Dutch Network for Emergency Care (LNAZ), Utrecht, The Netherlands.
Trauma Research Unit, Department of Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
Eur J Trauma Emerg Surg. 2022 Aug;48(4):2999-3009. doi: 10.1007/s00068-022-01891-5. Epub 2022 Feb 8.
The SARS-CoV-2 pandemic severely disrupted society and the health care system. In addition to epidemiological changes, little is known about the pandemic's effects on the trauma care chain. Therefore, in addition to epidemiology and aetiology, this study aims to describe the impact of the SARS-CoV-2 pandemic on prehospital times, resource use and outcome.
A multicentre observational cohort study based on the Dutch Nationwide Trauma Registry was performed. Characteristics, resource usage, and outcomes of trauma patients treated at all trauma-receiving hospitals during the first (W1, March 12 through May 11) and second waves (W2, May 12 through September 23), as well as the interbellum period in between (INT, September 23 through December 31), were compared with those treated from the same periods in 2018 and 2019.
The trauma caseload was reduced by 20% during the W1 period and 11% during the W2 period. The median length of stay was significantly shortened for hip fracture and major trauma patients (ISS ≥ 16). A 33% and 66% increase in the prevalence of minor self-harm-related injuries was recorded during the W1 and W2 periods, respectively, and a 36% increase in violence-related injuries was recorded during the INT. Mortality was significantly higher in the W1 (2.9% vs. 2.2%) and W2 (3.2% vs. 2.7%) periods.
The imposed restrictions in response to the SARS-CoV-2 pandemic led to diminished numbers of acute trauma admissions in the Netherlands. The long-lasting pressing demand for resources, including ICU services, has negatively affected trauma care. Further caution is warranted regarding the increased incidence of injuries related to violence and self-harm.
SARS-CoV-2 大流行严重扰乱了社会和医疗保健系统。除了流行病学变化外，人们对大流行对创伤护理链的影响知之甚少。因此，除了流行病学和病因学外，本研究还旨在描述 SARS-CoV-2 大流行对院前时间、资源使用和结果的影响。
本研究基于荷兰全国创伤登记处进行了一项多中心观察性队列研究。比较了在第一波（W1，3 月 12 日至 5 月 11 日）和第二波（W2，5 月 12 日至 9 月 23 日）期间在所有创伤接收医院接受治疗的创伤患者的特征、资源使用情况和结局，以及两次浪潮之间的平静期（INT，9 月 23 日至 12 月 31 日），并与 2018 年和 2019 年同期接受治疗的患者进行了比较。
W1 期间创伤患者数量减少了 20%，W2 期间减少了 11%。髋部骨折和严重创伤患者的中位住院时间明显缩短（ISS≥16）。W1 和 W2 期间轻度自我伤害相关损伤的患病率分别增加了 33%和 66%，INT 期间暴力相关损伤的患病率增加了 36%。W1（2.9%比 2.2%）和 W2（3.2%比 2.7%）期间的死亡率明显更高。
为应对 SARS-CoV-2 大流行而实施的限制措施导致荷兰急性创伤入院人数减少。对资源（包括 ICU 服务）的持久需求增加对创伤护理产生了负面影响。对于与暴力和自我伤害相关的伤害发生率增加，需要进一步谨慎。
