Impact of the COVID-19 Pandemic on Trauma Service Utilization at a New York City Level I Trauma Center

Rosen, Benjamin D.; Pelle, Annemarie L; Lakhi, Nisha

doi:10.2147/por.s378189

Cited by 3 publications

(3 citation statements)

References 22 publications

(30 reference statements)

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“…In addition, patients with missing data on in-hospital mortality were also excluded as this was our primary outcome of interest. Finally, patients with any AIS body score of 6 were also excluded, as these are considered non-survivable injuries 17 .…”

Section: Methodsmentioning

confidence: 99%

Assessment of the incremental prognostic value from the modified frailty index-5 in complete traumatic cervical spinal cord injury

Shakil

Jaja

Zhang

et al. 2023

Sci Rep

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Frailty, as measured by the modified frailty index-5 (mFI-5), and older age are associated with increased mortality in the setting of spinal cord injury (SCI). However, there is limited evidence demonstrating an incremental prognostic value derived from patient mFI-5. We conducted a retrospective cohort study to evaluate in-hospital mortality among adult complete cervical SCI patients at participating centers of the Trauma Quality Improvement Program from 2010 to 2018. Logistic regression was used to model in-hospital mortality, and the area under the receiver operating characteristic curve (AUROC) of regression models with age, mFI-5, or age with mFI-5 was used to compare the prognostic value of each model. 4733 patients were eligible. We found that both age (80 y versus 60 y: OR 3.59 95% CI [2.82 4.56], P < 0.001) and mFI-5 (score ≥ 2 versus < 2: OR 1.53 95% CI [1.19 1.97], P < 0.001) had statistically significant associations with in-hospital mortality. There was no significant difference in the AUROC of a model including age and mFI-5 when compared to a model including age without mFI-5 (95% CI Δ AUROC [− 8.72 × 10–4 0.82], P = 0.199). Both models were superior to a model including mFI-5 without age (95% CI Δ AUROC [0.06 0.09], P < 0.001). Our findings suggest that mFI-5 provides minimal incremental prognostic value over age with respect to in-hospital mortality for patients complete cervical SCI.

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Section: Methodsmentioning

confidence: 99%

Assessment of the incremental prognostic value from the modified frailty index-5 in complete traumatic cervical spinal cord injury

Shakil

Jaja

Zhang

et al. 2023

Sci Rep

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Section: Study Eligibilitymentioning

confidence: 99%

Comparison of Age and Modified Frailty Index-5 as Predictors of In-Hospital Mortality in Complete Traumatic Cervical Spinal Cord Injury

Shakil

Jaja²,

Zhang³

et al. 2022

Preprint

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Frailty, as measured by the modified frailty index-5 (mFI-5), and older age are associated with increased mortality in the setting of spinal cord injury (SCI). However, a comparison of the predictive power of each measure has not been completed. We conducted a retrospective cohort study to evaluate in-hospital mortality among adult complete cervical SCI patients at participating centers of the Trauma Quality Improvement Program from 2010 to 2018. Logistic regression was used to predict in-hospital mortality, and the area under the Receiver Operating Characteristic curve (AUROC) of regression models with age, mFI-5, or age with mFI-5 was used to compare predictive power. 4,733 patients were eligible. We found significant effect of age > 75 years (OR 9.77 95% CI [7.21 13.29]) and mFI-5 ≥ 2 (OR 3.09 95% CI [1.85 4.99]) on in-hospital mortality. The AUROC of a model including age and mFI-5 (0.81 95%CI [0.79 0.84] AUROC) was comparable to a model with age alone (0.81 95%CI [0.79 0.83] AUROC). Both models were superior to a model with mFI-5 alone (0.75 95% CI [0.72 0.77] AUROC)). Our findings suggest that age provides more predictive power than mFI-5 in the prediction of in-hospital mortality for complete cervical SCI.

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“…While there was an overall decrease in hospitalizations for trauma-related injuries, more aggressive and high-energy injuries were reported throughout the pandemic. In particular, data from a level 1 trauma center in New York showed a 117% increase in gunshot wounds (GSWs), a 110% increase in motorcycle crashes, and a 108% increase in strikes by blunt objects from March 1st, 2020 to September 1st, 2020 [ 14 ]. Interestingly, there was a 58% decrease in the number of ICU patients, which was believed to be a direct result of decreased bed space to accommodate COVID-19 patients.…”

Section: Introductionmentioning

confidence: 99%

Urban Traumatic Moving Injuries Before and During SARS-CoV-2: A Multilinear Regression Analysis

Jung¹,

Giordano²,

Harrington³

et al. 2023

Cureus

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BackgroundThe onset of the coronavirus pandemic (COVID-19/SARS-CoV-2) saw an overall decline in traffic. Fundamental shifts in the pattern of traffic-related traumas were observed across the United States and beyond. ObjectivesThis study aims to predict changes in the length of stay (LOS) for patients sustaining traumatic moving injuries before and during the coronavirus pandemic. MethodsAll moving injuries (bicycle accidents, pedestrians struck, motor vehicle/motorcycle accidents) before and during the first SARS-CoV-2 wave in the US were extracted from our hospital's trauma registry. The study period was from March 1st to October 31st of 2019 and 2020, respectively. Ordinary least squares (OLS) multilinear regression models were estimated with a significance level of 0.05. ResultsIn both periods, the Glasgow coma scores (GCS), ICU LOS, injury severity scores (ISS), and admitting service had significant impacts on hospital duration. Higher GCS scores increased the hospital LOS by 0.811 days in 2019 and 0.587 days in 2020. A higher ISS resulted in an increase in LOS by 0.207 days in 2019 and 0.124 days in 2020. The ICU admissions increased LOS by 0.82 days in 2019 and 1.25 days in 2020. Admissions to trauma services increased in duration by 2.111 days in 2019 and 1.379 days in 2020. Average LOS dropped from 3.09 to 2.50 days between both periods. ConclusionOur trauma center saw significant changes in the admission patterns of moving injuries during COVID-19. We must therefore be better prepared to handle increased volume during public health emergencies and potential reductions in trauma utilization. Local injury prevention efforts may help reduce the burden on trauma centers during such emergencies as they did during COVID-19, allowing for greater focus on nontrauma patients.

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Impact of the COVID-19 Pandemic on Trauma Service Utilization at a New York City Level I Trauma Center

Cited by 3 publications

References 22 publications

Assessment of the incremental prognostic value from the modified frailty index-5 in complete traumatic cervical spinal cord injury

Assessment of the incremental prognostic value from the modified frailty index-5 in complete traumatic cervical spinal cord injury

Comparison of Age and Modified Frailty Index-5 as Predictors of In-Hospital Mortality in Complete Traumatic Cervical Spinal Cord Injury

Urban Traumatic Moving Injuries Before and During SARS-CoV-2: A Multilinear Regression Analysis

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