Multicenter Study

. 2021 Oct;47(5):1335-1342.

doi: 10.1007/s00068-021-01699-9. Epub 2021 May 25.

COVID-19 in trauma: a propensity-matched analysis of COVID and non-COVID trauma patients

Eric O Yeates¹, Areg Grigorian^{1

2}, Morgan Schellenberg², Natthida Owattanapanich², Galinos Barmparas³, Daniel Margulies³, Catherine Juillard⁴, Kent Garber⁴, Henry Cryer⁴, Areti Tillou⁴, Sigrid Burruss⁵, Ryan Arthur Figueras⁵, Georgi Mladenov⁵, Megan Brenner⁶, Christopher Firek⁷, Todd Costantini⁸, Jarrett Santorelli⁸, Terry Curry⁸, Diane Wintz⁹, Walter L Biffl¹⁰, Kathryn B Schaffer¹⁰, Thomas K Duncan¹¹, Casey Barbaro¹¹, Graal Diaz¹¹, Arianne Johnson¹², Justine Chinn¹, Ariana Naaseh¹, Amanda Leung¹, Christina Grabar¹, Jeffry Nahmias¹³

Affiliations

¹ Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
² Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA.
³ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁴ Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
⁵ Department of Surgery, Loma Linda University, Loma Linda, CA, USA.
⁶ Department of Surgery, University of California, Riverside/Riverside University Health System, Moreno Valley, CA, USA.
⁷ Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Riverside University Health System, Moreno Valley, CA, USA.
⁸ Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA.
⁹ Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA.
¹⁰ Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA.
¹¹ Department of Surgery, Ventura County Medical Center, Ventura, CA, USA.
¹² Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA.
¹³ Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA. jnahmias@hs.uci.edu.

PMID: 34031703
PMCID: PMC8143988
DOI: 10.1007/s00068-021-01699-9

Multicenter Study

COVID-19 in trauma: a propensity-matched analysis of COVID and non-COVID trauma patients

Eric O Yeates et al. Eur J Trauma Emerg Surg. 2021 Oct.

. 2021 Oct;47(5):1335-1342.

doi: 10.1007/s00068-021-01699-9. Epub 2021 May 25.

Authors

Affiliations

¹ Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
² Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA.
³ Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
⁴ Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
⁵ Department of Surgery, Loma Linda University, Loma Linda, CA, USA.
⁶ Department of Surgery, University of California, Riverside/Riverside University Health System, Moreno Valley, CA, USA.
⁷ Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Riverside University Health System, Moreno Valley, CA, USA.
⁸ Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA.
⁹ Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA.
¹⁰ Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA.
¹¹ Department of Surgery, Ventura County Medical Center, Ventura, CA, USA.
¹² Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA.
¹³ Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA. jnahmias@hs.uci.edu.

PMID: 34031703
PMCID: PMC8143988
DOI: 10.1007/s00068-021-01699-9

Abstract

Purpose: There is mounting evidence that surgical patients with COVID-19 have higher morbidity and mortality than patients without COVID-19. Infection is prevalent amongst the trauma population, but any effect of COVID-19 on trauma patients is unknown. We aimed to evaluate the effect of COVID-19 on a trauma population, hypothesizing increased mortality and pulmonary complications for COVID-19-positive (COVID) trauma patients compared to propensity-matched COVID-19-negative (non-COVID) patients.

Methods: A retrospective analysis of trauma patients presenting to 11 Level-I and II trauma centers in California between 1/1/2019-6/30/2019 and 1/1/2020-6/30/2020 was performed. A 1:2 propensity score model was used to match COVID to non-COVID trauma patients using age, blunt/penetrating mechanism, injury severity score, Glasgow Coma Scale score, systolic blood pressure, respiratory rate, and heart rate. Outcomes were compared between the two groups.

Results: A total of 20,448 trauma patients were identified during the study period. 53 COVID trauma patients were matched with 106 non-COVID trauma patients. COVID patients had higher rates of mortality (9.4% vs 1.9%, p = 0.029) and pneumonia (7.5% vs. 0.0%, p = 0.011), as well as a longer mean length of stay (LOS) (7.47 vs 3.28 days, p < 0.001) and intensive care unit LOS (1.40 vs 0.80 days, p = 0.008), compared to non-COVID patients.

Conclusion: This multicenter retrospective study found increased rates of mortality and pneumonia, as well as a longer LOS, for COVID trauma patients compared to a propensity-matched cohort of non-COVID patients. Further studies are warranted to validate these findings and to elucidate the underlying pathways responsible for higher mortality in COVID trauma patients.

Keywords: COVID-19; Coronavirus; Length of stay; Mortality; Pneumonia; Trauma.

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Conflict of interest statement

The authors report no conflicts of interest.

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COVID-19 in trauma: a propensity-matched analysis of COVID and non-COVID trauma patients

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COVID-19 in trauma: a propensity-matched analysis of COVID and non-COVID trauma patients

Authors

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Conflict of interest statement

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