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. 2021 Apr 2;6(1):e000655.
doi: 10.1136/tsaco-2020-000655. eCollection 2021.

Multicenter study of US trauma centers examining the effect of the COVID-19 pandemic on injury causes, diagnoses and procedures

Kristin Salottolo  1 , Rachel Caiafa  2 , Jalina Mueller  3 , Allen Tanner  4 , Matthew M Carrick  5 , Mark Lieser  6 , Gina Berg  7 , David Bar-Or  3
Affiliations

Multicenter study of US trauma centers examining the effect of the COVID-19 pandemic on injury causes, diagnoses and procedures

Kristin Salottolo et al. Trauma Surg Acute Care Open. .

Abstract

Background: The COVID-19 pandemic resulted in nationwide social distancing and shelter-in-place orders meant to curb transmission of the SARS-CoV-2 virus. The effect of the pandemic on injury patterns has not been well described in the USA. The study objective is to determine the effect of the COVID-19 pandemic on the distribution and determinants of traumatic injuries.

Methods: This retrospective multi-institutional cohort study included all hospital admissions for acute traumatic injury at six community level I trauma centers. Descriptive statistics were used to compare injury causes, diagnoses and procedures over two similar time periods: prepandemic (March 11-June 30, 2019) and pandemic (March 11-June 30, 2020).

Results: There were 7308 trauma patients included: 3862 (53%) prepandemic and 3446 (47%) during the pandemic. Cause of injury significantly differed by period (p<0.001). During the pandemic, there were decreases in motor vehicle crashes (from 17.0% to 14.0%, p<0.001), worksite injuries (from 5.2% to 4.1%, p=0.02), pedestrian injuries (from 3.0% to 2.2%, p=0.02) and recreational injuries (from 3.0% to 1.7%, p<0.001), while there were significant increases in assaults (6.9% to 8.5%, p=0.01), bicycle crashes (2.8% to 4.2%, p=0.001) and off-road vehicle injuries (1.8% to 3.0%, p<0.001). There was no change by study period in falls, motorcycle injuries, crush/strikes, firearm and self-inflicted injuries, and injuries associated with home-improvement projects. Injury diagnoses differed between time periods; during the pandemic, there were more injury diagnoses to the head (23.0% to 27.3%, p<0.001) and the knee/leg (11.7% to 14.9%, p<0.001). There were also increases in medical/surgical procedures (57.5% to 61.9%, p<0.001), administration of therapeutics/blood products (31.4% to 34.2%, p=0.01) and monitoring (11.0% to 12.9%, p=0.01).

Discussion: Causes of traumatic injury, diagnoses, and procedures were significantly changed by the pandemic. Trauma centers must adjust to meet the changing demands associated with altered injury patterns, as they were associated with increased use of hospital resources.

Level of evidence: III (epidemiological).

Keywords: COVID-19; diagnosis; epidemiology; multiple trauma.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Incidence (%) of the three most common causes of injury, by surveillance week and pandemic period. (A) Incidence of falls; (B) incidence of motor vehicle crashes; and (C) incidence of assaults.
See this image and copyright information in PMC

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