Impact of COVID-19 pandemic on injury prevalence and pattern in the Washington, DC Metropolitan Region: a multicenter study by the American College of Surgeons Committee on Trauma, Washington, DC

Abstract

BackgroundThe COVID-19 pandemic has had far-reaching effects on healthcare systems and society with resultant impact on trauma systems worldwide. This study evaluates the impact the pandemic has had in the Washington, DC Metropolitan Region as compared with similar months in 2019.DesignA retrospective multicenter study of all adult trauma centers in the Washington, DC region was conducted using trauma registry data between January 1, 2019 and May 31, 2020. March 1, 2020 through May 31, 2020 was defined as COVID-19, and January 1, 2019 through February 28, 2020 was defined as pre-COVID-19. Variables examined include number of trauma contacts, trauma admissions, mechanism of injury, Injury Severity Score, trauma center location (urban vs. suburban), and patient demographics.ResultsThere was a 22.4% decrease in the overall incidence of trauma during COVID-19 compared with a 3.4% increase in trauma during pre-COVID-19. Blunt mechanism of injury decreased significantly during COVID-19 (77.4% vs. 84.9%, p<0.001). There was no change in the specific mechanisms of fall from standing, blunt assault, and motor vehicle crash. The proportion of trauma evaluations for penetrating trauma increased significantly during COVID-19 (22.6% vs. 15.1%, p<0.001). Firearm-related and stabbing injury mechanisms both increased significantly during COVID-19 (11.8% vs. 6.8%, p<0.001; 9.2%, 6.9%, p=0.002, respectively).Conclusions and relevanceThe overall incidence of trauma has decreased since the arrival of COVID-19. However, there has been a significant rise in penetrating trauma. Preparation for future pandemic response should include planning for an increase in trauma center resource utilization from penetrating trauma.Level of evidenceEpidemiological, level III.

Adding to the story, did penetrating trauma really increase? changes in trauma patterns during the COVID-19 pandemic: A multi-institutional, multi-region investigation

“…This was consistent with previously reported patterns of trauma during the COVID-19 pandemic suggest decreased total trauma volume with statistically significant decreases in blunt injury and concomitant marginal increases in penetrating trauma during the COVID-19 pandemic. [15] , [16] , [17] , [18] , [19] , [20] Results from the present study refine and elaborate upon described changes in patterns of trauma during the pandemic by showing region specific responses in trauma patterns to implemented SAHOs.…”

“…Many single institution or single-region investigations completed by the academic trauma community reported a significant decrease in total trauma volume with a minor yet important shift towards higher proportions of penetrating injuries during the first part of the COVID-19 pandemic. [15] , [16] , [17] , [18] , [19] , [20] …”

Impact of coronavirus disease 2019 (COVID-19) on trauma surgical education at a level I trauma center

“…The total number was increased in 2020 compared to 2019 but did not demonstrate statistical significance. This trend has been demonstrated by studies conducted in Washington DC, Philadelphia, and London with similar results [30][31][32]. Future pandemics may lead to similar trends.…”

Changes in the characteristics of trauma patients after the early COVID-19 outbreak

“…Chodos et al reported that penetrating trauma increased significantly during COVID-19, and other mechanisms, including falls and motor vehicle accidents, showed no change during COVID-19 in Washington DC. [ 7 ] Sephton et al reported that all the injury patterns were reduced, except for pushbike-related accidents. [ 8 ] Maletizke et al also reported that the proportion of household injuries, bicycle accidents, and domestic violence increased during the COVID-19 pandemic.…”