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Karmali S, Saxena S, Richards O, Thompson W, McFaull SR, Pike I. What was the impact of COVID-19 restrictions on unintentional injuries, in Canada and globally? A scoping review investigating how lockdown measures impacted the global burden of unintentional injury. Front Public Health 2024; 12:1385452. [PMID: 38887259 PMCID: PMC11180821 DOI: 10.3389/fpubh.2024.1385452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 05/20/2024] [Indexed: 06/20/2024] Open
Abstract
Background Injuries are among the leading causes for hospitalizations and emergency department (ED) visits. COVID-19 restrictions ensured safety to Canadians, but also negatively impacted health outcomes, including increasing rates of certain injuries. These differences in trends have been reported internationally however the evidence is scattered and needs to be better understood to identify opportunities for public education and to prepare for future outbreaks. Objective A scoping review was conducted to synthesize evidence regarding the impact of COVID-19 restrictions on unintentional injuries in Canada, compared to other countries. Methods Studies investigating unintentional injuries among all ages during COVID-19 from any country, published in English between December 2019 and July 2021, were included. Intentional injuries and/or previous pandemics were excluded. Four databases were searched (MEDLINE, Embase, Web of Science, SPORTDiscus), and a gray literature search was also conducted. Results The search yielded 3,041 results, and 189 articles were selected for extraction. A total of 41 reports were included from the gray literature search. Final studies included research from: Europe (n = 85); North America (n = 44); Asia (n = 32); Oceania (n = 12); Africa (n = 8); South America (n = 4); and multi-country (n = 4). Most studies reported higher occurrence of injuries/trauma among males, and the average age across studies was 46 years. The following mechanisms of injury were reported on most frequently: motor vehicle collisions (MVCs; n = 134), falls (n = 104), sports/recreation (n = 65), non-motorized vehicle (n = 31), and occupational (n = 24). Injuries occurring at home (e.g., gardening, home improvement projects) increased, and injuries occurring at schools, workplaces, and public spaces decreased. Overall, decreases were observed in occupational injuries and those resulting from sport/recreation, pedestrian-related, and crush/trap incidents. Decreases were also seen in MVCs and burns, however the severity of injury from these causes increased during the pandemic period. Increases were observed in poisonings, non-motorized vehicle collisions, lacerations, drownings, trampoline injuries; and, foreign body ingestions. Implications Findings from this review can inform interventions and policies to identify gaps in public education, promote safety within the home, and decrease the negative impact of future stay-at-home measures on unintentional injury among Canadians and populations worldwide.
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Affiliation(s)
- Shazya Karmali
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
| | | | | | | | | | - Ian Pike
- BC Injury Research and Prevention Unit, BC Children’s Hospital Research Institute, Vancouver, BC, Canada
- Faculty of Medicine, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada
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MacQuene T, Kleintjes W, Nieuwoudt W, Camp S, Lydon G, Chu K. An increase in electrical burns during the covid lockdown in Western Cape, South Africa. Burns 2024; 50:1174-1179. [PMID: 38461080 DOI: 10.1016/j.burns.2024.02.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 02/05/2024] [Accepted: 02/21/2024] [Indexed: 03/11/2024]
Abstract
BACKGROUND A severe Covid lockdown in South Africa may have changed burn patterns due to the downturn of the economy and stay-at-home policies. We describe the volume and type of burn admitted to a tertiary hospital before and during the Covid lockdown. MATERIALS AND METHODS This was a retrospective study from before (April 2019-March 2020) and during (April 2020-March 2021) the Covid pandemic. Patient demographics, burn etiology, and clinical outcomes were described. Logistic regression was used to model associations between burn etiology and the Covid period. RESULTS Of 544 burns, 254 (46.7%) occurred before and 290 (53.3%, p = 0.051) during Covid. The proportion of electrical burns doubled during Covid n = 20, 32.3% vs n = 42, 67.7%, (p = 0.053) periods. At least half were associated with suspected cable or copper theft. On multivariate analysis, flame burns (OR=2.42, p < 0.001), electrical burns (OR=4.88, p < 0.001), and paying patients (OR=4.21, p < 0.001) were more likely to be associated with the Covid period. CONCLUSION Electrical burns doubled during Covid, potentially related to an increase in cable and copper wire theft, a phenomenon described during hard economic times in other settings. More studies to understand this potential relationship are indicated to prepare burn centers during future pandemics and/or economic hardship.
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Affiliation(s)
- Tamlyn MacQuene
- Centre for Global Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Wayne Kleintjes
- Burn Unit, Tygerberg Academic Hospital, Cape Town, South Africa; Department of Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Willa Nieuwoudt
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Sarah Camp
- Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Georgia Lydon
- Department of Surgery, Medical University of South Carolina, Charleston, SC, United States
| | - Kathryn Chu
- Centre for Global Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa; Department of Surgery, University of Botswana, Gaborone, Botswana.
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Diab J, Pye M, Diab V, Hopkins Z, Cha J, Maitz PK, Issler-Fisher AC. The impact of COVID-19 on adult burns: A statewide review of epidemiology and clinical outcomes. Burns 2024; 50:381-387. [PMID: 37996282 DOI: 10.1016/j.burns.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/27/2023] [Accepted: 10/18/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION The COVID-19 pandemic has significantly impacted the clinical presentations of burns and the provision of services. This study aims to describe and analyse patterns and trends in adult burns across New South Wales (NSW) and the Australian Capital Territory. METHODS A NSW statewide retrospective review was conducted from 2017 to 2022 for adult patients with burns. A comparative analysis was performed for the COVID-19 group (2020-2022) and control group between 2017 and 2019. RESULTS We found a total of 11,433 patients (7102 non-COVID vs 4331 COVID-19). The average age in the COVID-19 group was 1.4 years older than counterparts (40.6 vs 42.0, p < 0.001). The 18 - 25 and 36 - 45 age groups experienced significantly lower proportions of presentations, whereas, the 76-85 years experienced significantly higher proportions. There was a significantly higher proportion of pressure injuries (0.1% vs 0.4%, p < 0.001) and contact burns (17.2% vs 18.7%), but lower explosions (1.3% vs 0.2%) for the COVID-19 group compared to their counterparts. The mean TBSA% was 0.4% greater in the COVID-19 group compared to their counterparts (2.4 vs 2.8, p < 0.001). There were significantly more operating sessions (0.2 vs 0.3, p < 0.001). The mean length of stay was significantly greater by 0.8 days for the COVID-19 group compared to their counterparts (1.5 vs 2.3, p < 0.001). CONCLUSIONS Epidemiological changes were not greatly different to previous years from the impact of COVID-19. The shift in elderly presentations and operative interventions reflects the holistic care of burns units working in a new landscape with an invigorated focus on telehealth and outpatient care.
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Affiliation(s)
- Jason Diab
- Concord Repatriation General Hospital, Burns Unit, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia; School of Medicine, University of Notre Dame, Sydney, Australia; School of Medicine, University of New South Wales, Sydney, Australia.
| | - Miranda Pye
- Concord Repatriation General Hospital, Burns Unit, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
| | - Vanessa Diab
- School of Medicine, University of Notre Dame, Sydney, Australia
| | | | - Jeon Cha
- Royal North Shore Hospital, Burns Unit, Australia
| | - Peter Km Maitz
- Concord Repatriation General Hospital, Burns Unit, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
| | - Andrea C Issler-Fisher
- Concord Repatriation General Hospital, Burns Unit, Australia; ANZAC Research Institute, Concord Repatriation General Hospital, Sydney, Australia; Concord Clinical School, University of Sydney, Sydney, Australia
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Olawoye OA, Isamah CP, Obadan IO, Ademola SA, Aderibigbe RO, Michael AI, Iyun AO, Oluwatosin OM. The Impact of Covid-19 Pandemic on Acute Burn Admissions at the University College Hospital, Ibadan, Nigeria. J Burn Care Res 2024; 45:93-97. [PMID: 37235751 PMCID: PMC11023356 DOI: 10.1093/jbcr/irad079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Indexed: 05/28/2023]
Abstract
The coronavirus disease and the subsequent pandemic that followed drastically changed human civilization with disruptive effects on health and overall wellbeing of mankind. This disruptive effect has been shown to include changes in epidemiology of burn injuries. This study therefore aimed to determine the impact of covid-19 on acute burn presentation at the University College Hospital (UCH), Ibadan. This was a retrospective study carried out between April 1, 2019 and March 31, 2021. The period was divided into two: April 1, 2019 to March 31, 2020 and April 1, 2020 to March 31, 2021. Data obtained from the burn unit registry were analyzed using the Scientific Package For Social Sciences version 25. The only statistically significant finding from this study was the marked reduction in burn ICU admission during the pandemic (P < 0.001). A total of 144 patients presented to the burn intensive care unit at UCH, Ibadan during the period under review with 92 patients in the prepandemic year, and 52 patients in the pandemic year. Patient group from 0- to 9-year-olds representing 42% in prepandemic, and 30.8% in the pandemic period was the most affected age group. Scald was predominantly among the pediatric age group in both groups. Males were more likely to suffer flame burn in both study periods with a near gender equilibration during the pandemic. Burn injury during the pandemic resulted in more total body surface area burned. The lockdown effect of the pandemic resulted in a significant reduction in acute burn admissions at the UCH, Ibadan.
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Affiliation(s)
- Olayinka A Olawoye
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Chinsunum P Isamah
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Izegaegbe O Obadan
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Samuel A Ademola
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Rotimi O Aderibigbe
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Afieharo I Michael
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Ayodele O Iyun
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
| | - Odunayo M Oluwatosin
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital, Ibadan, Nigeria
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Ademola SA, Michael AI, Iyun AO, Isamah CP, Aderibigbe RO, Olawoye OA, Oluwatosin OM. Current Trend in the Epidemiology of Thermal Burn Injury at a Tertiary Hospital in South Western Nigeria. J Burn Care Res 2024; 45:190-199. [PMID: 37721894 PMCID: PMC11023490 DOI: 10.1093/jbcr/irad143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Indexed: 09/20/2023]
Abstract
Worldwide, thermal burn is the leading etiological type of burn injury accounting for 86% of burn injuries requiring admissions. Flame, Scald, and contact burn are the leading causes of thermal burn. Changes in the sociodemographic characteristics of societies have led to alterations in the epidemiology of burn. An understanding of such changes in the epidemiology of burn is essential in formulating and executing adequate burn prevention programs. We sought to establish the current trend in the etiology, gender distribution, age, occurrence of inhalation injury, burn surface area, burn depth, and mortality rate of thermal burns at Ibadan. This was a retrospective study carried out between January 2013 and December 2022. Thermal burns constitute 92% of burn injuries. The male-to-female ratio was 1.4:1. There were 265 (45%) patients in the pediatric age group and 323 adults (55% of the patients). The proportion of flame, scald, and contact burns were 378 (58%), 203 (32%), and 14 (2%), respectively. Flame burns resulting from liquified petroleum gas (LPG) explosion show a rising trend, with a decline in flame burns from kerosene (P < .001). One hundred and ninety (32%) patients had inhalation injury. The overall mortality was 19% (N = 114). Kerosene flame, 38% (17 of 45 patients), and LPG, 32% (41 of 130 patients), were the most lethal causes of flame injuries (P < .043). The study shows the increasing contribution of LPG to the etiology of thermal burn injuries. Burn prevention programs should target safe use of LPG stoves and cylinders.
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Affiliation(s)
- Samuel Adesina Ademola
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Afieharo Igbibia Michael
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Ayodele Olukayode Iyun
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Chinsunum Peace Isamah
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Rotimi Opeyemi Aderibigbe
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
| | - Olayinka Adebanji Olawoye
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
| | - Odunayo Moronfoluwa Oluwatosin
- Department of Plastic, Reconstructive, and Aesthetic Surgery, University College Hospital Ibadan, Ibadan, Oyo, Nigeria
- Department of Surgery, College of Medicine, University of Ibadan, Ibadan, Oyo, Nigeria
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Mobayen M, Torabi H, Bagheri Toolaroud P, Tolouei M, Dehnadi Moghadam A, Saadatmand M, EslamiKenarsari H, Feizkhah A, Ghazanfari MJ, Osuji J, Ghorbani Vajargah P, Karkhah S. Acute burns during the COVID-19 pandemic: A one-year retrospective study of 611 patients at a referral burn centre in northern Iran. Int Wound J 2023; 20:3204-3211. [PMID: 37095647 PMCID: PMC10502268 DOI: 10.1111/iwj.14199] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
Patients with acute burns are more vulnerable to COVID-19 because of physiologically weak immune systems. This study aimed to assess and compare individual characteristics, clinical features, and clinical outcomes of acute burn among COVID-19 and non-COVID-19 patients. A retrospective study, with data collected from 611 acute burn patients with or without a COVID-19 diagnosis referred to a burn centre in Iran. Data were collected from April 2020 to 2021. The mean age of acute burns patients with COVID-19 was higher compared with acute burns patients with non-COVID-19 (47.82 vs. 32.59 years, P < .001). Acute burns occurred more frequently in COVID-19 patients with comorbidities compared with non-COVID-19 patients (48.72% vs. 26.92%, P = .003). 58.97% of COVID-19 patients and 55.42% of non-COVID-19 patients had grade II & III and II burns, respectively (P < .001). The mean total body surface area of the burn was higher in COVID-19 patients compared with non-COVID-19 patients (32.69% vs. 16.22%, P < .001). Hospitalisation in the intensive care unit (ICU) was higher in COVID-19 patients than in non-COVID-19 patients (76.92% vs. 15.73%, P < .001). Length of stay in hospital and ICU, the cost of hospitalisation, and waiting time for the operating room was higher in COVID-19 patients compared with non-COVID-19 patients (15.30 vs. 3.88 days, P < .001; 9.61 vs. 0.75 days, P < .001; 30 430 628.717 vs. 10 219 192.44 rials, P = .011; 0.84 vs. 0.24 min, P < .001, respectively). Intubation and mortality in-hospital were higher in COVID-19 patients compared with non-COVID-19 patients (41.02% vs. 6.99%, P < .001; 35.90% vs. 6.12%, P < .001, respectively). Therefore, it is recommended that health managers and policymakers develop a care plan to provide high-quality care to acute burns patients with COVID-19, especially in low-income countries.
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Affiliation(s)
- Mohammadreza Mobayen
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
| | - Hossein Torabi
- Department of General Surgery, Poursina Medical & Educational CenterGuilan University of Medical SciencesRashtIran
| | | | - Mohammad Tolouei
- Department of General Surgery, Faculty of MedicineGuilan University of Medical SciencesRashtIran
| | | | - Mohammad Saadatmand
- Clinical Research Development Unit of Poursina HospitalGuilan University of Medical SciencesRashtIran
| | - Habib EslamiKenarsari
- Poursina Clinical Research Development UnitGuilan University of Medical SciencesRashtIran
| | - Alireza Feizkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical Physics, School of MedicineGuilan University of Medical SciencesRashtIran
| | - Mohammad Javad Ghazanfari
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Joseph Osuji
- School of Nursing and Midwifery, Faculty of Health, Community, and EducationMount Royal UniversityCalgaryAlbertaCanada
| | - Pooyan Ghorbani Vajargah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
| | - Samad Karkhah
- Burn and Regenerative Medicine Research CenterGuilan University of Medical SciencesRashtIran
- Department of Medical‐Surgical Nursing, School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
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Chawla S, Papp A. Adult kitchen-related burn injuries: The impact of COVID-19. Burns 2023; 49:1328-1334. [PMID: 36566093 PMCID: PMC9722612 DOI: 10.1016/j.burns.2022.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 10/19/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Kitchen-related burn injuries are common and preventable. To limit the spread of COVID-19, public health orders encouraged the public to stay at home which may have led to an increase in kitchen-related burn injuries. OBJECTIVE To assess adult kitchen-related burns treated in an outpatient setting in general, and especially looking at the impact of the COVID-19 pandemic on the incidence and epidemiology of these burns. METHODS For this retrospective, population-based study, data were obtained for adult patients who suffered burn injuries resulting in a visit to a Canadian tertiary Burn Clinic between April 2016 and March 2021 specifically looking at demographics, burn etiology, severity and anatomical location and the need for surgery. Separately, we compared the patients before and after the beginning of the COVID-19 pandemic (April 1, 2020). RESULTS A total of 1380 burn patients were identified. Of these, 38 % (N = 521) sustained a kitchen-related burn. The median patient age was 40 years (range 18-95) and 282 (54.1 %) were female. The most common etiology and location were scald (76.8 %) and anterior arm (28.5 %), respectively. Thirty-two (6.1 %) patients required admission to the Burn Unit and 26 of these had surgeries. Additionally, 72 (13.8 %) patients had surgery as an outpatient. During the COVID-19 pandemic, East Asian patients saw a significant increase in kitchen burns (p < 0.01). CONCLUSION Over 1/3 of burns at the outpatient burn clinic were kitchen-related. About 94 % of these were treated as outpatient only. The incidence of kitchen-related burns did not change during the COVID-19 pandemic, but we found significant differences in ethnic distribution. These results provide a unique opportunity to focus on communication and education and set up preventative measures.
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Affiliation(s)
- Sahil Chawla
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
| | - Anthony Papp
- Division of Plastic Surgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada.
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Amado V, Moller J, Couto MT, Wallis L, Laflamme L. Effect of the COVID-19 pandemic on emergency department attendances for pediatric injuries in Mozambique's central hospitals: an interrupted time series and a comparison within the restriction periods between 2019 and 2020. Trauma Surg Acute Care Open 2023; 8:e001062. [PMID: 37484836 PMCID: PMC10350904 DOI: 10.1136/tsaco-2022-001062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 05/25/2023] [Indexed: 07/25/2023] Open
Abstract
Objectives Hospital-based studies indicate that restriction measures imposed during the COVID-19 pandemic have affected the number and characteristics of pediatric injuries. However, few studies have been conducted in resource-poor countries. This study aimed to determine whether injury-related emergency department (ED) attendances in Mozambique were affected during the restriction periods in 2020 and how the pattern of injury changed. Methods Mozambique faced two restriction periods in 2020. An interrupted time series was applied to weekly data of pediatric injuries from the ED records of four central hospitals in Mozambique in 2019 and 2020. Weekly numbers of injuries were modeled using a Poisson regression model to estimate the effect of COVID-19 restrictions on trends over calendar time. Then, for each restriction period, differences in injury mechanisms, severity, need for surgery, and intensive care unit (ICU) attendances were compared between 2019 and 2020. Results During the 76 weeks preceding the restrictions, there was a stable trend in ED attendances. The weekly number dropped by 48.7% after implementation of the first restrictions. By the end of 2020, the weekly numbers were back to the levels observed before the restrictions. Road traffic injuries (RTIs) and falls dropped during the first restriction period and RTIs and burns during the second. There was an increase of 80% in ICU attendances in all periods of 2020 at three hospitals during the first and second restriction periods. Conclusion The COVID-19 restrictions yielded a reduction in the weekly number of pediatric injuries seen at Mozambique's central hospitals, above all RTIs and falls. The drop reflects reductions in visits most importantly for RTIs, falls, and burns, but was accompanied by an increase in the proportion of ICU cases. This effect was not maintained when the restrictions were relaxed. Whether this reflects reduced exposure to injury or hesitancy to seek care remains to be determined. Level of evidence Level III, retrospective study with up to two negative criteria.
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Affiliation(s)
- Vanda Amado
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Department of Surgery, University of Eduardo Mondlane Faculty of Medicine, Maputo, Mozambique
| | - Jette Moller
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
| | - Maria Tereza Couto
- Department of Community Health, University of Eduardo Mondlane Faculty of Medicine, Maputo, Mozambique
| | - Lee Wallis
- Division of Emergency Medicine, University of Cape Town Faculty of Health Sciences, Cape Town, South Africa
| | - Lucie Laflamme
- Department of Global Public Health, Karolinska Institute, Stockholm, Sweden
- Institute for Social and Health Sciences, University of South Africa, Pretoria, South Africa
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9
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Habarth-Morales TE, Rios-Diaz AJ, Isch E, Qi L, Ni R, Caterson EJ. Increased Incidence of Suspected Smoke Inhalation During the Coronavirus Disease 2019 Pandemic: A National Database Study. J Burn Care Res 2023; 44:945-948. [PMID: 36260537 PMCID: PMC9620764 DOI: 10.1093/jbcr/irac155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Indexed: 11/13/2022]
Abstract
The COVID-19 pandemic has forced many Americans to adapt their daily routines. In 2020, there was a significant increase in house fires according to the National Fire Prevention Association (NFPA). The objective of this study was to characterize the changes in suspected smoke inhalations (SSIs) during the first year of the pandemic in the National Emergency Medical Services Information System (NEMSIS). The NEMSIS database was queried for all EMS transports captured between 2017 and 2020. Differences in the incidences of SSIs and fire dispatches in 2020 were estimated using Poisson regression models. There was a 13.4% increase in the incidence of fire dispatches and a 15% increase in SSIs transported in 2020 compared to the previous 3 years. The incidence rate ratio of both fire dispatches (1.271; 95% CI: 1.254-1.288; P < .001) and SSI (1.152; 95% CI: 1.070-1.241; P < .001) was significantly elevated in 2020. The increases in fire dispatches and SSIs observed in the NEMSIS database are in concordance with other literature indicating the increase in fire incidence and morbidity observed during the pandemic. These results should inform fire prevention outreach efforts and resource allocation in burn centers in the event of future pandemic.
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Affiliation(s)
- Theodore E Habarth-Morales
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
- Division of Plastic Surgery, Department of Surgery, Nemours Children’s Health, Wilmington, DE, United States of America
| | - Arturo J Rios-Diaz
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Emily Isch
- Department of Surgery, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Lucy Qi
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Rose Ni
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, United States of America
| | - Edward J Caterson
- Division of Plastic Surgery, Department of Surgery, Nemours Children’s Health, Wilmington, DE, United States of America
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Vasudevan A, Bailey HM, Sager A, Kazis LE. Impact of the Early COVID-19 Pandemic on Burn Care: A Multi-National Study. J Burn Care Res 2023; 44:580-589. [PMID: 35661890 PMCID: PMC9214119 DOI: 10.1093/jbcr/irac076] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Indexed: 11/30/2022]
Abstract
This qualitative study documents and analyzes COVID-19's impacts on burn care in twelve nations. Burn care saw valuable improvements in surgical techniques, skin grafting, and other acute treatments during the decades before the COVID-19 pandemic which increased severely burned patients' survival rates and quality of life. Detailed interviews, conducted in the 12 nations reveal that the COVID-19 pandemic greatly affected the delivery of acute and rehabilitation services for burn patients. Resources have been suctioned away from non-COVID healthcare and burn care has not been spared. Acute, post-acute rehabilitation, and mental health services have all suffered. Weak preparation has deeply burdened health care services in most nations, resulting in lower access to care. Access problems have accelerated innovations like telehealth in many nations. The spread of misinformation through social and traditional media has contributed to the varied responses to COVID-19. This compounded problems in health care delivery. Burn care providers delivered services for survivors during extremely difficult circumstances by continuing to furnish acute and long-term services for patients with complex disease. Emphasis on future pandemic preparedness will be vital because they undermine all aspects of burn care and patient outcomes. As the COVID-19 pandemic continues to unfold around the world, it will be important to continue to monitor and analyze the adaptability of nations, health care systems, and burn care providers.
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Affiliation(s)
| | - Hannah M Bailey
- Department of Health Law, Policy and Management, Boston University School of Public Health, Massachusetts, USA
| | - Alan Sager
- Department of Health Law, Policy and Management, Boston University School of Public Health, Massachusetts, USA
| | - Lewis E Kazis
- Department of Health Law, Policy and Management, Boston University School of Public Health and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Massachusetts, USA
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11
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Yoon JS, Khoo KH, Akhavan AA, Lagziel T, Ha M, Cox CA, Blanding R, Werthman EH, Caffrey J, Hultman CS. Changes in Burn Surgery Operative Volume and Metrics due to COVID-19. J Burn Care Res 2022; 43:1233-1240. [PMID: 35986489 PMCID: PMC9384663 DOI: 10.1093/jbcr/irac111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Due to COVID-19, hospitals underwent drastic changes to operating room policy to mitigate the spread of the disease. Given these unprecedented measures, we aimed to look at the changes in operative volume and metrics of the burn surgery service at our institution. A retrospective review was conducted for operative cases and metrics for the months of March to May for 2019, 2020, and 2021, which correspond with pre-COVID, early COVID (period without elective cases), and late COVID (period with resumed elective cases). Inclusion criteria were cases related to burns. Case types and operative metrics were compared amongst the three time periods. Compared to the hospital, the burn service had a smaller decrease in volume during early COVID (28.7% vs. 50.1%) and exceeded pre-pandemic volumes during late COVID (+21.8% vs. -4.6%). There was a significant increase in excision and grafting cases in early and late COVID periods (p < .0001 and p < .002). There was a significant decrease in laser scar procedures that persisted even during late COVID (p < .0001). The projected and actual lengths of cases significantly increased and persisted into late COVID (p < .01). COVID-19 related operating room closures led to an expected decrease in the number of operative cases. However, there was no significant decline in the number of burn specific cases. The elective cases were largely replaced with excision and grafting cases and this shift has persisted even after elective cases have resumed. This change is also reflected in increased operative times.
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Affiliation(s)
- Joshua S Yoon
- Division of Plastic, Reconstructive & Maxillofacial Surgery, R Adams Cowley Shock Trauma Center , Baltimore, MD USA
- Department of Surgery, George Washington University Hospital , Washington, DC USA
| | - Kimberly H Khoo
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Arya A Akhavan
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Tomer Lagziel
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
| | - Michael Ha
- Division of Plastic Surgery, University of Maryland School of Medicine , Baltimore, MD USA
| | - Carrie A Cox
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Renee Blanding
- Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - Emily H Werthman
- Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
- Department of Pain and Translational Symptom Science, University of Maryland School of Nursing , Baltimore, MD USA
| | - Julie Caffrey
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
| | - C Scott Hultman
- Department of Plastic and Reconstructive Surgery, Johns Hopkins University , Baltimore, MD USA
- Adult Burn Center, Johns Hopkins University Bayview Medical Center , Baltimore, MD USA
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12
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Altıner S, Tuncal S, Ünal Y, Çöl M, Büyükkasap Ç, Pekcici MR. The effect of COVID-19 pandemic on the number of patients in burns services. Int Wound J 2022; 19:1975-1979. [PMID: 35808900 PMCID: PMC9434328 DOI: 10.1111/iwj.13797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/09/2022] [Indexed: 11/29/2022] Open
Abstract
This study was conducted to examine the effects of the coronavirus disease 2019 (COVID‐19) pandemic on the epidemiological characteristics and causes of burns in patients admitted to burns services. A total of 629 patients who applied to the burn center of our hospital on March 11 to June 11, 2019, and March 11 to June 11, 2020, were included in this single‐center, retrospective study. The demographic information of the patients, causes of burns, burn degrees, affected anatomical areas, admission times and burn surface areas were recorded retrospectively according to patient records. The findings of our study suggest that gender, age, causes of burns, affected anatomical areas and application times did not differ before and after the COVID‐19 pandemic. The number of cases has significantly decreased during the COVID‐19 pandemic compared with that of the previous year. As a result, burn trauma is an emergency; it is preventable and cannot be ignored. The COVID‐19 pandemic has had many effects on social, cultural and economic fields, as well as on the field of health.
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Affiliation(s)
- Saygın Altıner
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - Salih Tuncal
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - Yılmaz Ünal
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - Mert Çöl
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
| | - Çağrı Büyükkasap
- Department of General Surgery, Gazi University Faculty of Medicine, Ankara, Turkey
| | - M Recep Pekcici
- Department of General Surgery, Ankara Training and Research Hospital, Ankara, Turkey
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13
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Kohlhauser M, Luze H, Nischwitz SP, Kamolz LP. Challenges in Burn Care during the COVID-19 Pandemic-A Scoping Review. J Clin Med 2022; 11:jcm11123410. [PMID: 35743479 PMCID: PMC9225094 DOI: 10.3390/jcm11123410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/07/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022] Open
Abstract
Objective: The aim of this review is to map and summarize the experiences of various burn centers worldwide during the COVID-19 pandemic, in order to enable future strategies with regard to the most effective measures in burn care during pandemics and to detect possible gaps in knowledge. Background: The coronavirus disease 2019 (COVID-19) pandemic had a major impact on economies, social interactions, and health systems worldwide. Burn units all over the world face a new challenge in maintaining the care of acute burn wounds and follow-up treatments while dealing with constantly changing regulations. Infrastructural changes, the establishment of efficient triage systems, protective measures, personnel resources, in addition to the maintenance of efficient patient care and the guarantee of supply chains, are challenging tasks to be addressed. This review provides an overview of recent developments regarding different strategies and methods used by burn units worldwide to safely overcome the COVID-19 pandemic outbreak. Methods: A scoping review of the literature was conducted using the electronic databases PubMed and Google Scholar. Publications were screened for the following key terms: burns, burn injuries, thermal injuries, burn center, burn unit, burn ward, in combination with COVID-19, COVID-19 pandemic, SARS-CoV-2, Corona, and Coronavirus. Articles dealing with the management of burn units during the pandemic were further analyzed and included. Results: Of the 136 publications, 10 were considered relevant to the key question and were included in the present review. Results were divided into six major topics, such as infrastructural and personnel management, triaging, severe burns and emergencies, elective surgeries, patient and visitor management, and outpatient management. Conclusion: Only a few studies about managing burn units during the COVID-19 pandemic have been published. Personnel resources and equipment needed to be redistributed to cope with country-specific challenges during the COVID-19 pandemic and to maintain adequate burn care. Since all of these articles refer to the period of the initial outbreak, a lack of clinical studies exists regarding the prevention measures taken by burn units during the COVID-19 pandemic. In addition, we identified gaps in knowledge about the impact of implemented measures on burn patient outcomes in the published literature. Further studies are mandatory in order to provide generally applicable guidelines regarding COVID-19 prevention measures at a burn unit.
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Affiliation(s)
- Michael Kohlhauser
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (S.P.N.); (L.-P.K.)
- Correspondence:
| | - Hanna Luze
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (S.P.N.); (L.-P.K.)
| | - Sebastian Philipp Nischwitz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (S.P.N.); (L.-P.K.)
| | - Lars-Peter Kamolz
- Division of Plastic, Aesthetic and Reconstructive Surgery, Department of Surgery, Medical University of Graz, 8036 Graz, Austria; (H.L.); (S.P.N.); (L.-P.K.)
- COREMED—Cooperative Centre for Regenerative Medicine, Joanneum Research Forschungsgesellschaft mbH, 8010 Graz, Austria
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14
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Barreto Cazumbá ML, Buda AM, Bittencourt MM, Moura C, Braga P, Bowder AN, Corlew DS, Botelho F, Magalhães L, Pompermaier L. The use of alcohol as a disinfectant during the pandemic and flame burns: a Brazilian study. J Burn Care Res 2022; 43:753-754. [PMID: 35090170 DOI: 10.1093/jbcr/irac011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
| | - Alexandra M Buda
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - Marcela M Bittencourt
- Universidade José do Rosário Vellano, UNIFENAS, Belo Horizonte, Minas Gerais, Brazil
| | - Carolina Moura
- Faculdade da Saúde e Ecologia Humana, FASEH, Vespasiano, MG, Brazil
| | - Paula Braga
- Faculdade da Saúde e Ecologia Humana, FASEH, Vespasiano, MG, Brazil
| | - Alexis N Bowder
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | - D Scott Corlew
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA
| | | | | | - Laura Pompermaier
- Program in Global Surgery and Social Change, Harvard Medical School, Boston, MA, USA.,Department of Hand Surgery, Plastic Surgery and Burns, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
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