Trauma Center, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
Department of Surgery, School of Medicine, Kyungpook National University, Daegu, Republic of Korea.
BMC Emerg Med. 2024 Apr 3;24(1):53. doi: 10.1186/s12873-024-00963-6.
Interhospital transfer (IHT) is necessary for providing ultimate care in the current emergency care system, particularly for patients with severe trauma. However, studies on IHT during the pandemic were limited. Furthermore, evidence on the effects of the coronavirus disease 2019 (COVID-19) pandemic on IHT among patients with major trauma was lacking.
This retrospective cohort study was conducted in an urban trauma center (TC) of a tertiary academic affiliated hospital in Daegu, Korea. The COVID-19 period was defined as from February 1, 2020 to January 31, 2021, whereas the pre-COVID-19 period was defined as the same duration of preceding span. Clinical data collected in each period were compared. We hypothesized that the COVID-19 pandemic negatively impacted IHT.
A total of 2,100 individual patients were included for analysis. During the pandemic, the total number of IHTs decreased from 1,317 to 783 (- 40.5%). Patients were younger (median age, 63 [45-77] vs. 61[44-74] years, p = 0.038), and occupational injury was significantly higher during the pandemic (11.6% vs. 15.7%, p = 0.025). The trauma team activation (TTA) ratio was higher during the pandemic both on major trauma (57.3% vs. 69.6%, p = 0.006) and the total patient cohort (22.2% vs. 30.5%, p < 0.001). In the COVID-19 period, duration from incidence to the TC was longer (218 [158-480] vs. 263[180-674] minutes, p = 0.021), and secondary transfer was lower (2.5% vs. 0.0%, p = 0.025).
We observed that the total number of IHTs to the TC was reduced during the COVID-19 pandemic. Overall, TTA was more frequent, particularly among patients with major trauma. Patients with severe injury experienced longer duration from incident to the TC and lesser secondary transfer from the TC during the COVID-19 pandemic.
在当前的急救系统中，为患者提供最终治疗需要进行医院间转院（IHT），尤其是对于严重创伤患者而言。然而，大流行期间有关 IHT 的研究有限。此外，缺乏有关 2019 年冠状病毒病（COVID-19）大流行对重大创伤患者 IHT 影响的证据。
本回顾性队列研究在韩国大邱市一家三级学术附属医院的城市创伤中心（TC）进行。将 COVID-19 时期定义为 2020 年 2 月 1 日至 2021 年 1 月 31 日，而 COVID-19 之前的时期则定义为相同的时间段。比较每个时期收集的临床数据。我们假设 COVID-19 大流行对 IHT 产生负面影响。
共纳入 2100 名个体患者进行分析。在大流行期间，IHT 的总数从 1317 例减少到 783 例（-40.5%）。患者年龄较小（中位数年龄，63 [45-77]岁比 61[44-74]岁，p=0.038），并且在大流行期间职业性损伤明显更高（11.6%比 15.7%，p=0.025）。在大流行期间，主要创伤（57.3%比 69.6%，p=0.006）和总患者队列（22.2%比 30.5%，p<0.001）的创伤团队激活（TTA）比例均较高。在 COVID-19 期间，从发病到 TC 的时间更长（218[158-480]分钟比 263[180-674]分钟，p=0.021），并且二次转院率较低（2.5%比 0.0%，p=0.025）。
我们观察到，在 COVID-19 大流行期间，TC 的 IHT 总数减少。总体而言，TTA 更为频繁，尤其是在主要创伤患者中。在 COVID-19 大流行期间，严重受伤的患者从发病到 TC 的时间更长，并且从 TC 进行二次转院的比例更低。
