Abstract
Background: The aim of this study was to describe the impact of a COVID-19 lockdown on the variation in the volumes and types of injuries at a level one trauma center while focusing on preserving trauma care resources. Methods: A retrospective, descriptive study of prospectively collected data from the Trauma Registry. Data collection included patient demographics, injury mechanism, injury type and treatment required. The time periods studied corresponded with the lockdown period in Israel and a parallel period in 2019. Results: Overall, there was no reduction in all injury-related admissions. There was a significant reduction in pedestrian injuries (p < 0.02) and a non-significant increase in children admissions aged 0–2 years. Compared to the previous years, the severity of injuries during the March–April 2020 lockdown was unchanged. Hospital resources (number and percentage of trauma patients who required an operation, ICU stay and LOS) were not different between the lockdown period compared to the previous 5 years. Less trauma patients arrived with a Trauma Team Activation code during the lockdown period (58, 33% decrease compared to the control), but a significantly higher proportion of those patients required hospitalization (77.6%, p < 0.0001). Conclusions: During a lockdown period, road accidents were still the main cause for major trauma admissions, resulting in prolonged and complex surgeries, and hospitals should continue to provide full services until resource limitations are unavoidable. Maintenance of an effective full-staffed trauma service is vital throughout a COVID-19 lockdown.
Highlights
The COVID-19 pandemic is poised to challenge the volume and capability of acute care facilities
The aim of this study was to gain a clear understanding of the impact that a nationwide lockdown has on the demographics, mechanisms and severity of injuries compared to a parallel period and provide recommendations for trauma service practice in a tertiary trauma center during a pandemic lockdown
A retrospective, descriptive study was conducted on prospectively collected trauma registry data on injured patients of all age groups and injury severities hospitalized to a level one trauma center during the community lockdown in response to the COVID-19 pandemic
Summary
The COVID-19 pandemic is poised to challenge the volume and capability of acute care facilities. As the number of patients requiring hospital-level care due to COVID-19 escalates, it is likely that available resources will be relocated in favor of the growing number of COVID-19 patients. While this acute care is on the rise, injuries will continue to occur in our community. In this complex situation, hospital planners and trauma team leaders must simultaneously balance the needs of trauma patients with those of COVID-19 patients, as well as other medical and surgical emergencies [1]. Hospital resources (number and percentage of trauma patients who required an operation, ICU stay and LOS) were not different between the lockdown period compared to the previous 5 years. Maintenance of an effective full-staffed trauma service is vital throughout a COVID-19 lockdown
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