Abstract
PurposeThe coronavirus (COVID-19) pandemic has caused major healthcare challenges worldwide resulting in an exponential increase in the need for hospital- and intensive care support for COVID-19 patients. As a result, surgical care was restricted to urgent cases of surgery. However, the care for trauma patients is not suitable for reduction or delayed treatment. The influence of the pandemic on the burden of disease of trauma care remains to be elucidated.MethodsAll patients with traumatic injuries that were presented to the emergency departments (ED) of the Amsterdam University Medical Center, Location Academic Medical Center (AMC) and VU medical center (VUMC) and the Northwest Clinics (NWC) between March 10, 2019 and May 10, 2019 (non-COVID) and March 10, 2020 and May 10, 2020 (COVID-19 period) were included. The primary outcome was the difference in ED admissions for trauma patients between the non-COVID and COVID-19 study period. Additionally, patient- and injury characteristics, health care consumption, and 30-day mortality were evaluated.ResultsA 37% reduction of ED admissions for trauma patients was seen during the COVID-19 pandemic (non-COVID n = 2423 and COVID cohort n = 1531). Hospital admission was reduced by 1.6 trauma patients per day. Fewer patients sustained car- and sports-related injuries. Injuries after high energetic trauma were more severe in the COVID-19 period (Injury Severity Score 17.3 vs. 12.0, p = 0.006). Relatively more patients were treated operatively (21.4% vs. 16.6%, p < 0.001) during the COVID-19 period. Upper-(17.6 vs. 12.5%, p = 0.002) and lower extremity injuries (30.7 vs. 23.0%, p = 0.002) mainly accounted for this difference. The 30-day mortality rate was higher during the pandemic (1.0 vs. 2.3%, p = 0.001).ConclusionThe burden of disease and healthcare consumption of trauma patients remained high during the COVID-19 pandemic. Results of this study can be used to optimize the use of hospital capacity and anticipate health care planning in future outbreaks.
Highlights
During the past year, the novel severe acute respiratory syndrome coronavirus 2 (COVID-19) has caused a pandemic resulting in severe healthcare challenges and socioeconomic consequences worldwide
The burden of disease and healthcare consumption of trauma patients remained high during the COVID-19 pandemic
Results of this study can be used to optimize the use of hospital capacity and anticipate health care planning in future outbreaks
Summary
The novel severe acute respiratory syndrome coronavirus 2 (COVID-19) has caused a pandemic resulting in severe healthcare challenges and socioeconomic consequences worldwide. COVID-19 forced the current healthcare system to adapt promptly to the Hakkenbrak et al Scand J Trauma Resusc Emerg Med (2021) 29:130 increasing demand for respiratory- and intensive care support. Major adaptation in healthcare allocation across all hospital departments was required due to the nationwide rising number of COVID-19 infections and exponential growth in hospital- and intensive care unit (ICU) admissions. The Dutch government implemented national measures to limit the spread of the virus amongst the Dutch population. Besides the existing hygiene measures, social distancing, quarantine in case of symptoms and advice to work from home as much as possible, additional compulsory measures by the government were implemented: closing all retail shops, restaurants, bars, sports- and fitness clubs, schools, universities, and childcare facilities, prohibiting events, nursing home visits and restricting in- and outdoor groups to a maximum of three persons or household.
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