Impact of COVID-19 pandemic on injury prevalence and pattern in the Washington, DC Metropolitan Region: a multicenter study by the American College of Surgeons Committee on Trauma, Washington, DC.

COVID-19 injury

Journal

Trauma surgery & acute care open
ISSN: 2397-5776
Titre abrégé: Trauma Surg Acute Care Open
Pays: England
ID NLM: 101698646

Informations de publication

Date de publication:
2021
Historique:
received: 04 12 2020
revised: 01 01 2021
accepted: 04 01 2021
entrez: 30 6 2021
pubmed: 1 7 2021
medline: 1 7 2021
Statut: epublish

Résumé

The COVID-19 pandemic has had far-reaching effects on healthcare systems and society with resultant impact on trauma systems worldwide. This study evaluates the impact the pandemic has had in the Washington, DC Metropolitan Region as compared with similar months in 2019. A retrospective multicenter study of all adult trauma centers in the Washington, DC region was conducted using trauma registry data between January 1, 2019 and May 31, 2020. March 1, 2020 through May 31, 2020 was defined as COVID-19, and January 1, 2019 through February 28, 2020 was defined as pre-COVID-19. Variables examined include number of trauma contacts, trauma admissions, mechanism of injury, Injury Severity Score, trauma center location (urban vs. suburban), and patient demographics. There was a 22.4% decrease in the overall incidence of trauma during COVID-19 compared with a 3.4% increase in trauma during pre-COVID-19. Blunt mechanism of injury decreased significantly during COVID-19 (77.4% vs. 84.9%, p<0.001). There was no change in the specific mechanisms of fall from standing, blunt assault, and motor vehicle crash. The proportion of trauma evaluations for penetrating trauma increased significantly during COVID-19 (22.6% vs. 15.1%, p<0.001). Firearm-related and stabbing injury mechanisms both increased significantly during COVID-19 (11.8% vs. 6.8%, p<0.001; 9.2%, 6.9%, p=0.002, respectively). The overall incidence of trauma has decreased since the arrival of COVID-19. However, there has been a significant rise in penetrating trauma. Preparation for future pandemic response should include planning for an increase in trauma center resource utilization from penetrating trauma. Epidemiological, level III.

Sections du résumé

BACKGROUND BACKGROUND
The COVID-19 pandemic has had far-reaching effects on healthcare systems and society with resultant impact on trauma systems worldwide. This study evaluates the impact the pandemic has had in the Washington, DC Metropolitan Region as compared with similar months in 2019.
DESIGN METHODS
A retrospective multicenter study of all adult trauma centers in the Washington, DC region was conducted using trauma registry data between January 1, 2019 and May 31, 2020. March 1, 2020 through May 31, 2020 was defined as COVID-19, and January 1, 2019 through February 28, 2020 was defined as pre-COVID-19. Variables examined include number of trauma contacts, trauma admissions, mechanism of injury, Injury Severity Score, trauma center location (urban vs. suburban), and patient demographics.
RESULTS RESULTS
There was a 22.4% decrease in the overall incidence of trauma during COVID-19 compared with a 3.4% increase in trauma during pre-COVID-19. Blunt mechanism of injury decreased significantly during COVID-19 (77.4% vs. 84.9%, p<0.001). There was no change in the specific mechanisms of fall from standing, blunt assault, and motor vehicle crash. The proportion of trauma evaluations for penetrating trauma increased significantly during COVID-19 (22.6% vs. 15.1%, p<0.001). Firearm-related and stabbing injury mechanisms both increased significantly during COVID-19 (11.8% vs. 6.8%, p<0.001; 9.2%, 6.9%, p=0.002, respectively).
CONCLUSIONS AND RELEVANCE CONCLUSIONS
The overall incidence of trauma has decreased since the arrival of COVID-19. However, there has been a significant rise in penetrating trauma. Preparation for future pandemic response should include planning for an increase in trauma center resource utilization from penetrating trauma.
LEVEL OF EVIDENCE METHODS
Epidemiological, level III.

Identifiants

pubmed: 34192164
doi: 10.1136/tsaco-2020-000659
pii: tsaco-2020-000659
pmc: PMC7817381
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e000659

Informations de copyright

© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: None declared.

Références

J Emerg Med. 2020 Oct;59(4):602-603
pubmed: 32737006
N Z Med J. 2020 Apr 24;133(1513):81-88
pubmed: 32325471
Bone Jt Open. 2020 Nov 1;1(6):261-266
pubmed: 33215112
PLoS One. 2016 Mar 15;11(3):e0150939
pubmed: 26977599
West J Emerg Med. 2020 May 22;21(4):819-822
pubmed: 32726250
Trauma Surg Acute Care Open. 2020 May 7;5(1):e000505
pubmed: 32426529
BMJ Glob Health. 2020 May;5(5):
pubmed: 32404471
Ann Surg. 2020 Aug;272(2):e53-e54
pubmed: 32675495
Afr J Emerg Med. 2020 Dec;10(4):193-196
pubmed: 32837876
Crime Sci. 2020;9(1):6
pubmed: 32455094
Am J Emerg Med. 2021 Jan;39:225-226
pubmed: 32444297
JAMA Netw Open. 2019 Oct 2;2(10):e1912850
pubmed: 31596492
Injury. 2020 Oct;51(10):2332
pubmed: 32605787
Transfusion. 2018 Oct;58(10):2326-2334
pubmed: 30209804

Auteurs

Marc Chodos (M)

Orthopedic Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Babak Sarani (B)

Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Andrew Sparks (A)

Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Brandon Bruns (B)

Surgery, University of Maryland Medical System, Baltimore, Maryland, USA.

Shailvi Gupta (S)

Surgery, University of Maryland Medical System, Baltimore, Maryland, USA.

Christopher P Michetti (CP)

Surgery, Inova Fairfax Hospital, Falls Church, Virginia, USA.

Joshua Crane (J)

Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Erin Hall (E)

Department of Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Christine T Trankiem (CT)

Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Chadi Abouassaly (C)

Surgery, MedStar Washington Hospital Center, Washington, DC, USA.

Elliott R Haut (ER)

Surgery, Johns Hopkins Medicine School of Medicine, Baltimore, Maryland, USA.

Eric Etchill (E)

Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.

Mark L Kovler (ML)

Surgery, Johns Hopkins Medicine, Baltimore, Maryland, USA.

Mallory Williams (M)

Surgery, Howard University Hospital, Washington, DC, USA.

Ahmad Zeineddin (A)

Surgery, Howard University Hospital, Washington, DC, USA.

Jordan Estroff (J)

Surgery, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

Classifications MeSH