Garcia A , Walter D , Chan H K , Walia S , Hoot N , Huebinger R , Ugalde I , Chavez S
{"title":"在COVID-19大流行之前和期间,一级创伤中心成人创伤的变化","authors":"Garcia A , Walter D , Chan H K , Walia S , Hoot N , Huebinger R , Ugalde I , Chavez S","doi":"10.1016/j.jemrpt.2023.100024","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Prior research has shown the COVID-19 pandemic is associated with changes in ED volumes, trauma caseloads and distribution of disease.</p></div><div><h3>Objectives</h3><p>We aim to characterize the impact of the COVID-19 pandemic at a diverse, high-volume Level 1 trauma center in the US.</p></div><div><h3>Methods</h3><p>We performed a retrospective review of our institutional trauma registry at our center from 2018 through 2021 to study changes before and after COVID-19. We established March 14 – December 31 as the study period of interest for each year. We analyzed the data with descriptive statistics and created Poisson regression models to determine the estimated percentage year-to-year changes.</p></div><div><h3>Results</h3><p>Total number of trauma cases increased with each subsequent year from 2018 (N = 4605) to 2021 (N = 7331) (total N = 23,727). In general, the proportion of Black or African American patients increased over time (2018: 19.2%, 2021: 23.0%). The proportion of patients insured by Medicaid (8.0% vs 10.5%) and Medicare (26.5% vs 32.8%) increased from 2018 to 2021. Comparing 2019 to 2020, we found increases in violent traumas: GSW (+88.6%, 95% CI 63.8%–117.2%) and stabbings (+39.6%, 95% CI 8.1%–80.3%). Trauma patient ED LOS decreased from 300 min (67–400 IQR) in 2018 to 249 min in 2021 (104–510 IQR).</p></div><div><h3>Conclusion</h3><p>This analysis identified increased trauma volumes, especially violent trauma (GSW, stabbing, other penetrating). There was a greater proportion of Black/African American patients and those insured with Medicare or Medicaid during the pandemic. TED LOS decreased over time while ED mortality and hospital LOS remained stable.</p></div>","PeriodicalId":73546,"journal":{"name":"JEM reports","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122564/pdf/","citationCount":"1","resultStr":"{\"title\":\"Changes in adult trauma at a level 1 trauma center before and during the COVID-19 pandemic\",\"authors\":\"Garcia A , Walter D , Chan H K , Walia S , Hoot N , Huebinger R , Ugalde I , Chavez S\",\"doi\":\"10.1016/j.jemrpt.2023.100024\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Prior research has shown the COVID-19 pandemic is associated with changes in ED volumes, trauma caseloads and distribution of disease.</p></div><div><h3>Objectives</h3><p>We aim to characterize the impact of the COVID-19 pandemic at a diverse, high-volume Level 1 trauma center in the US.</p></div><div><h3>Methods</h3><p>We performed a retrospective review of our institutional trauma registry at our center from 2018 through 2021 to study changes before and after COVID-19. We established March 14 – December 31 as the study period of interest for each year. We analyzed the data with descriptive statistics and created Poisson regression models to determine the estimated percentage year-to-year changes.</p></div><div><h3>Results</h3><p>Total number of trauma cases increased with each subsequent year from 2018 (N = 4605) to 2021 (N = 7331) (total N = 23,727). In general, the proportion of Black or African American patients increased over time (2018: 19.2%, 2021: 23.0%). The proportion of patients insured by Medicaid (8.0% vs 10.5%) and Medicare (26.5% vs 32.8%) increased from 2018 to 2021. Comparing 2019 to 2020, we found increases in violent traumas: GSW (+88.6%, 95% CI 63.8%–117.2%) and stabbings (+39.6%, 95% CI 8.1%–80.3%). Trauma patient ED LOS decreased from 300 min (67–400 IQR) in 2018 to 249 min in 2021 (104–510 IQR).</p></div><div><h3>Conclusion</h3><p>This analysis identified increased trauma volumes, especially violent trauma (GSW, stabbing, other penetrating). There was a greater proportion of Black/African American patients and those insured with Medicare or Medicaid during the pandemic. TED LOS decreased over time while ED mortality and hospital LOS remained stable.</p></div>\",\"PeriodicalId\":73546,\"journal\":{\"name\":\"JEM reports\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2023-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10122564/pdf/\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"JEM reports\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2773232023000202\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"JEM reports","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2773232023000202","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Changes in adult trauma at a level 1 trauma center before and during the COVID-19 pandemic
Background
Prior research has shown the COVID-19 pandemic is associated with changes in ED volumes, trauma caseloads and distribution of disease.
Objectives
We aim to characterize the impact of the COVID-19 pandemic at a diverse, high-volume Level 1 trauma center in the US.
Methods
We performed a retrospective review of our institutional trauma registry at our center from 2018 through 2021 to study changes before and after COVID-19. We established March 14 – December 31 as the study period of interest for each year. We analyzed the data with descriptive statistics and created Poisson regression models to determine the estimated percentage year-to-year changes.
Results
Total number of trauma cases increased with each subsequent year from 2018 (N = 4605) to 2021 (N = 7331) (total N = 23,727). In general, the proportion of Black or African American patients increased over time (2018: 19.2%, 2021: 23.0%). The proportion of patients insured by Medicaid (8.0% vs 10.5%) and Medicare (26.5% vs 32.8%) increased from 2018 to 2021. Comparing 2019 to 2020, we found increases in violent traumas: GSW (+88.6%, 95% CI 63.8%–117.2%) and stabbings (+39.6%, 95% CI 8.1%–80.3%). Trauma patient ED LOS decreased from 300 min (67–400 IQR) in 2018 to 249 min in 2021 (104–510 IQR).
Conclusion
This analysis identified increased trauma volumes, especially violent trauma (GSW, stabbing, other penetrating). There was a greater proportion of Black/African American patients and those insured with Medicare or Medicaid during the pandemic. TED LOS decreased over time while ED mortality and hospital LOS remained stable.