Impact of the First and Second Wave of the SARS-CoV-2 Pandemic on Severe Trauma and the Care Structures in the German TraumaNetzwerk DGU®

Colcuc, Christian; Fischer, Sebastian; Leimkühler, Philipp; Miersbach, Marco; Lefering, Rolf; Dgu, TraumaRegister; Wähnert, Dirk; Grüneweller, Niklas

doi:10.3390/jcm11237036

Cited by 3 publications

(3 citation statements)

References 13 publications

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“…During that phase, intensive care has been challenged a lot, and therapeutic changes may have occurred. However, separate analyses from the TR-DGU did not suggest that less trauma patients received intensive care, nor that length of stay did change during the pandemic ( 21 ).…”

Section: Discussionmentioning

confidence: 99%

Prediction of prolonged length of stay on the intensive care unit in severely injured patients—a registry-based multivariable analysis

Lefering,

Waydhas

2024

Front. Med.

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PurposeMortality is the primary outcome measure in severely injured trauma victims. However, quality indicators for survivors are rare. We aimed to develop and validate an outcome measure based on length of stay on the intensive care unit (ICU).MethodsThe TraumaRegister DGU of the German Trauma Society (DGU) was used to identify 108,178 surviving patients with serious injuries who required treatment on ICU (2014–2018). In a first step, need for prolonged ICU stay, defined as 8 or more days, was predicted. In a second step, length of stay was estimated in patients with a prolonged stay. Data from the same trauma registry (2019–2022, n = 72,062) were used to validate the models derived with logistic and linear regression analysis.ResultsThe mean age was 50 years, 70% were males, and the average Injury Severity Score was 16.2 points. Average/median length of stay on ICU was 6.3/2 days, where 78% were discharged from ICU within the first 7 days. Prediction of need for a prolonged ICU stay revealed 15 predictors among which injury severity (worst Abbreviated Injury Scale severity level), need for intubation, and pre-trauma condition were the most important ones. The area under the receiver operating characteristic curve was 0.903 (95% confidence interval 0.900–0.905). Length of stay prediction in those with a prolonged ICU stay identified the need for ventilation and the number of injuries as the most important factors. Pearson’s correlation of observed and predicted length of stay was 0.613. Validation results were satisfactory for both estimates.ConclusionLength of stay on ICU is a suitable outcome measure in surviving patients after severe trauma if adjusted for severity. The risk of needing prolonged ICU care could be calculated in all patients, and observed vs. predicted rates could be used in quality assessment similar to mortality prediction. Length of stay prediction in those who require a prolonged stay is feasible and allows for further benchmarking.

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Section: Discussionmentioning

confidence: 99%

Prediction of prolonged length of stay on the intensive care unit in severely injured patients—a registry-based multivariable analysis

Lefering,

Waydhas

2024

Front. Med.

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“…According to the European Commission report, with 66 road fatalities per million inhabitants, Poland remains one of the most dangerous countries to drive in Europe. In Germany, researchers reported a 3.7% decrease in car accidents and a 3.2% increase in bike accidents in a group of more than 40,000 severely injured patients from the German trauma registry during the lockdown [52]. According to the authors, social restrictions and an increase in those who switched to working from home resulted in less traffic and a decrease in MVCs.…”

Section: Injury Mechanismsmentioning

confidence: 99%

“…We observed a significant reduction in patient referrals with head trauma. Colcuc et al reported contradictory results in their multicenter analysis and recognized an increase in the percentage of head injuries during the lockdown period [52]. According to them, the lower physical activity in society with increased interest in bike-related sports were the reasons for this phenomenon.…”

Section: Anatomic Description Of Injurymentioning

confidence: 99%

Evaluating Changes in Trauma Epidemiology during the COVID-19 Lockdown: Insights and Implications for Public Health and Disaster Preparedness

Jojczuk,

Pawlikowski,

Kamiński

et al. 2023

Healthcare

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The COVID-19 pandemic demanded changes in healthcare systems worldwide. The lockdown brought about difficulties in healthcare access. However, trauma still required further attention considering its modifications. The presented study aims to investigate the variances in epidemiological patterns of trauma during the lockdown and the previous year, with a view to better understand the modifications in healthcare provision. The authors analyzed data from the first lockdown in 2020 (12 March–30 May) and the same period in 2019 from 35 hospitals in Lublin Province. A total of 10,806 patients in 2019 and 5212 patients in 2020 were included in the research. The uncovered changes adhered to the total admissions and mortality rate, the frequency of injuries in particular body regions, and injury mechanisms. The lockdown period resulted in a reduction in trauma, requiring an altered approach to healthcare provision. Our research indicates that the altered approach facilitated during such periods is essential for delivering tailored help to trauma patients.

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Foot and Ankle Trauma: Epidemiology Before, During, and Post COVID-19 Pandemic in a Level I Trauma Center: A 5-Year Experience and Data Analysis

Mascio,

Greco,

Comisi

et al. 2024

JCM

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Background: Foot and ankle injuries are one of the leading orthopedic causes of emergency department (ED) admissions. The purpose of this study was to analyze, through 5 years of data collection, differences in number and type of admissions, as well as the severity of foot and ankle trauma to the ED in the pre-pandemic period, during the COVID-19 emergency, and in the post-pandemic period. This study aims to assess epidemiological and clinical data. Methods: Five years of data were collected on admissions to the ED at the Fondazione Policlinico Universitario A. Gemelli using an electronic database. The system allowed the use of a numeric code assessed at triage ranging from 1 to 5, where 1 indicated a patient with compromised vital functions, and it continued in decreasing criticality. Data were extensively analyzed and extrapolated to obtain epidemiological and clinical evaluation. Results: Data from 3787 patients, including 1945 males with a mean age of 41.4 years, were collected. Data were evaluated in the three different periods. In the pre-pandemic period, 2228 ED admissions were recorded, including 1138 males with a mean age of 37.4 years and a mean of 2.79 admissions per day. Codes 3 and 4 reported in the ED triage were 4.8% and 90.1%, respectively; the average surgical treatment was 5.6%. During the COVID period, the total number of admissions was 981, with 501 males with an average age of 43.8 years and a mean of 1.30 admissions per day. Codes 3 and 4 were 22.5% and 72.7%, respectively; the average surgical treatment was 10.4%. In the post-COVID period, 578 admissions were, including 306 males with a mean age of 43.2 years, and a daily access rate of 1.58 patients. Codes 3 and 4 reported in the ED triage were 25.4% and 70.8%, respectively; the average surgical treatment was 8.6%. Conclusions: During the pandemic period due to COVID-19 a substantial decrease in total admissions per day in the ED was noted, but an increase in more complex codes occurred, as evidenced by the percentage increase in surgical admissions compared to total admissions during the pandemic; the mean age of users gradually increased. Total hospitalization data remained stable in the post-pandemic period, likely due to the global impact of the pandemic. COVID-19 radically and concretely changed people’s living habits and priorities for accessing the ED.

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Impact of the First and Second Wave of the SARS-CoV-2 Pandemic on Severe Trauma and the Care Structures in the German TraumaNetzwerk DGU®

Cited by 3 publications

References 13 publications

Prediction of prolonged length of stay on the intensive care unit in severely injured patients—a registry-based multivariable analysis

Prediction of prolonged length of stay on the intensive care unit in severely injured patients—a registry-based multivariable analysis

Evaluating Changes in Trauma Epidemiology during the COVID-19 Lockdown: Insights and Implications for Public Health and Disaster Preparedness

Foot and Ankle Trauma: Epidemiology Before, During, and Post COVID-19 Pandemic in a Level I Trauma Center: A 5-Year Experience and Data Analysis

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