TY  - JOUR
PY  - 2021//
TI  - The effect of the COVID-19 pandemic on mental health associated trauma, admissions and fractures at a London major trauma centre
JO  - Annals of the Royal College of Surgeons of England
A1  - Hay, D.
A1  - Jamal, M. S.
A1  - Al-Tawil, K.
A1  - Petohazi, A.
A1  - Gulli, V.
A1  - Bednarczuk, N. F.
A1  - Baldwin-Smith, R.
A1  - Gibbons, J.
A1  - Sinha, J.
SP  - 114
EP  - 119
VL  - 103
IS  - 2
N2  - INTRODUCTION: Non-injury-related factors have been extensively studied in major trauma and have been shown to have a significant impact on patient outcomes. Mental illness and associated medication use has been proven to have a negative effect on bone health and fracture healing. <br><br>MATERIALS AND METHODS: We collated data retrospectively from the records of orthopaedic inpatients in a non-COVID and COVID period. We analysed demographic data, referral and admission numbers, orthopaedic injuries, surgery performed and patient comorbidities, including psychiatric history. <br><br>RESULTS: There were 824 orthopaedic referrals and 358 admissions (six/day) in the non-COVID period, with 38/358 (10.6%) admissions having a psychiatric diagnosis and 30/358 (8.4%) also having a fracture. This was compared with 473 referrals and 195 admissions (three/day) in the COVID period, with 73/195 (37.4%) admissions having a documented psychiatric diagnosis and 47/195 (24.1%) having a fracture. <br><br>DISCUSSION: There was a reduction in the number of admissions and referrals during the pandemic, but a simultaneous three-fold rise in admissions with a psychiatric diagnosis. The proportion of patients with both a fracture and a psychiatric diagnosis more than doubled and the number of patients presenting due to a traumatic suicide attempt almost tripled. <br><br>CONCLUSION: While total numbers using the orthopaedic service decreased, the impact of the pandemic and lockdown disproportionately affects those with mental health problems, a group already at higher risk of poorer functional outcomes and non-union. It is imperative that adequate support is in place for patients with vulnerable mental health during these periods, particularly as we look towards a potential 'second wave' of COVID-19.<p />  <p>Language: en</p>
LA  - en
SN  - 0035-8843
UR  - http://dx.doi.org/10.1308/rcsann.2020.7026
ID  - ref1
ER  -