Study Design Retrospective cohort study. Objective The purpose of this study is to evaluate the impact of the COVID-19 global pandemic on the regional trends in facial trauma at a tertiary care, level 1 trauma center in Central New York. Methods The study sample was derived from the population of patients who presented with facial trauma to the emergency department at the Downtown and/or Community Campuses of SUNY Upstate University Hospital between March 1, 2020, and May 15, 2020, and compared to two historical controls in 2018 and 2019. Descriptive and bivariate statistics were calculated for study variables in each cohort. Poisson regression was used to compare incident rate ratios (IRR) with 95% confidence intervals with significance set at P < .05. Results Sixty five patients presented during the COVID-19 pandemic, while 83 presented in 2019 and 95 in 2018. For the study period, the most common mechanism was assault in 47.7%. IRR was significantly lower than in 2018 (IRR = 1.46, P = .018), but not significantly different from 2019 (IRR = 1.28, P = .14). During lockdown, IRR was significantly decreased compared to 2019 (IRR = 1.84, P = .0029) and 2018 (IRR = 2.16, P < .001). Conclusion The volume of facial trauma seen in Central New York appears undeterred in the absence of “shelter in place” orders. Analysis of pandemic and regional trauma variations can offer valuable insight for improved resource allocation to better prepare for potentially high-risk procedures.

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Objective To explore the relationship between distance traveled and rurality to clinical timepoints and 2‐year disease free survival (DFS) in newly diagnosed HNC patients. Methods This study was conducted through retrospective analysis, with key independent variables including distance to academic medical center and rurality score. To better understand delays in care, the sample was divided into two groups based on an optimal treatment timeline. We then assessed for the impact of distance traveled. Results A higher proportion of patients in the optimal treatment timeline group resided in metropolitan areas, which also had a lower mean index of medically underserviced score. Patients in this group had a shorter duration from first presentation for HNC to presentation to an academic medical center and a shorter duration from referral to presentation. However, there was no significant difference in 2‐year DFS between the groups. Those who lived closest to Upstate were more likely to identify as Black. Those who live in suburban communities around Upstate were most likely to initiate treatment within 1 month of presentation. Those who live farthest from Upstate were the least likely to have an HPV‐negative cancer of the head and neck, and more likely to receive surgery as part of treatment and to receive a biopsy prior to presenting to Upstate. Conclusions Despite differences in distance traveled and rurality between communities, there was no impact on 2‐year DFS. Together, we suggest that these findings support that socioeconomic and patient factors, instead of travel distance alone, impact HNC workup patterns. Level of Evidence Level III.

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