Evaluation of Patterns of Trauma Reporting to the Emergency Department During the First COVID-19 Lockdown in India

Abstract

Background On March 24, 2020, the Government of India declared a nationwide lockdown and a series of measures aimed at limiting the spread of the coronavirus disease 2019 (COVID-19) infection. This led to dynamic changes in patient inflow and management in the emergency department.This study aims to evaluate the impact of the pre-lockdown and lockdown periods on the demography of trauma in a tertiary care teaching hospitaland to compare it with the homologous period of 2019. Methods The trauma caseloads between March 25, 2020, and April 14, 2020, and that of the homologous period of 2019 were thoroughly analyzed and compared retrospectively. Results There was an overall decrease in trauma patients. Elderly male patients had an increased incidence of injury during the lockdown period with a significant p-value (0.0009). There was a significant increase in the number of minor orthopedic procedures while there was a significant decrease in the number of major orthopedic procedures. Fractures of the proximal femur were significantly increased during the lockdown period (p-value0.011) and fractures of the femur and tibia shaft were significantly decreased during the lockdown period (p-value0.002). Fractures of the distal radius were significantly increased during the lockdown period (p-value0.005) and fractures of the shaft of humerus, radius, and ulna were significantly decreased during the lockdown period (p-value0.028). Injuries following fall, trivial trauma, and animal-induced trauma were significantly increased (p-values <0.0001, <0.0001, 0.014, respectively), whereas injuries following sports and motor vehicle accidents were significantly decreased (p-value 0.006, <0.0001, respectively). The number of patients reaching within the golden hour (<1 hour) was significantly increased (p-value 0.0003). The total number of patients presenting under the influence of alcohol during the lockdown period was significantly decreased (p-value- <0.0001). The use of government-sponsored ambulances for transport to the hospital was significantly increased during the lockdown period (p <0.0001). Conclusion Strict administrative measures had a high impact on the number and epidemiology of trauma with remarkable changes. There was a decreased number of trauma cases but the mechanism, type, and management of these cases were significantly altered from the homologous period of the previous year.