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Observational Study
. 2021 Jun;47(3):637-645.
doi: 10.1007/s00068-020-01593-w. Epub 2021 Feb 9.

The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

Alfred Adiamah  1 , Amari Thompson  2 , Christopher Lewis-Lloyd  2 , Edward Dickson  2 , Lauren Blackburn  2 , Nick Moody  2 , Sunil Gida  2 , Angelo La Valle  2 , John-Joe Reilly  2 , John Saunders  2 , Adam Brooks  2 ; ICON Trauma Study Group
Collaborators, Affiliations
Observational Study

The ICON Trauma Study: the impact of the COVID-19 lockdown on major trauma workload in the UK

Alfred Adiamah et al. Eur J Trauma Emerg Surg. 2021 Jun.

Abstract

Background: The global pandemic caused by SARS-CoV-2 has impacted population health and care delivery worldwide. As information emerges regarding the impact of "lockdown measures" and changes to clinical practice worldwide; there is no comparative information emerging from the United Kingdom with regard to major trauma.

Methods: This observational study from a UK Major Trauma Centre matched a cohort of patients admitted during a 10-week period of the SARS-CoV-2-pandemic (09/03/2020-18/05/2020) to a historical cohort of patients admitted during a similar time period in 2019 (11/03/2019-20/05/2019). Differences in demographics, Clinical Frailty Scale, SARS-CoV-2 status, mechanism of injury and injury severity were compared using Fisher's exact and Chi-squared tests. Univariable and multivariable logistic regression analyses examined the associated factors that predicted 30-days mortality.

Results: A total of 642 patients were included, with 405 in the 2019 and 237 in the 2020 cohorts, respectively. 4/237(1.69%) of patients in the 2020 cohort tested positive for SARS-CoV-2. There was a 41.5% decrease in the number of trauma admissions in 2020. This cohort was older (median 46 vs 40 years), had more comorbidities and were frail (p < 0.0015). There was a significant difference in mechanism of injury with a decrease in vehicle related trauma, but an increase in falls. There was a twofold increased risk of mortality in the 2020 cohort which in adjusted multivariable models, was explained by injury severity and frailty. A positive SARS-CoV-2 status was not significantly associated with increased mortality when adjusted for other variables.

Conclusion: Patients admitted during the COVID-19 pandemic were older, frailer, more co-morbid and had an associated increased risk of mortality.

Keywords: Covid-19; ICON-TRAUMA; Injury severity; Major trauma; Mortality.

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Conflict of interest statement

None of the authors have any conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Trend of trauma call admissions (by count and rolling average). Comparative week-to-week analysis: significant drop in trauma call admissions throughout study period especially during week 2–3, with approximately 50% drop in the expected trauma call activations
Fig. 2
Fig. 2
Deaths by Method of injury. For the 3 commonest methods of injury, falls < 2 m, falls > 2 m and vehicle incidents/collisions—there were more deaths in the 2020 cohort than in the 2019 cohort
See this image and copyright information in PMC

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