The coronavirus disease 2019 (COVID-19) stay-at-home order’s unequal effects on trauma volume by insurance status in Southern California

Yeates, Eric O; Juillard, Catherine; Grigorian, Areg; Schellenberg, Morgan; Owattanapanich, Natthida; Barmparas, Galinos; Margulies, Daniel R.; Garber, Kent; Cryer, H. Gill; Tillou, Areti; Burruss, Sigrid; Penaloza-Villalobos, Liz; Lin, Ann; Figueras, Ryan Arthur; Brenner, Megan; Firek, Christopher J.; Costantini, Todd W.; Santorelli, Jarrett; Curry, Terry; Wintz, Diane; Biffl, Walter L.; Schaffer, Kathryn B.; Duncan, Tyrone E.; Barbaro, Casey; Diaz, Graal; Johnson, Arianne; Chinn, Justine; Naaseh, Ariana; Leung, Amanda; Grabar, Christina; Yeates, T.O.; Nahmias, Jeffry

doi:10.1016/j.surg.2021.02.060

Cited by 9 publications

(21 citation statements)

References 23 publications

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“…This occurred even in the setting of known increased use of some illicit substances during the COVID pandemic as well as an increased rate of Medicaid patients. 35,36 Our findings are similar to prior studies dedicated to examining changes in trauma volume and mechanisms of injury, though these studies had significant limitations. 17,22,24 Notably, these studies did not account for the increase in penetrating trauma during the COVID pandemic.…”

Section: Discussionsupporting

confidence: 86%

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

Yeates

Grigorian

Schellenberg

et al. 2022

The American Journal of Surgery

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Section: Discussionsupporting

confidence: 86%

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

Yeates

Grigorian

Schellenberg

et al. 2022

The American Journal of Surgery

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“…Similar findings have been described in the adult trauma population as well. 20 This indicates that the COVID-19 SAH orders inadequately protected lower income individuals, possibly for the adult population because they were more likely to be part of the essential workforce and unable to work from home, and thus more likely to experience trauma. While the Medicaid adolescent population may not have a similar work burden, they may have had less adult supervision as their parents continued to work.…”

Section: Discussionmentioning

confidence: 99%

Adolescent Trauma During the COVID Pandemic: Just Like Adults, Children, or Someone Else?

Ruhi-Williams

Yeates

Grigorian

et al. 2022

The American Surgeon

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COVID-19 stay-at-home (SAH) orders were impactful on adolescence, when social interactions affect development. This has the potential to change adolescent trauma. A post-hoc multicenter retrospective analysis of adolescent (13-17 years-old) trauma patients (ATPs) at 11 trauma centers was performed. Patients were divided into 3 groups based on injury date: historical control (CONTROL:3/19/2019-6/30/2019, before SAH (PRE:1/1/2020-3/18/2020), and after SAH (POST:3/19/2020-6/30/2020). The POST group was compared to both PRE and CONTROL groups in separate analyses. 726 ATPs were identified across the 3 time periods. POST had a similar penetrating trauma rate compared to both PRE (15.8% vs 13.8%, P = .56) and CONTROL (15.8% vs 14.5%, P = .69). POST also had a similar rate of suicide attempts compared to both PRE (1.2% vs 1.5%, P = .83) and CONTROL (1.2% vs 2.1%, P = .43). However, POST had a higher rate of drug positivity compared to CONTROL (28.6% vs 20.6%, P = .032), but was similar in all other comparisons of alcohol and drugs to PRE and POST periods (all P > .05). Hence ATPs were affected differently than adults and children, as they had a similar rate of penetrating trauma, suicide attempts, and alcohol positivity after SAH orders. However, they had increased drug positivity compared to the CONTROL, but not PRE group.

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“…Significant shifts within the adult trauma population during COVID-19 are now well described and include an increase in penetrating trauma and drug use, variations in trauma volume based on insurance status, and a shorter length of stay (LOS) [ 17 – 26 ]. However, studies dedicated to the pediatric trauma population are sparse and have been mostly single-center in design [ 27 – 34 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of the COVID-19 pandemic on pediatric trauma in Southern California

et al. 2021

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Purpose The COVID-19 pandemic resulted in increased penetrating trauma and decreased length of stay (LOS) amongst the adult trauma population, findings important for resource allocation. Studies regarding the pediatric trauma population are sparse and mostly single-center. This multicenter study examined pediatric trauma patients, hypothesizing increased penetrating trauma and decreased LOS after the 3/19/2020 stay-at-home (SAH) orders. Methods A multicenter retrospective analysis of trauma patients ≤ 17 years old presenting to 11 centers in California was performed. Demographic data, injury characteristics, and outcomes were collected. Patients were divided into three groups based on injury date: 3/19/2019–6/30/2019 (CONTROL), 1/1/2020–3/18/2020 (PRE), 3/19/2020–6/30/2020 (POST). POST was compared to PRE and CONTROL in separate analyses. Results 1677 patients were identified across all time periods (CONTROL: 631, PRE: 479, POST: 567). POST penetrating trauma rates were not significantly different compared to both PRE (11.3 vs. 9.0%, p = 0.219) and CONTROL (11.3 vs. 8.2%, p = 0.075), respectively. POST had a shorter mean LOS compared to PRE (2.4 vs. 3.3 days, p = 0.002) and CONTROL (2.4 vs. 3.4 days, p = 0.002). POST was also not significantly different than either group regarding intensive care unit (ICU) LOS, ventilator days, and mortality (all p > 0.05). Conclusions This multicenter retrospective study demonstrated no difference in penetrating trauma rates among pediatric patients after SAH orders but did identify a shorter LOS.

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The coronavirus disease 2019 (COVID-19) stay-at-home order’s unequal effects on trauma volume by insurance status in Southern California

Cited by 9 publications

References 23 publications

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

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

Adolescent Trauma During the COVID Pandemic: Just Like Adults, Children, or Someone Else?

Effects of the COVID-19 pandemic on pediatric trauma in Southern California

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