Impact of the first COVID-19 shutdown on patient volumes and surgical procedures of
      a Level I trauma center

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Abstract

Purpose

In Dec 2019, COVID-19 was first recognized and led to a worldwide pandemic. The German government implemented a shutdown in Mar 2020, affecting outpatient and hospital care. The aim of the present article was to evaluate the impact of the COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center in Germany.

Methods

All emergency patients were recorded retrospectively during the shutdown and compared to a calendar-matched control period (CTRL). Total emergency patient contacts including trauma mechanisms, injury patterns and operation numbers were recorded including absolute numbers, incidence proportions and risk ratios.

Results

During the shutdown period, we observed a decrease of emergency patient cases (417) compared to CTRL (575), a decrease of elective cases (42 vs. 13) and of the total number of operations (397 vs. 325). Incidence proportions of emergency operations increased from 8.2 to 12.2% (shutdown) and elective surgical cases decreased (11.1 vs. 4.3%). As we observed a decrease for most trauma mechanisms and injury patterns, we found an increasing incidence proportion for severe open fractures. Household-related injuries were reported with an increasing incidence proportion from 26.8 to 47.5% (shutdown). We found an increasing tendency of trauma and injuries related to psychological disorders.

Conclusion

This analysis shows a decrease of total patient numbers in an emergency department of a Level I trauma center and a decrease of the total number of operations during the shutdown period. Concurrently, we observed an increase of severe open fractures and emergency operations. Furthermore, trauma mechanism changed with less traffic, work and sports-related accidents.

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Most cited references 17

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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The impact of the COVID-19 pandemic on suicide rates

Leo Sher (2020)

Abstract Multiple lines of evidence indicate that the COVID-19 pandemic has profound psychological and social effects. The psychological sequelae of the pandemic will probably persist for months and years to come. Studies indicate that the COVID-19 pandemic is associated with distress, anxiety, fear of contagion, depression, and insomnia in the general population and among health care professionals. Social isolation, anxiety, fear of contagion, uncertainty, chronic stress, and economic difficulties may lead to the development or exacerbation of depressive, anxiety, substance use, and other psychiatric disorders in vulnerable populations including individuals with pre-existing psychiatric disorders and people who reside in high COVID-19 prevalence areas. Stress-related psychiatric conditions including mood and substance use disorders are associated with suicidal behavior. COVID-19 survivors may also be at elevated suicide risk. The COVID-19 crisis may increase suicide rates during and after the pandemic. Mental health consequences of the COVID-19 crisis including suicidal behavior are likely to be present for a long time and peak later than the actual pandemic. To reduce suicides during the COVID-19 crisis it is imperative to decrease stress, anxiety, fears and loneliness in the general population. There should be traditional and social media campaigns to promote mental health and reduce distress. Active outreach is necessary, especially for people with a history of psychiatric disorders, COVID-19 survivors, and older adults. Research studies are needed of how mental health consequences can be mitigated during and after the COVID-19 pandemic.

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DANGER IN DANGER: INTERPERSONAL VIOLENCE DURING COVID-19 QUARANTINE

Marianna Mazza, Giuseppe Marano, Carlo Lai … (2020)

HIGHLIGHTS • Subjects who have undergone intimate partner violence are at increased risk of multiple mental health condition and physical health conditions. • During the quarantine due to Coronavirus pandemic disease 2019 (COVID-19) victims of domestic violence are required to stay the whole day with partners and away from help and abusive situations can further deteriorate, with a possible growing of domestic homicides or murder-suicides or deviant behaviours towards children. • Particularly in COVID emergence is mandatory to provide programs of funding sources to guarantee telephone or remote counseling services or psychological assistance hotlines to manage and attempt to prevent crisis situations.

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Author and article information

Contributors

Michael J. Raschke:

ORCID: http://orcid.org/0000-0002-0265-8098

michael.raschke@ukmuenster.de

Journal

Journal ID (nlm-ta): Eur J Trauma Emerg Surg

Journal ID (iso-abbrev): Eur J Trauma Emerg Surg

Title: European Journal of Trauma and Emergency Surgery

Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )

ISSN (Print): 1863-9933

ISSN (Electronic): 1863-9941

Publication date (Electronic): 21 April 2021

Publication date PMC-release: 21 April 2021

Pages: 1-11

Affiliations

[1 ]GRID grid.16149.3b, ISNI 0000 0004 0551 4246, Department of Trauma, Hand and Reconstructive Surgery, , University Hospital Muenster, ; Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany

[2 ]GRID grid.16149.3b, ISNI 0000 0004 0551 4246, Department of Medical Management and Medical Controlling, , University Hospital Muenster, ; Muenster, Germany

[3 ]GRID grid.16149.3b, ISNI 0000 0004 0551 4246, University Hospital Muenster, ; Muenster, Germany

Author information

Carolin A. Kreis http://orcid.org/0000-0003-3453-5479

Birte Ortmann http://orcid.org/0000-0003-4098-0253

Moritz Freistuehler http://orcid.org/0000-0003-0860-4071

René Hartensuer http://orcid.org/0000-0002-6175-2754

Hugo Van Aken http://orcid.org/0000-0001-6878-9851

Michael J. Raschke http://orcid.org/0000-0002-0265-8098

Benedikt Schliemann http://orcid.org/0000-0002-4267-2863

Article

Publisher ID: 1654

DOI: 10.1007/s00068-021-01654-8

PMC ID: 8059116

PubMed ID: 33881555

SO-VID: b934c0cd-03e5-47b5-bce3-2cda900ee68d

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

History

Date received : 18 January 2021

Date accepted : 21 March 2021

Funding

Funded by: Universitätsklinikum Münster (8918)

Open Access :

Open Access funding enabled and organized by Projekt DEAL.

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Impact of the first COVID-19 shutdown on patient volumes and surgical procedures of a Level I trauma center

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Abstract

Purpose

Methods

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Conclusion

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Novel Coronavirus Disease COVID-19

Most cited references 17

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

The impact of the COVID-19 pandemic on suicide rates

DANGER IN DANGER: INTERPERSONAL VIOLENCE DURING COVID-19 QUARANTINE

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