Traumatology and Orthopedics of RussiaTraumatology and Orthopedics of RussiaТравматология и ортопедия России2311-29052542-0933Vreden National Medical Research Center of Traumatology and Orthopedics799410.17816/2311-2905-7994Trauma and orthopedic careОрганизация травматолого-ортопедической помощиTrauma and orthopedic careResearch ArticleThe Effect of Nationwide Lockdown in India on the Epidemiology of Injuries During the First Wave of COVID-19Влияние национального локдауна на эпидемиологию травм во время первой волны COVID-19 в Индииhttps://orcid.org/0000-0001-5080-1656ZachariaBalajiЗахарияБаладжиZachariaBalaji
India

Professor, Department of Orthopedics

профессор

Professor

balaji.zacharia@gmail.comhttps://orcid.org/0000-0002-9746-8528UdupaHarshitha HayavadanaУдупаХаршитха ХаяваданаUdupaHarshitha Hayavadana
India

Senior Resident, Dept. Of Orthopedics

Senior Resident

harshithaudupa@gmail.comhttps://orcid.org/0000-0002-4897-5582ChandranRahulЧандранРахулChandranRahul
India

Senior Resident, Dept. Of Orthopedics

rahulchandrannair55@gmail.comhttps://orcid.org/0009-0007-5173-2569PrakasArunПракасАрунPrakasArun
India

Assistant Professor, Department of Orthopedics

drarunprakas@gmail.comGovernment Medical CollegeГосударственный медицинский колледжGovernment Medical College050520232306202329288981803202311042023Copyright ©; 2023, Eco-VectorCopyright ©; 2023, Эко-ВекторCopyright ©; 2023,2023Eco-VectorЭко-Векторhttps://creativecommons.org/licenses/by-nc-nd/4.0https://journal.rniito.org/jour/article/view/7994

Background. The pattern of hospital admissions and medical care changed during the COVID pandemic.

The aim of the study — to describe the nature of patients attending the orthopedic emergency department of a level 1 trauma center in terms of number and proportion based on demographic characteristics and the nature of the injury before the lockdown, during the lockdown, and during the unlocking period of the nationwide lockdown for controlling the COVID-19 pandemic in India.

Methods. We conducted a longitudinal study from 01.01.2020 to 31.12.2020. Patients attending the orthopedic emergency were grouped based on cause, type, and site of injury. The median number observed each day with IQR. The distribution of the same was compared between the prelockdown with lockdown period and the lockdown period with a phased unlocking period.

Results. A total of 10513 patients were included. There was a statistically significant reduction in the proportion of patients needing inpatient care between the prelockdown phase and lockdown phase (p = 0.008). However, this was not seen between lockdown and postlockdown periods (p = 0.47). The proportion of road traffic accidents dropped from 26% to 15% during this time (p<0.001). The proportion of contusions was reduced and that of soft tissue injuries increased (p<0.001). The proportion of lower limb injuries decreased from the prelockdown phase to the lockdown phase, and that of spinal injury patients increased (p = 0.007). The proportion of patients with contusions increased and soft tissue injuries decreased during this period (p<0.001). Lower limb injuries and road traffic accidents increased, and spinal injuries were reduced (p<0.001).

Conclusion. The lockdown for controlling the spread of the pandemic affected the demographic and epidemiological aspects of injuries attending the orthopedic emergency department of a level 1 trauma center in a developing country. There was a decrease in the proportion of females and children attending the ED during the lockdown. The number of road traffic accedents s decreased during the lockdown. The number of patients with contusions attending the trauma center during the lockdown decreased, but there was an increase in the number of patients with spine injuries. We suggest that improvement in triage facilities, wider use of telemedicine, and increasing the stock of PPEs are essential for tackling such situations in the future.

Введение. Во время пандемии COVID-19 изменилась структура госпитализаций и оказания медицинской помощи.

Цель — проанализировать эпидемиологию и тип травм, полученных пациентами, обратившимися в травмоцентр 1-го уровня во время пандемии и локдауна в Индии.

Материал и методы. Мы провели лонгитюдное исследование с 01.01.2020 по 31.12.2020 Пациенты, обратившиеся за неотложной травматологической помощью, были сгруппированы в зависимости от причины, типа и места повреждения. Среднее число ежедненых обращений было расчитано с помощью IQR (интерквартильного размаха). Было проведено сравнение распределений среднего числа наблюдений между периодами до и во время локдауна, а также во время локдауна и после его снятия.

Результаты. Всего в исследование было включено 10 513 пациентов. Наблюдалось статистически значимое снижение доли пациентов, нуждающихся в госпитализации, между периодами до и во время локдауна (p = 0,008). Однако этого не наблюдалось между периодами локдауна и постлокдауна (p = 0,47). Доля дорожно-транспортных происшествий снизилась с 26% до 15% между периодами до и во время локдауна (p<0,001). Доля ушибов уменьшилась, а мягкотканных повреждений увеличилась (p<0,001). Доля травм нижних конечностей уменьшилась между периодами до и во время локдауна, а доля травм позвоночника увеличилась (p = 0,007).

Заключение. Национальный локдаун повлиял на демографические и эпидемиологические показатели травм в травмоцентре 1-го уровня в Индии. Наблюдалось снижение доли женщин и детей, обратившихся в отделение неотложной помощи. Количество ДТП сократилось во время локдауна. Количество пациентов с ушибами, обратившихся в травматологический центр во время локдауна уменьшилось, а количество пациентов с травмами позвоночника увеличилось. Мы рекомендуем улучшить медицинскую сортировку, расширить использование телемедицины и увеличить запасы средств индивидуальной защиты для борьбы с подобными ситуациями в будущем.

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