Hatem Abdallah, MD
Intern
Massachusetts General Hospital, United States
Disclosure information not submitted.
Michael Vella, MD, MBA
Associate Trauma Medical Director, Kessler Trauma Center
University of Rochester School of Medicine and Dentistry, United States
Disclosure information not submitted.
Paul Burchard, MD
Resident
University of Rochester School of Medicine and Dentistry, United States
Disclosure information not submitted.
Lewis Kaplan, MD, FACS, FCCP,FCCM
Professor, Surgery
Perelman SOM, U of Pennsylvania
Philadelphia, Pennsylvania
Disclosure information not submitted.
Jose Pascual, MD, PhD, FACS
Professor of Surgery
Hospital of the University of Pennsylvania and the Presbyterian Medical Center of Philadelphia, United States
Disclosure information not submitted.
Title: A Uniquely Violent Year: The Impact of Social and Political Events on 2020 Urban Injury Patterns
Introduction: 2020 was marked by social and political events that substantially disrupted healthcare. The COVID-19 pandemic, lockdown, public health measures, as well as civic and political unrest over racial tensions during an election year could plausibly impact injury care. We hypothesized that increased injuries related to high-risk activities during 2020 was temporally related to sociopolitical unrest and pandemic public health measures.
Methods: Retrospective data from two Level 1 urban, adult trauma centers in different US states (City A population:1.6M, City B:0.21M) were assessed (1/1/2020-12/31/2020). Calendar months were divided into quartiles and compared to analogous quartiles in years 2016 -2019. Variables studied (demographics, injury mechanisms and outcomes) were compared between years, and across 2020 quartiles, against a backdrop of key sociopolitical events.
Results: More patients presented for injury in 2020 (A: n=1057, B: n= 1053) than in prior years (p< 0.05). Compared to 2016-2019, 2020, patients were more often black (A:63.1% vs. 69.8% p< 0.001; B:31.0% vs. 34.3%, p=0.02). Institution A patients were more likely to be male (p=0.002) & younger (p< 0.001) in 2020 vs. 2016-2019. Both institutions noted a steep rise in gunshot wound (GSW) and motor vehicle collision (MVC) injuries following state lockdowns (Fig A, B) with a persistent rise in GSWs until late fall (Fig C).
Conclusions: 2020 was a unique year of sociopolitical unrest interwoven with a pandemic. Most affected populations were young, black males in two different urban centers and primarily involved GSWs and MVCs. Future disaster response planning should consider the drivers of these trends to mitigate their impact, especially in vulnerable populations.