Impact of the SARS-CoV-2 pandemic on trauma care: a nationwide observational study

Driessen, M.L.S.; Ditshuizen, Jan C. van; Waalwijk, Job F; Bunt, Gerrita van den; IJpma, Frank F. A.; Reininga, Inge H. F.; Fiddelers, Audrey A. A.; Habets, Karin; Homma, Paulien C.M.; Berg, Marleen H van den; Bloemers, Frank W.; Schipper, I.B.; Leenen, Luke P. H.; Jongh, Mariska A. C. de

doi:10.1007/s00068-022-01891-5

Cited by 4 publications

(9 citation statements)

References 37 publications

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“…In Japan, EMS transport responsiveness was delayed not only in an urban area but also in a minimally affected region 4,11 . Similar increased prehospital times spent on scene were found in the Netherlands 12 . By contrast, the EMS prehospital time for patients with trauma in the earlier pandemic period in the United States did not change from that in 2019, because social distancing and working from home led to fewer people traveling via motor vehicles and shortened total EMS prehospital time 13 .…”

Section: Discussionmentioning

confidence: 81%

“… 4 , 11 Similar increased prehospital times spent on scene were found in the Netherlands. 12 By contrast, the EMS prehospital time for patients with trauma in the earlier pandemic period in the United States did not change from that in 2019, because social distancing and working from home led to fewer people traveling via motor vehicles and shortened total EMS prehospital time. 13 In addition, EMS calls for patients with alcohol‐related injuries decreased due to social distancing measures during the lockdown.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, patients who were Black, uninsured or on Medicaid, who were assaulted, and who used illicit substances increased, 19 , 20 which may reflect the socioeconomic chaos during the pandemic. Similar to the results from the current study, the number of suicide attempts in Japan 21 and Europe 12 increased, presumably due to the reduced opportunities for social contact and isolation. 22 …”

Section: Discussionmentioning

confidence: 99%

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Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

Nishimura

Suga

Ishihara

et al. 2023

Acute Medicine & Surgery

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Aim In the current era of the coronavirus disease 2019 (COVID‐19) pandemic, the responsiveness of emergency medical service (EMS) transport for patients with internal illness is often delayed. However, the influence of the COVID‐19 pandemic on prehospital transport for patients with trauma has not yet been fully elucidated. This study aims to examine the effect of COVID‐19 case surges on EMS transport for patients with trauma during the COVID‐19 states of emergency in Kobe, Japan. Methods EMS data during the states of emergency were compared with those in the 2019 prepandemic period. The incidence of difficulty securing hospital acceptance (four or more calls to medical institutions and ambulance staying at the scene for 30 min or more) was evaluated as a primary outcome. Secondary outcomes were the time spent at the trauma scene and the number of calls requesting hospital acceptance. The time spent at the trauma scene was stratified by trauma severity. Results The incidence of difficulty securing hospital acceptance increased (1.2% versus 3.2%, P < 0.01). Logistic regression analysis revealed that the duration of the states of emergency was associated with difficulty securing hospital acceptance (odds ratio [OR] 2.08, 95% confidence interval 1.77–2.45; P < 0.01). Although the mean time spent at the trauma scene among the less severe, moderately severe, and severe trauma groups was prolonged, the time for the life‐threatening group did not change. The number of request calls increased during the states of emergency. Conclusion Difficulty securing hospital acceptance increased; however, the time spent at the trauma scene did not significantly change for the life‐threatening group.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

Nishimura

Suga

Ishihara

et al. 2023

Acute Medicine & Surgery

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“…This observation is supported by the working group of Driessen et al from a multicenter observational cohort study based on the Dutch Nationwide Trauma Registry. They showed that the total pre-hospital time was significantly longer for all periods in 2020: 54 min (IQR 44–65) during 1st wave, 53 min (IQR 43–64) during interbellum period, and 54 min (IQR 45–66) during 2nd wave [ 8 ]. Different reasons suggest effects of the pandemic on pre-hospital rescue time.…”

Section: Discussionmentioning

confidence: 99%

Impact of the First and Second Wave of the SARS-CoV-2 Pandemic on Severe Trauma and the Care Structures in the German TraumaNetzwerk DGU®

Colcuc

Fischer

Leimkühler

et al. 2022

JCM

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(1) Background: The aim of this study was to investigate the effects of the pandemic on transfer rates of severely injured patients within the German TraumaNetzwerk of the DGU. Furthermore, cause of accident, rescue times, and trauma cases are compared to pre-pandemic times. (2) Methods: For this investigation patients documented in the TraumaRegister DGU® from 2018 to 2020 were analyzed. The years 2018 and 2019 served as a comparison to 2020, the first COVID-19 pandemic year. All primary admissions and transfers were included if treated on an intensive care unit. (3) Results: Demographics (age, sex) and injury severity in 2020 were comparable with 2018/2019. In 2020, a significant decrease (3.7%) in car accidents was found. In contrast, a significant increase (3.2%) in bicycle accidents was seen. During the second wave, there was a significant burden of COVID-19 patients on hospitals. In this time, we found a significant increase in early transfers of trauma patients primarily from small level 3 to large level 1 centers. There was also a small but significant increase in rescue time, especially during the 2nd wave. (4) Conclusions: Our data confirm the importance of the network structures established in the TraumaNetzwerk DGU®, especially during the pandemic. The established structures allow smaller hospitals to spread their resources and prevent internal collapse. Therefore, the structures of the TraumaNetzwerk DGU® play a prominent role in stabilizing the healthcare system by helping to maintain both surgical and critical care capacity and providing adequate emergency care.

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“…Die Einschränkungen des öffentlichen Lebens bedingten einen deutlichen Rückgang an verunfallten Patienten, insbesondere infolge von Verkehrsunfällen, Sportverletzungen und Unfällen im Freien [ 5 , 21 , 22 ]. Bei der Prävalenz von hüftgelenknahen Verletzungen oder Schwerverletzten zeigten sich jedoch keine wesentlichen Veränderungen [ 6 , 9 , 19 ].…”

Section: Hintergrund Und Fragestellungunclassified

Impact of the COVID-19 pandemic on the care of major trauma patients: analysis from the TraumaRegister DGU®

et al. 2023

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Zusammenfassung Hintergrund Die Behandlung von Schwerverletzten bedarf intensivmedizinischer Kapazitäten, welche insbesondere während der COVID-19-Pandemie eine entscheidende Ressource darstellten. Das Ziel dieser Studie war es deshalb, die Auswirkung auf die Versorgung von Schwerverletzten unter Berücksichtigung der intensivmedizinischen Behandlung COVID-19-positiver Patienten zu analysieren. Methoden Demografische, präklinische und intensivmedizinische Behandlungsdaten aus dem TraumaRegister DGU® der Deutschen Gesellschaft für Unfallchirurgie (DGU) der Jahre 2019 und 2020 wurden analysiert. Eingeschlossen wurden nur Schwerverletzte aus dem Bundesland Bayern. Die stationären Behandlungsdaten der COVID-19-Patienten in Bayern im Jahr 2020 wurden mittels IVENA eHealth ermittelt. Ergebnisse Im Untersuchungszeitraum wurden 8307 Schwerverletzte im Bundesland Bayern behandelt. Insgesamt zeigte sich kein Rückgang der Anzahl der Schwerverletzten im Jahr 2020 (n = 4032) im Vergleich zu 2019 (n = 4275) (p = 0,4). Hinsichtlich der COVID-19-Fallzahlen wurden in den Monaten April und Dezember mit täglich über 800 Patienten auf einer Intensivstation Maximalwerte erreicht. In der kritischen Phase (≥ 100 COVID-19-Patienten auf Intensivstation) zeigte sich eine verlängerte Rettungszeit (64,8 ± 32,5 vs. 67,4 ± 30,6 min; p = 0,003). Die Verweildauer und die Behandlung von Schwerverletzten auf einer Intensivstation wurden nicht durch die COVID-19-Pandemie negativ beeinflusst. Diskussion Die intensivmedizinische Versorgung von Schwerverletzten konnte während der kritischen Phasen der COVID-19-Pandemie gewährleistet werden. Die verlängerten präklinischen Rettungszeiten zeigen mögliches Optimierungspotenzial der horizontalen Integration von Präklinik und Klinik auf.

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Impact of the SARS-CoV-2 pandemic on trauma care: a nationwide observational study

Cited by 4 publications

References 37 publications

Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

Influence of coronavirus disease 2019 case surges on prehospital emergency medical service for patients with trauma in Kobe, Japan

Impact of the First and Second Wave of the SARS-CoV-2 Pandemic on Severe Trauma and the Care Structures in the German TraumaNetzwerk DGU®

Impact of the COVID-19 pandemic on the care of major trauma patients: analysis from the TraumaRegister DGU®

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