ICON Trauma (Impact of COVID-19 on Major Trauma workload) Study

Adiamah, Alfred; Moody, Nick; Blackburn, Lauren; Dickson, Edward; Thompson, A.; Reilly, John‐Joe; Saunders, J.; Brooks, Adam

doi:10.1002/bjs.11855

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…The EM-MTC was able to make early preparations in 2020, anticipating the expected disruptions of COVID-19. The present results show a significant reduction in major trauma admissions, similar to observations reported elsewhere 5 . Interestingly, there was no difference in time to radiological imaging when 2020 was compared with 2019.…”

supporting

confidence: 93%

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Impact of COVID-19 on access and availability of radiological imaging and surgical intervention at the East Midlands Major Trauma Centre: An ICON Trauma Study

Seehra

Lewis‐Lloyd

Gida

et al. 2021

British Journal of Surgery

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supporting

confidence: 93%

“…The Impact of COVID‐19 on Major Trauma workload (ICON Trauma) initiative was extended to investigate the availability and timeliness of CT and emergency operating during the COVID-19 national lockdown 5 .…”

mentioning

confidence: 99%

Impact of COVID-19 on access and availability of radiological imaging and surgical intervention at the East Midlands Major Trauma Centre: An ICON Trauma Study

Seehra

Lewis‐Lloyd

Gida

et al. 2021

British Journal of Surgery

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“…The COVID-19 pandemic has changed health care delivery, particularly the allocation of resources for pandemic response but also all other forms of health care 10. , 11.…”

Section: Introductionmentioning

confidence: 99%

Injury burdens and care delivery in relation to the COVID-19 pandemic in Kigali, Rwanda: A prospective interrupted cross-sectional study

Uwamahoro

Marqués

Beeman

et al. 2021

African Journal of Emergency Medicine

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Introduction Injuries cause significant burdens in sub-Saharan Africa. In Rwanda, national regulations to reduce COVID-19 altered population mobility and resource allocations. This study evaluated epidemiological trends and care among injured patients preceding and during the COVID-19 pandemic at the Centre Hospitalier Universitaire de Kigali (CHUK) in Kigali, Rwanda. Methods This prospective interrupted cross-sectional study enrolled injured adult patients (≥15 years) presenting to the CHUK emergency department (ED) from January 27th-March 21st (pre-COVID-19 period) and June 1st-28th (intra-COVID-19 period). Trained study personnel continuously collected standardized data on enrolled participants through the first six-hours of ED care. The Kampala Trauma Score (KTS) was calculated as a metric of injury severity. Case characteristics prior to and during the pandemic were compared, statistical differences were assessed using χ 2 or Fisher's exact tests. Results Data were collected from 409 pre-COVID-19 and 194 intra-COVID-19 cases. Median age was 32, with a male predominance (74.3%). Road traffic injuries (RTI) were the most common injury mechanism pre-COVID-19 (47.8%) and intra-COVID-19 (53.6%) ( p = 0.27). There was a significant increase in the number of transfer cases during the intra-COVID-19 period (52.1%) versus pre-COVID-19 (41.3%) ( p = 0.01). KTS was significantly lower among intra-COVID-19 patients ( p = 0.04), indicating higher severity of presentation. In the intra-COVID-19 period, there was a significant increase in the number of surgery consultations (40.7%) versus pre-COVID-19 (26.7%) ( p < 0.001). The number of hospital admissions increased from 35.5% pre-COVID-19 to 46.4% intra-COVID-19 ( p = 0.01). There was no significant mortality difference pre-COVID-19 as compared to the intra-COVID-19 period among injured patients ( p = 0.76). Conclusion Emergency injury care showed increased injury burden, inpatient admission and resource requirements during the pandemic period. This suggests the spectrum of disease may be more severe and that greater resources for injury management may continue to be needed during the ongoing COVID-19 pandemic in Rwanda and other similar settings.

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“…Despite the limitations of our study, our work demonstrates the need for fast-track emergency surgical services during the pandemic to decrease time to operation and reduce post-operative complication severity. This has been described by other orthopaedic departments globally [ 25 , 26 ].…”

Section: Discussionmentioning

confidence: 59%

Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital

Patel

Green

Henessy

et al. 2021

IJOO

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Background The Coronavirus disease (COVID-19) pandemic has contributed to over 1,000,000 deaths worldwide. Hospitals responded by expanding services to accommodate the forecasted rise in COVID-19-related admissions. We describe the effects these changes had on management of orthopaedic trauma and patient outcomes at a district general hospital in Southern England. Methods Data were extrapolated retrospectively from two separate 6-week periods in 2019 and 2020 (1st April–13th May) using electronic records of patients referred to the orthopaedic team. Soft tissue injuries were included where a confirmed diagnosis was made with radiological evidence. Patients were excluded if no orthopaedic intervention was required. Data were compared between the two time periods. Results There were fewer attendances to hospital in 2020 compared with 2019 (178 vs. 328), but time from presentation to surgery significantly increased in 2020 (2.94 days vs. 4.91 days, p = 0.009). There were fewer operative complications in 2020 (36/145 vs. 11/88, p < 0.001). However, ordinal logistic regression analysis found a significantly greater complication severity in 2020 including death ( p = 0.039). Complication severity was unrelated to COVID-19 status. Conclusions Restructuring of orthopaedic services in response to the COVID-19 pandemic has been associated with significant delays to surgery and higher post-operative complication severity. Our results demonstrate the need for fast-track emergency operative orthopaedic services in UK district general hospitals whilst the COVID-19 pandemic continues.

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ICON Trauma (Impact of COVID-19 on Major Trauma workload) Study

Cited by 8 publications

References 5 publications

Impact of COVID-19 on access and availability of radiological imaging and surgical intervention at the East Midlands Major Trauma Centre: An ICON Trauma Study

Impact of COVID-19 on access and availability of radiological imaging and surgical intervention at the East Midlands Major Trauma Centre: An ICON Trauma Study

Injury burdens and care delivery in relation to the COVID-19 pandemic in Kigali, Rwanda: A prospective interrupted cross-sectional study

Lessons Learnt from Managing Orthopaedic Trauma During the First Wave of the COVID-19 Pandemic at a UK District General Hospital

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