Injury Mechanism, Volume, and Severity of General Surgical Trauma Patients During COVID-19 Lockdown

Abstract

BackgroundAfter the declaration of the COVID-19 pandemic, countries have taken many restriction measures to reduce the spread of the virus and ensure the health system's proper functioning. Our knowledge about the general surgery trauma patients being affected by the restrictions is very limited. ObjectiveTo examine the association of the lockdown measurements during the COVID-19 pandemic with general surgical trauma patients' volume and severity at a university teaching hospital. MethodsAll patients admitted to the emergency department because of trauma and evaluated by the general surgery team were examined in two groups. The COVID-19 restrictions period ( 17March 2020 -31 May 2020) and the corresponding time last year (17 March 2019 -31 May 2019). Demographic properties, injury mechanisms, emergency trauma scores (ETS), hospital length of stays (HLOS), intensive care unit (ICU) admission rates, surgical interventions, and mortality were compared. ResultsThe number of patients in the restrictions period is 30% lower than the before COVID-19 cohort. ETS was significantly higher in the restrictions period compared to the previous year, whereas no significant difference was detected in terms of injury mechanisms between the groups (p=0.001 vs p=0.493, respectively). HLOS was found to be higher in the restrictions period (p=0.038). ConclusionsAlthough there was a decrease in the number of general surgical trauma admissions, a significant increase in the severity of trauma was observed during COVID-19 restrictions. We hope these findings will help authorities to guide resource allocation in future pandemic waves.

Emergencies do not shut down during a pandemic: COVID pandemic impact on Acute Care Surgery volume and mortality at a level I trauma center

“…Several trauma centers saw decreased overall and blunt volume by up to 22% 11 but increased penetrating rates by up to 30% and increased severity of presentation. 12 , 13 , 14 , 15 , 16 In other countries the pandemic was associated with decreased intensive care unit (ICU) admission and increased mortality in traumatic brain injury subgroups, 17 however the trauma mortality rate in large US series was similar to pre-pandemic levels. 15 , 16 Additionally, emergency surgical conditions continued to present, and some evidence demonstrated later presentation and increased severity, possibly due to fear of COVID exposure or overutilizing the already taxed medical system.…”