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Musculoskeletal Attendances to a Minor Injury Department During a Pandemic
Richard J Dowell1, Neil Ashwood2, Jamie Hind3
1Emergency Department, University Hospitals of Derby and Burton, Derby, GBR.
Insights
Emergency department visits, including musculoskeletal trauma, significantly decreased during the COVID-19 lockdown. However, fractures and soft tissue injuries still presented, possibly due to increased DIY accidents and altered behaviors.
Area of Science:
- Emergency Medicine
- Public Health
- Traumatology
Background:
- The COVID-19 pandemic led to widespread lockdowns and social distancing measures globally.
- Emergency departments in the UK observed a marked decline in patient attendances during lockdown periods compared to previous years.
- Musculoskeletal (MSK) trauma cases also showed a significant reduction in emergency department visits.
Purpose of the Study:
- To conduct a retrospective audit investigating injury patterns presenting to emergency departments during the COVID-19 pandemic.
- To specifically analyze injury trends during the stringent lockdown phases of the pandemic.
Main Methods:
- A retrospective audit of electronic medical record data from Queens Hospital Burton.
- Data collected during the first UK lockdown period (2020) and compared with the same period in 2019.
- Analysis included overall emergency department complaints and specific diagnoses/activity status for minor injuries.
Main Results:
- Overall emergency department attendances dropped by 45.42% during the first lockdown compared to 2019.
- MSK complaints decreased significantly: back pain by 58.88%, neck pain by 78.52%, and limb problems by 59.74%.
- In the minor injury department, limb problems decreased by 20.45%, soft tissue injuries by 24.05%, and fractures by 7.96%.
Conclusions:
- Emergency department attendances, including MSK injuries, were substantially reduced during the COVID-19 lockdown.
- Fracture and soft tissue injury rates in the minor injury department decreased, but not proportionally to overall attendance.
- Continued presentations of fractures and soft tissue injuries may be linked to increased DIY-related incidents and altered behaviors during lockdown, warranting further investigation.
Introduction:
As coronavirus disease 2019 (COVID-19) became a public health emergency of international concern, countries across the globe began to instate strict social distancing restrictions or "lockdowns". During these times emergency departments in the United Kingdom (UK) recorded a significant drop in patients attending when compared to the same months of previous years. Attendances related to musculoskeletal (MSK) trauma also saw a significant drop in numbers Objective: The purpose of this retrospective audit was to investigate patterns of injuries attending during the pandemic and more specifically during times of lockdown.
Method:
Retrospective audit data was collected from an electronic medical record system (MediTech V6) during the time period of the first lockdown in the UK. Data was collected for patients attending the emergency department at the Queens Hospital Burton site of the University Hospitals of Derby and Burton National Health Service (NHS) Trust. Presenting complaints were recorded for the entire emergency department, and diagnosis on discharge and activity status was recorded for minor injuries only. This data was then compared to the same date from 2019.
Results:
Overall attendances in the emergency department decreased by 45.42% during the first lockdown when compared to the same time period in 2019. MSK problems also saw a significant drop as back pain decreased by 58.88%, neck pain fell by 78.52% and limb problems decreased by 59.74%. When comparing data from the minor injury department, limb problems decreased by 20.45%. The number of soft tissue injuries decreased by 24.05% and fractures decreased by 7.96%.
Conclusion:
Attendances in the emergency department were greatly reduced during the COVID-19 pandemic, especially during the first lockdown. The rates of fractures and soft tissue injuries within the minors' area of the emergency department were also reduced but not at the same rate as the overall attendance. A large number of fractures and soft tissue injuries still presented to the emergency department despite reduced national activity. These attendances may be as a result of the increased rate of Do It Yourself (DIY)-related injuries and altered patient/social behaviour due to lockdown, social distancing, and seasons/weather. Further research would be required to investigate the changing patterns of behaviour especially as we enter a second wave of cases.
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