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The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis

The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidem...

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Autores principales: Matthay, Zachary A., Kornblith, Aaron E., Matthay, Ellicott C., Sedaghati, Mahsa, Peterson, Sue, Boeck, Marissa, Bongiovanni, Tasce, Campbell, Andre, Chalwell, Lauren, Colwell, Christopher, Farrell, Michael S., Kim, Woon Cho, Knudson, M. Margaret, Mackersie, Robert, Li, Lilian, Nunez-Garcia, Brenda, Langness, Simone, Plevin, Rebecca E., Sammann, Amanda, Tesoriero, Ronald, Stein, Deborah M., Kornblith, Lucy Z.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979514/
https://www.ncbi.nlm.nih.gov/pubmed/33252457
http://dx.doi.org/10.1097/TA.0000000000003044
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author Matthay, Zachary A.
Kornblith, Aaron E.
Matthay, Ellicott C.
Sedaghati, Mahsa
Peterson, Sue
Boeck, Marissa
Bongiovanni, Tasce
Campbell, Andre
Chalwell, Lauren
Colwell, Christopher
Farrell, Michael S.
Kim, Woon Cho
Knudson, M. Margaret
Mackersie, Robert
Li, Lilian
Nunez-Garcia, Brenda
Langness, Simone
Plevin, Rebecca E.
Sammann, Amanda
Tesoriero, Ronald
Stein, Deborah M.
Kornblith, Lucy Z.
author_facet Matthay, Zachary A.
Kornblith, Aaron E.
Matthay, Ellicott C.
Sedaghati, Mahsa
Peterson, Sue
Boeck, Marissa
Bongiovanni, Tasce
Campbell, Andre
Chalwell, Lauren
Colwell, Christopher
Farrell, Michael S.
Kim, Woon Cho
Knudson, M. Margaret
Mackersie, Robert
Li, Lilian
Nunez-Garcia, Brenda
Langness, Simone
Plevin, Rebecca E.
Sammann, Amanda
Tesoriero, Ronald
Stein, Deborah M.
Kornblith, Lucy Z.
author_sort Matthay, Zachary A.
collection PubMed
description The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses. METHODS: A single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place. RESULTS: Trauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March–June 2020) remained lower compared with corresponding months for all previous 5 years (2015–2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01). CONCLUSION: Although the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses. LEVEL OF EVIDENCE: Epidemiological study, level III.
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spelling pubmed-79795142021-03-26 The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis Matthay, Zachary A. Kornblith, Aaron E. Matthay, Ellicott C. Sedaghati, Mahsa Peterson, Sue Boeck, Marissa Bongiovanni, Tasce Campbell, Andre Chalwell, Lauren Colwell, Christopher Farrell, Michael S. Kim, Woon Cho Knudson, M. Margaret Mackersie, Robert Li, Lilian Nunez-Garcia, Brenda Langness, Simone Plevin, Rebecca E. Sammann, Amanda Tesoriero, Ronald Stein, Deborah M. Kornblith, Lucy Z. J Trauma Acute Care Surg Original Articles The large-scale social distancing efforts to reduce SARS-CoV-2 transmission have dramatically changed human behaviors associated with traumatic injuries. Trauma centers have reported decreases in trauma volume, paralleled by changes in injury mechanisms. We aimed to quantify changes in trauma epidemiology at an urban Level I trauma center in a county that instituted one of the earliest shelter-in-place orders to inform trauma care during future pandemic responses. METHODS: A single-center interrupted time-series analysis was performed to identify associations of shelter-in-place with trauma volume, injury mechanisms, and patient demographics in San Francisco, California. To control for short-term trends in trauma epidemiology, weekly level data were analyzed 6 months before shelter-in-place. To control for long-term trends, monthly level data were analyzed 5 years before shelter-in-place. RESULTS: Trauma volume decreased by 50% in the week following shelter-in-place (p < 0.01), followed by a linear increase each successive week (p < 0.01). Despite this, trauma volume for each month (March–June 2020) remained lower compared with corresponding months for all previous 5 years (2015–2019). Pediatric trauma volume showed similar trends with initial decreases (p = 0.02) followed by steady increases (p = 0.05). Reductions in trauma volumes were due entirely to changes in nonviolent injury mechanisms, while violence-related injury mechanisms remained unchanged (p < 0.01). CONCLUSION: Although the shelter-in-place order was associated with an overall decline in trauma volume, violence-related injuries persisted. Delineating and addressing underlying factors driving persistent violence-related injuries during shelter-in-place orders should be a focus of public health efforts in preparation for future pandemic responses. LEVEL OF EVIDENCE: Epidemiological study, level III. Lippincott Williams & Wilkins 2021-04 2020-11-05 /pmc/articles/PMC7979514/ /pubmed/33252457 http://dx.doi.org/10.1097/TA.0000000000003044 Text en Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved. This article is made available via the PMC Open Access Subset for unrestricted re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the COVID-19 pandemic or until permissions are revoked in writing. Upon expiration of these permissions, PMC is granted a perpetual license to make this article available via PMC and Europe PMC, consistent with existing copyright protections.
spellingShingle Original Articles
Matthay, Zachary A.
Kornblith, Aaron E.
Matthay, Ellicott C.
Sedaghati, Mahsa
Peterson, Sue
Boeck, Marissa
Bongiovanni, Tasce
Campbell, Andre
Chalwell, Lauren
Colwell, Christopher
Farrell, Michael S.
Kim, Woon Cho
Knudson, M. Margaret
Mackersie, Robert
Li, Lilian
Nunez-Garcia, Brenda
Langness, Simone
Plevin, Rebecca E.
Sammann, Amanda
Tesoriero, Ronald
Stein, Deborah M.
Kornblith, Lucy Z.
The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title_full The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title_fullStr The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title_full_unstemmed The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title_short The DISTANCE study: Determining the impact of social distancing on trauma epidemiology during the COVID-19 epidemic—An interrupted time-series analysis
title_sort distance study: determining the impact of social distancing on trauma epidemiology during the covid-19 epidemic—an interrupted time-series analysis
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7979514/
https://www.ncbi.nlm.nih.gov/pubmed/33252457
http://dx.doi.org/10.1097/TA.0000000000003044
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