@article{ref1,
title="Changes in traumatic mechanisms of injury in southern California related to CoViD-19: penetrating trauma as a second pandemic",
journal="Journal of trauma and acute care surgery",
year="2020",
author="Nahmias, Jeffry and Grabar, Christina and Leung, Amanda and Naaseh, Ariana and Chinn, Justine and Johnson, Arianne and Grigorian, Areg and Yeates, Eric O. and Barmparas, Galinos and Owattanapanich, Natthida and Schellenberg, Morgan and Barrios, Cristobal and Diaz, Graal and Barbaro, Casey and Duncan, Thomas K. and Schaffer, Kathryn B. and Biffl, Walter L. and Wintz, Diane and Curry, Terry and Santorelli, Jarrett and Costantini, Todd and Firek, Christopher and Brenner, Megan and Figueras, Ryan and Lin, Ann and Penaloza-Villalobos, Liz and Burruss, Sigrid and Tilou, Areti and Cryer, Henry and Garber, Kent and Juillard, Catherine and Margulies, Daniel",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND: The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19, 2020, forcing large-scale behavioral changes and  taking an emotional and economic toll. The effects of SAH orders on the trauma  population remains unknown. We hypothesized an increase in rates of penetrating  trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern  California trauma population after the SAH order. <br><br>METHODS: A multicenter  retrospective analysis of all trauma patients presenting to 11 American College of  Surgeons (ACS) Level I and II trauma centers spanning seven counties in California  was performed. Demographic data, injury characteristics, clinical data, and outcomes  were collected. Patients were divided into three groups based on injury date: before  SAH from 1/1/2020-3/18/2020 (PRE), after SAH from 3/19/2020-6/30/2020 (POST), and a  historical control from 3/19/2019-6/30/2019 (CONTROL). POST was compared to both PRE  and CONTROL in two separate analyses. <br><br>RESULTS: Across all time periods, 20,448  trauma patients were identified (CONTROL: 7,707, PRE: 6,022, POST: 6,719). POST had  a significantly increased rate of penetrating trauma (13.0% vs. 10.3%, p<0.001 and  13.0% vs. 9.9%, p<0.001) and gunshot wounds (4.5% vs. 2.4%, p=0.002 and 4.5% vs. 3.7%, p=0.025) compared to PRE and CONTROL, respectively. POST had a suicide attempt  rate of 1.9% and a domestic violence rate of 0.7%, which were similar to PRE  (p=0.478, p=0.514) and CONTROL (p=0.160, p=0.618). <br><br>CONCLUSIONS: This multicenter  Southern California study demonstrated an increased rate of penetrating trauma and  gunshot wounds after the COVID-19 SAH orders, but no difference in attempted suicide  or domestic violence rates. These findings may provide useful information regarding  resource utilization and a target for societal intervention during the current or  future pandemic(s). LEVEL OF EVIDENCE: IV.<p /> <p>Language: en</p>",
language="en",
issn="2163-0755",
doi="10.1097/TA.0000000000003068",
url="http://dx.doi.org/10.1097/TA.0000000000003068"
}