Impact of the COVID‐19 pandemic on epidemiology, treatment, and outcome of major trauma in Japan in 2020: a retrospective observational nationwide registry‐based study

Abstract

Aim The nationwide impact of the coronavirus disease (COVID‐19) pandemic on major trauma in Japan is unknown. The nationwide registry‐based data of the Japanese Trauma Data Bank were analyzed to elucidate the impact of COVID‐19 on the epidemiology, treatment, and outcomes of major trauma patients. Methods Among patients transported directly from the injury site by ambulance with an Injury Severity Score of ≥16, we compared patients managed from April to December in 2019 to those managed from April to December in 2020. Results In total, 9792 patients were included in this study (2019, n = 5194; 2020, n = 4598). There were no significant differences in age or sex, but there were significant differences between 2019 and 2020 in the rates of “self‐injury (suicide)”, “motor vehicle accident”, “fall from height”, “fall down”, and “fall to the ground”, which are factors associated with patient age. Injury severity in 2019 and 2020 did not differ to a statistically significant extent, but the rate of major spinal injury increased. The time of prehospital care significantly increased in 2020 compared to 2019. There was no noticeable change in hospital treatment or in‐hospital mortality between 2019 and 2020. Conclusion This study suggests that the COVID‐19 pandemic might have altered the injuries of major trauma; however, medical services for major trauma were well supplied in Japan in 2020.

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

“…An increase in mean age was observed in a study of major trauma admissions in four hospitals in Finland presented by Riuttanen et al [47]. On the other hand, in a large database study of trauma admission during the COVID-19 pandemic in Japan, a significant difference in mean age was not reported [48]. This study analyzed only major trauma and assessed the influence of COVID-19 over a longer time period than in our study.…”

“…In the study by Ghafil et al, trends in trauma admissions (14,000 admissions) during the COVID-19 pandemic in 15 trauma centers in Los Angeles Country were analyzed, and they found no significant differences in transportation injuries and falls compared with the same period in 2020 [51]. Ojiima et al assessed the impact of the COVID-19 pandemic on major trauma in Japan, and a significant decrease in motorvehicle collision (MVC) injuries was reported during the lockdown period [48]. Moyer also reported a statistically significant reduction in cases only in MVCs among major trauma patients in France [41].…”

Factors associated with difficulty in hospital acceptance during the COVID-19 pandemic period in Osaka Prefecture, Japan: a population-based study

“…In contrast, a systemic review of severe trauma during the restriction policy period in the first wave of the COVID-19 pandemic reported that the number of severe trauma patients decreased during this wave of the COVID-19 pandemic, but severity and mortality remained the same ( 22 ). Another study analyzing a multicenter trauma registry in Japan reported that time related to prehospital care increased during the pandemic in 2020, but in-hospital mortality did not change ( 23 ). As more patient occupy treatment space at medical facilities, emergency patients will have to be transported by ambulance to distant medical facilities because the facilities will not be able to accept excess patients.…”