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Illinois Trauma Following the 9/11/01 Terrorist Attacks

Illinois Trauma Following the 9/11/01 Terrorist Attacks. Scott A Miller, MD Edward P Sloan, MD, MPH University of Illinois at Chicago. Introduction: Clinical Issues. Sept 11 a significant day in history USA seemed to come to standstill Behavior of people altered significantly

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Illinois Trauma Following the 9/11/01 Terrorist Attacks

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  1. Illinois Trauma Following the 9/11/01 Terrorist Attacks Scott A Miller, MD Edward P Sloan, MD, MPH University of Illinois at Chicago

  2. Introduction:Clinical Issues • Sept 11 a significant day in history • USA seemed to come to standstill • Behavior of people altered significantly • Did the change in behavior affect trauma frequency?

  3. Introduction:Prior Work on Sept 11 • Johnston 2002: Fewer injuries, more CP after 9/11 • Schlenger 2002: More PTSD months after 9/11 • Galea 2002: More PTSD close to WTC • Silver 2002: More PTSD immediately after 9/11 • Schuster 2001: Stress increased after 9/11 • Cardenas 2002: More depression, ETOH, drugs • There was a change in psyche and behavior in the days following 9/11

  4. Introduction:Study Questions • What was the impact of Sept 11 on trauma? • Overall trauma? • Intentional vs. unintentional? • Chicago vs. Non-Chicago? • Was the weekly periodicity affected?

  5. Methods:Data Collection • Illinois Department of Public Health trauma registry • Statewide data from Level I & II trauma centers • Traumatic injuries • Admitted, transferred, or DOA • Discharged patients not included in registry • External classification of disease (E-code) to determine type of trauma

  6. Results:Mechanism of Injury • Most trauma was blunt and unintentional

  7. Results:Major Subgroup Comparison Intentional Chicago Unintentional Non-Chicago

  8. Results:Time Periods • Week One Sept 5-11, 2000 877 • Week Two Sept 12-18, 2000 859 • Week Three Sept 4-10, 2001 946 • Week Four Sept 11-17, 2001 792

  9. Results:Overall Trauma Volume • 2000 (Wk 1,2): 124/day • 2001 (Wk 3): 135/day +9.0% p<.002 • 2001 (Wk 4): 113/day -8.8% p<.008 • Despite greater trauma volume in 2001, it was reduced after 9/11

  10. Results:Difference Between Weeks 2000 Wk 1 2000 Wk 2 2001 Wk 3 2001 Wk 4

  11. Results:Difference Between Weeks

  12. Results:Unintentional Trauma • 2000 (Wk 1,2): 108/day • 2001 (Wk 3): 117/day +10.0% p<.003 • 2001 (Wk 4): 97/day -9.8% p<.018 • Unintentional trauma increased in 2001, with a significant decrease after 9/11

  13. Results:Non-Chicago Trauma • 2000 (Wk 1,2): 92/day • 2001 (Wk 3): 106/day +13.4% p<.003 • 2001 (Wk 4): 88/day -9.2% p<.049 • Trauma outside of Chicago was increased in 2001, but decreased after 9/11

  14. Results:Other Comparisons • Intentional—no significant change • Chicago—no significant change • No trauma center specific data

  15. Results: Week 3 2000 Week 4

  16. Results:Comparison by day • Week 4 volume less for every day of week • Still a periodicity in week 4 • Shape of curve similar to week 2, suggesting no significant difference in periodicity

  17. Conclusions:Illinois Trauma After 9/11 • Despite increasing in 2001, trauma volume significantly decreased after 9/11 • Change was in unintentional trauma and outside of urban setting • Decrease implies less risky behavior by population • Weekly periodicity remained after 9/11 with increase of trauma on weekend

  18. Recommendations:Trauma after 9/11 • Future research should link each trauma to the corresponding hospital. • Analyze other major events (Oklahoma city bombing, other terrorist attacks) • Nationwide analysis

  19. Implications:Trauma after 9/11 • Potential to divert resources

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