Variation in patterns and volumes of injuries admitted to a level one trauma center during lockdown for COVID-19

Abstract

Introduction: Due to the global COVID-19 pandemic, a ban on sports outside one's home and a prohibition on travel between communities were imposed in spring 2020 in Tyrol, Austria. The aim of this study was to evaluate the impact of these restrictions on a level one trauma center. The objective was to identify the most common injury patterns to ensure targeted prevention in times of an ongoing pandemic.

Material and methods: Patients who presented themselves to our trauma center between weeks 7 and 22 in 2020 were retrospectively compared to a mean of the patients of the three previous years (2017-2019). The evaluated variables were the number of patients, age, gender, country of residence, place of accident, time of treatment, injured body region and anatomical structure, number of surgical intervention and severely injured patients.

Results: Comparing the mean count of treated patients per week in 2020 of the pre-lockdown period (n = 804.6) with the lockdown period (n = 201.8) a decrease in admissions by 69.7% could be observed. The admission incidence was 9.9 times higher in previous years than in 2020 during the lockdown period. Among the injuries treated during the lockdown the largest increase in relative numbers was in home injuries, head or face injuries and superficial or penetrating injuries. There was a decrease of seriously injured patients as well as patients that needed surgery during the lockdown compared to previous years.

Conclusions: We observed a significant change in the pattern and volume of injuries during a strict lockdown. Intervention programs to reduce the risk of home injuries should be introduced. Furthermore, in order to save resources during a pandemic, specific guidelines on patient management and treatment should be established for the respective medical specialties.

Trial registration: 1157/2020, 10.12.2020.

Keywords: COVID-19; Ischgl; Lockdown; Pandemic; SARS-CoV-2; Trauma center.

Fig. 1

Number of patients admitted to the trauma center per week within the study period weeks 7–22; mean presentations per week in 2017–2019 (blue, triangle) compared to the presentations per week in 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 2

Incidence of trauma admissions within the period of the strict lockdown, comparing previous years with 2020 in specific subgroups. RR = relative risk, CI = confidence interval. ^aSeverely injured patients were assessed with New Injury Severity Scale > 12

Fig. 3

Proportion of all patients admitted to the trauma center per week within the study period in the year 2020 depending on the place of accident. Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 4

Absolute number of patients admitted because of place of accident at home throughout the study period comparing years 2017–2019 (blue, triangle) with the year 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 5

Number of patients admitted because of an accident at work throughout the study period comparing years 2017–2019 (blue, triangle) with year 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 6

Number of patients admitted because of an accident at a nursing home throughout the study period comparing years 2017–2019 (blue, triangle) with year 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 7

Number of patients admitted because of a traffic accident throughout the study period comparing years 2017–2019 (blue, triangle) with year 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 8

Number of severely injured patients admitted to the trauma center according to the New Injury Severity Scale in 2020. Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 9

Number of patients admitted to the trauma center undergoing surgery comparing years 2017–2019 (blue, triangle) with year 2020 (red, circle). Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 10

Number of patients admitted to the trauma center in 2020 throughout the study period grouped into admissions at day, evening and night. Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 11

Relative count of body region injured in 2020. Beginning and end of lockdown are marked with lines in weeks 12 and 15

Fig. 12

Relative count of anatomical structure injured in 2020. Beginning and end of lockdown are marked with lines in weeks 12 and 15