Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic

Eric O Yeates¹, Areg Grigorian², Morgan Schellenberg³, Natthida Owattanapanich⁴, Galinos Barmparas⁵, Daniel Margulies⁶, Catherine Juillard⁷, Kent Garber⁸, Henry Cryer⁹, Areti Tillou¹⁰, Sigrid Burruss¹¹, Liz Penaloza-Villalobos¹², Ann Lin¹³, Ryan Arthur Figueras¹⁴, Raul Coimbra¹⁵, Megan Brenner¹⁶, Todd Costantini¹⁷, Jarrett Santorelli¹⁸, Terry Curry¹⁹, Diane Wintz²⁰, Walter L Biffl²¹, Kathryn B Schaffer²², Thomas K Duncan²³, Casey Barbaro²⁴, Graal Diaz²⁵, Arianne Johnson²⁶, Justine Chinn²⁷, Ariana Naaseh²⁸, Amanda Leung²⁹, Christina Grabar³⁰, Jeffry Nahmias³¹

Affiliations

¹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: yeatese@hs.uci.edu.
² University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA; University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: areg.grigorian@med.usc.edu.
³ University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: morgan.schellenberg@med.usc.edu.
⁴ University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: natthida.owa@gmail.com.
⁵ Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: galinos.barmparas@cshs.org.
⁶ Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: daniel.margulies@cshs.org.
⁷ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: cjuillard@mednet.ucla.edu.
⁸ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: kgarber@mednet.ucla.edu.
⁹ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: hcryer@mednet.ucla.edu.
¹⁰ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: atillou@mednet.ucla.edu.
¹¹ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: sburruss@llu.edu.
¹² Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: lpenalozavillalobos@llu.edu.
¹³ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: aclin@llu.edu.
¹⁴ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: rfigueras@llu.edu.
¹⁵ Loma Linda University, Department of Surgery, Loma Linda, CA, USA; Riverside University Health System Medical Center, Moreno Valley, CA, USA. Electronic address: r.coimbra@ruhealth.org.
¹⁶ University of California, Riverside/Riverside University Health System Department of Surgery, Moreno Valley, CA, USA. Electronic address: m.brenner@ruhealth.org.
¹⁷ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: tcostantini@health.ucsd.edu.
¹⁸ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: jsantorelli@health.ucsd.edu.
¹⁹ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: tcurry@health.ucsd.edu.
²⁰ Sharp Memorial Hospital, Department of Surgery, San Diego, CA, USA. Electronic address: diane.wintzmd@sharp.com.
²¹ Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA, USA. Electronic address: biffl.walter@scrippshealth.org.
²² Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA, USA. Electronic address: schaffer.kathryn@scrippshealth.org.
²³ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: thomas.duncan@ventura.org.
²⁴ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: casey.barbaro@ventura.org.
²⁵ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: graal.diaz@ventura.org.
²⁶ Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA. Electronic address: a11johns@sbch.org.
²⁷ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: jochinn@hs.uci.edu.
²⁸ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: anaaseh1@hs.uci.edu.
²⁹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: leungac1@hs.uci.edu.
³⁰ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: grabarc@hs.uci.edu.
³¹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: jnahmias@hs.uci.edu.

PMID: 35219493
PMCID: PMC8863305
DOI: 10.1016/j.amjsurg.2022.02.055

Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic

Eric O Yeates et al. Am J Surg. 2022 Jul.

. 2022 Jul;224(1 Pt A):90-95.

doi: 10.1016/j.amjsurg.2022.02.055. Epub 2022 Feb 22.

Authors

Affiliations

¹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: yeatese@hs.uci.edu.
² University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA; University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: areg.grigorian@med.usc.edu.
³ University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: morgan.schellenberg@med.usc.edu.
⁴ University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA. Electronic address: natthida.owa@gmail.com.
⁵ Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: galinos.barmparas@cshs.org.
⁶ Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA. Electronic address: daniel.margulies@cshs.org.
⁷ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: cjuillard@mednet.ucla.edu.
⁸ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: kgarber@mednet.ucla.edu.
⁹ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: hcryer@mednet.ucla.edu.
¹⁰ University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA. Electronic address: atillou@mednet.ucla.edu.
¹¹ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: sburruss@llu.edu.
¹² Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: lpenalozavillalobos@llu.edu.
¹³ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: aclin@llu.edu.
¹⁴ Loma Linda University, Department of Surgery, Loma Linda, CA, USA. Electronic address: rfigueras@llu.edu.
¹⁵ Loma Linda University, Department of Surgery, Loma Linda, CA, USA; Riverside University Health System Medical Center, Moreno Valley, CA, USA. Electronic address: r.coimbra@ruhealth.org.
¹⁶ University of California, Riverside/Riverside University Health System Department of Surgery, Moreno Valley, CA, USA. Electronic address: m.brenner@ruhealth.org.
¹⁷ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: tcostantini@health.ucsd.edu.
¹⁸ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: jsantorelli@health.ucsd.edu.
¹⁹ University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA. Electronic address: tcurry@health.ucsd.edu.
²⁰ Sharp Memorial Hospital, Department of Surgery, San Diego, CA, USA. Electronic address: diane.wintzmd@sharp.com.
²¹ Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA, USA. Electronic address: biffl.walter@scrippshealth.org.
²² Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA, USA. Electronic address: schaffer.kathryn@scrippshealth.org.
²³ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: thomas.duncan@ventura.org.
²⁴ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: casey.barbaro@ventura.org.
²⁵ Ventura County Medical Center, Department of Surgery, Ventura, CA, USA. Electronic address: graal.diaz@ventura.org.
²⁶ Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA. Electronic address: a11johns@sbch.org.
²⁷ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: jochinn@hs.uci.edu.
²⁸ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: anaaseh1@hs.uci.edu.
²⁹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: leungac1@hs.uci.edu.
³⁰ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: grabarc@hs.uci.edu.
³¹ University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA. Electronic address: jnahmias@hs.uci.edu.

PMID: 35219493
PMCID: PMC8863305
DOI: 10.1016/j.amjsurg.2022.02.055

Abstract

Background: The COVID-19 pandemic overwhelmed hospitals, forcing adjustments including discharging patients earlier and limiting intensive care unit (ICU) utilization. This study aimed to evaluate ICU admissions and length of stay (LOS) for blunt trauma patients (BTPs).

Methods: A retrospective review of COVID (3/19/20-6/30/20) versus pre-COVID (3/19/19-6/30/19) BTPs at eleven trauma centers was performed. Multivariable analysis was used to identify risk factors for ICU admission.

Results: 12,744 BTPs were included (6942 pre-COVID vs. 5802 COVID). The COVID cohort had decreased mean LOS (3.9 vs. 4.4 days, p = 0.029), ICU LOS (0.9 vs. 1.1 days, p < 0.001), and rate of ICU admission (22.3% vs. 24.9%, p = 0.001) with no increase in complications or mortality compared to the pre-COVID cohort (all p > 0.05). On multivariable analysis, the COVID period was associated with decreased risk of ICU admission (OR = 0.82, CI 0.75-0.90, p < 0.001).

Conclusions: BTPs had decreased LOS and associated risk of ICU admission during COVID, with no corresponding increase in complications or mortality.

Keywords: Blunt; COVID-19; Intensive care unit; Length of stay; Trauma.

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Conflict of interest statement

The authors report that there are no conflicts of interest.

References

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1. Centers for Disease Control and Prevention United States COVID-19 cases and deaths by state. https://covid.cdc.gov/covid-data-tracker/#cases_casesinlast7days Updated April 23, 2021. Available at:
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Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic

Affiliations

Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic

Authors

Affiliations

Abstract

Conflict of interest statement

References

MeSH terms

LinkOut - more resources

Full Text Sources

Medical