Leichtle Stefan W, Rodas Edgar B, Procter Levi, Bennett Jonathan, Schrader Robin, Aboutanos Michel B
Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.
Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.
Injury. 2020 Nov;51(11):2437-2441. doi: 10.1016/j.injury.2020.08.014. Epub 2020 Aug 8.
The COVID pandemic of 2020 resulted in unprecedented restrictions of public life in most countries around the world, and many hospital systems experienced dramatic decreases in non-COVID related patient admissions. We aimed to compare trauma volumes, patient characteristics, and trauma mechanisms at a large, urban Level 1 trauma center in the United States during a state-wide "State of Emergency" and "stay-at-home" order to corresponding historic dates. All adult trauma activations from March 1 through April 30, 2020 and a historic control from March 1 through April 30, 2018 and 2019 were reviewed in the institution's trauma registry. Trauma volumes, patient characteristics, and trauma mechanisms were compared over time as increasingly stricter COVID-related restrictions were enacted in the Commonwealth of Virginia. After declaration of a state-wide "Public Health Emergency" on March 17, 2020, the daily number of trauma activations significantly declined to a mean of 4.7 (standard deviation, SD = 2.6), a decrease by 43% from a mean of 8.2 (SD = 0.3) for the same dates in 2018 and 2019. Trauma activations during COVID restrictions vs. historic control were characterized by significantly higher prevalence of chronic alcohol use (15.5% vs. 6.8%, p < 0.01), higher median (25th - 75th percentile) Injury Severity Score of 9 (5 - 16) vs. 6 (4 - 14), p = 0.01, and shorter median (25th - 75th percentile) length of hospital stay of 2 (1 - 6) days vs. 3 (1 - 7) days, p = 0.03. The COVID-related Public Health Emergency and "stay-at-home" order in the Commonwealth of Virginia dramatically reduced overall trauma volumes with minor but interesting changes in trauma patterns.
2020年的新冠疫情导致全球大多数国家对公共生活实施了前所未有的限制，许多医院系统的非新冠相关患者入院量大幅下降。我们旨在比较美国一家大型城市一级创伤中心在全州“紧急状态”和“居家”令期间与相应历史日期的创伤量、患者特征和创伤机制。对该机构创伤登记处2020年3月1日至4月30日所有成人创伤激活病例以及2018年和2019年3月1日至4月30日的历史对照病例进行了回顾。随着弗吉尼亚州颁布越来越严格的新冠相关限制措施，对创伤量、患者特征和创伤机制随时间进行了比较。2020年3月17日宣布全州“公共卫生紧急状态”后，每日创伤激活病例数显著下降至平均4.7例（标准差，SD = 2.6），比2018年和2019年同一日期的平均8.2例（SD = 0.3）减少了43%。与历史对照相比，新冠限制期间的创伤激活病例具有慢性酒精使用患病率显著更高（15.5%对6.8%，p < 0.01）、中位（第25 - 75百分位数）损伤严重程度评分更高，分别为9（5 - 16）对6（4 - 14），p = 0.01，以及中位（第25 - 75百分位数）住院时间更短，分别为2（1 - 6）天对3（1 - 7）天，p = 0.03。弗吉尼亚州与新冠相关的公共卫生紧急状态和“居家”令显著减少了总体创伤量，同时创伤模式有轻微但有趣的变化。
