Impact of the COVID-19 Pandemic on Trauma Encounters

Abstract

Objectives The Coronavirus Disease 2019 pandemic has affected the health care system significantly. We compare 2019 to 2020 to evaluate how trauma encounters has changed during the pandemic. Methods Retrospective analysis using a large US health care system to compare trauma demographics, volumes, mechanisms of injury, and outcomes. Statistical analysis was used to evaluate for significant differences comparing 2019 to 2020. Results Data was collected from 88 hospitals across 18 states. 169 892 patients were included in the study. There were 6.3% fewer trauma patient encounters in 2020 compared to 2019. Mechanism of injury was significantly different between 2019 and 2020 with less blunt injuries (89.64% vs. 88.39%, P < .001), more burn injuries (1.84% vs. 2.00%, P = .021), and more penetrating injuries (8.58% vs. 9.75%, P < .001). Compared to 2019, patients in 2020 had higher mortality (2.62% vs. 2.88%, P < .001), and longer hospital LOS (3.92 ± 6.90 vs. 4.06 ± 6.56, P < .001). Conclusion The COVID-19 pandemic has significantly affected trauma patient demographics, LOS, mechanism of injury, and mortality.

Coronavirus Disease 2019 and the Injured Patient: A Multicenter Review

“…COVID 19+ patients had a lower overall survival probability than COVID 19-patients (Figure 3). Similarly, COVID 19+ patients had longer discharge probability with a longer time to discharge (Median [IQR] = 5 [4][5][6][7] vs. 3 [3][4] days) compared to COVID 19-patients (Figure 3).…”

“…[3][4][5] Other studies on the impact of the pandemic on trauma centers and outcomes of trauma patients revealed an increased risk of mortality, longer length of stay and pulmonary complications in COVID-19 positive (COVID 19+) patients, along with fewer traumatic blunt injury encounters. 6,7 Increased complications have also been seen in other surgical COVID 19+ patients as compared to COVID-19 negative (COVID 19-) patients; mainly pulmonary in nature, followed by multi-organ complications. 8 To our knowledge, none of these studies identified a biochemical marker associated with the risk of worse outcomes for COVID 19+ trauma patients.…”

The Impact of the COVID-19 Pandemic on the Pattern of Trauma Presenting to a Tertiary Care Trauma Centre in Oman

“…This change was also demonstrated in studies conducted in the United States of America and the United Kingdom. 8,17,18 The increase in penetrating injuries has reached up to 21% in a multicenter retrospective study from South California, USA. 19 This was attributed to the socio-economic stress that resulted from the pandemic such as cutting down working staff and a rise in unemployment rate.…”

Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic

“…This finding could be due to either coincidental regional factors, as the impact of COVID-19 on trauma centers was variable, or a result of true differences in management between different levels of trauma center. 22 , 42 To our knowledge, there are no studies on this topic. Further studies with a larger number of both Level-I and especially Level-II centers are needed to confirm whether trauma center level alone is associated with outcomes during COVID.…”