Decrease in Trauma Admissions with COVID-19 Pandemic

Kamine, Tovy Haber; Rembisz, Adam; Barron, Rebecca; Baldwin, Carey; Kromer, Mark

doi:10.5811/westjem.2020.5.47780

Cited by 96 publications

(127 citation statements)

References 2 publications

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“…The societal changes necessitated by COVID-19 impact pediatric mental health, child neglect, and the occurrence of pediatric traumatic injuries [ 4 , 5 ]. Consistent with previous reports, we identified decreased overall trauma encounters during stay-at-home regulations which was attributable to decreased blunt injuries [ 6 , 7 ]. This included decreases in pediatric orthopedic injuries during the pandemic and likely reflect reduced motor vehicle travel, lack of extracurricular activities, and changes in childcare/observation [6] , [7] , [8] .…”

Section: Discussionsupporting

confidence: 91%

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Sanford

Zagory

Blackwell

et al. 2021

Journal of Pediatric Surgery

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Background: Trauma is the leading cause of morbidity and mortality in the pediatric population. However, during the societal disruptions secondary to the coronavirus (COVID-19) stay-at-home regulations, there have been reported changes to the pattern and severity of pediatric trauma. We review our twoinstitution experience. Methods: Pediatric trauma emergency department (ED) encounters from the National Trauma Registry for a large, tertiary, metropolitan level 1 pediatric trauma center and pediatric burn admission at the regional burn center were extracted for children less than 19 years from March 15th thru May 15th during the years 2015-2020. The primary outcome was the difference in encounters during the COVID-19 (2020) epoch versus the pre-COVID-19 epoch (2015)(2016)(2017)(2018)(2019). Results: There were 392 pediatric trauma encounters during the COVID-19 epoch as compared to 451, 475, 520, 460, 432 (mean 467.6) during the pre-COVID-19 epoch. Overall trauma admissions and ED trauma encounters were significantly lower ( p < 0.001) during COVID-19. Burn injury admissions ( p < 0.001) and penetrating trauma encounters ( p = 0.002) increased during the COVID-19 epoch while blunt trauma encounters decreased ( p < 0.001). Trauma occurred among more white ( p = 0.01) and privately insured ( p < 0.001) children, but no difference in suspected abuse, injury severity, mortality, age, or gender were detected. Sub-analysis showed significant decreases in motor vehicle crashes ( p < 0.001), pedestrians struck by automobile ( p < 0.001), all-terrain vehicle (ATV)/motorcross/bicycle/skateboard involved injuries ( p = 0.02), falls ( p < 0.001), and sports related injuries ( p < 0.001). Fewer injuries occurring in the playground or home play equipment such as trampolines neared significance ( p = 0.05). Interpersonal violence (assault, NAT, self-harm) was lower during the COVID-19 era ( p = 0.04). For burn admissions, there was a significant increase in flame burns ( p < 0.001). Conclusions: Stay-at-home regulations alter societal patterns, leading to decreased overall and blunt traumas. However, the proportion of penetrating and burn injuries increased. Owing to increased stressors and time spent at home, healthcare professionals should keep a high suspicion for abuse and neglect.

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Section: Discussionsupporting

confidence: 91%

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Sanford

Zagory

Blackwell

et al. 2021

Journal of Pediatric Surgery

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“…Kamine et al . also reported a 57.4% decrease in trauma admissions, with an 80.5% decrease in motor vehicle collisions during the lockdown period February–April 2020 in Portsmouth, USA 11 …”

Section: Discussionmentioning

confidence: 93%

Impact of societal restrictions and lockdown on trauma admissions during the COVID‐19 pandemic: a single‐centre cross‐sectional observational study

Jacob

Mwagiru

Thakur

et al. 2020

ANZ Journal of Surgery

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Background: Societal restrictions and lockdown during the coronavirus (COVID-19) pandemic have had a significant impact on the volume and nature of trauma admissions. We assessed the impact of COVID-19 related societal restrictions and lockdown on trauma admissions to single level 1 trauma centre in Westmead, Australia. We hypothesized that the number of trauma admissions would decrease and number of admissions due to selfharm and assault (specifically domestic violence) would increase. Methods: Data was collected from the prospectively maintained Westmead Hospital Trauma Registry. The primary outcome compared was the average number of trauma admissions during March and April during years 2016 to 2020. Analysis of variance was used to analyse means. Pairwise differences among group means were evaluated with Tukey's honestly significant difference test. Secondary outcomes compared were in-hospital interventions and patient outcomes. Results: There was a 23-34% decrease (P = 0.018) in the mean monthly average trauma admissions during March/April 2020 compared with previous years 2016-2019. In addition, there was a 40-52% decrease (P = 0.025) and 13-29% decrease (P = 0.020) in admissions due to road traffic collisions and falls respectively. Conclusion: There was a significant decrease in the overall number of trauma-related admissions during the COVID-19-related period of societal restrictions and lockdown. This was due to a decrease in minor traumas, falls and road traffic collisions. There was no difference in the number of admissions secondary to major traumas, self-harm or assault.

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“…There has been a decline in the number of acute trauma referrals, admissions, operations, and aerosolizing anesthetic procedures since implementing the stay at home mandates [1]. At a Level II trauma center in New Hampshire, significant decreases in overall trauma admissions have been as high as 57.4% [2]. Counties have noted up to 4.8-fold decrease in trauma activations since the shelter-in-place orders went into effect [3].…”

Section: Introductionmentioning

confidence: 99%

“…Trauma centers located in Florida, New York, and Massachusetts have reported a significant downward trend in MVCs [4]. After reviewing trauma admissions from 2017 to 2020, February to April, a New Hampshire Level II trauma center reported an 80.5% reduction in MVCs [2]. Pedestrian vehicle accidents have decreased as well [5].…”

Section: Introductionmentioning

confidence: 99%

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Trauma Trends During the Initial Peak of the COVID-19 Pandemic in the Midst of Lockdown: Experiences From a Rural Trauma Center

Rhodes¹,

Petersen²,

Biswas³

2020

Cureus

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Background As the early peak phase in the coronavirus outbreak has intensified, stay at home mandates were advised requiring individuals to remain home to prevent community transmission of the disease. Further mandates escalated isolated environments such as school closures, social distancing, travel restrictions, closure of public gathering spaces, and business closures. As citizens were forced to stay home during the pandemic, the crisis created unique trends in trauma referrals, which consisted of atypical trends in injuries related to trauma. Methods A retrospective review of all trauma registry patients presenting to a rural American College of Surgeons (ACS) verified Level I trauma center with associated trauma activation before and during the Coronavirus 2019 (COVID-19) pandemic, integral dates January 1, 2020, to May 1, 2020. A comparison was made regarding trauma trends based on the previous year (January 1, 2019, to May 1, 2019). The data collected included patient characteristics, grouping by trauma activation, injury type, injury severity score (ISS), alcohol screen, drug screen, and mode of injury. Results A statistically significant increase was found largely among males (p = 0.02) with positive alcohol screens (p < 0.001). The statistically significant mode of injury among this trauma population included falling, jumping, pushed (p = 0.02); self-harm-jump (p = 0.01); assault (p = 0.03); and assault with sharp object (p = 0.036). Conclusions Although overall trauma volume was reduced preceding and during the COVID-19 stay at home mandates, a significant increase in specific trauma trends were observed, such as falls, jumps, and pushed; self-harm-jumps; assaults; and assaults with sharp objects. Largely, the trauma trends were among men with higher levels of alcohol than previously reported.

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Decrease in Trauma Admissions with COVID-19 Pandemic

Cited by 96 publications

References 2 publications

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Changes in pediatric trauma during COVID-19 stay-at-home epoch at a tertiary pediatric hospital

Impact of societal restrictions and lockdown on trauma admissions during the COVID‐19 pandemic: a single‐centre cross‐sectional observational study

Trauma Trends During the Initial Peak of the COVID-19 Pandemic in the Midst of Lockdown: Experiences From a Rural Trauma Center

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