.2020.09.028
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