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Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 1/2021

Open Access 01-12-2021 | Care | Original research

Trauma care during the COVID-19 pandemic in the Netherlands: a level 1 trauma multicenter cohort study

Authors: Nadia A. G. Hakkenbrak, Sverre A. I. Loggers, Eva Lubbers, Jarik de Geus, Stefan F. van Wonderen, Eva Berkeveld, Sarah Mikdad, Georgios F. Giannakopoulos, Kees J. Ponsen, Frank W. Bloemers, COVID-trauma collaborator group

Published in: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine | Issue 1/2021

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Abstract

Purpose

The coronavirus (COVID-19) pandemic has caused major healthcare challenges worldwide resulting in an exponential increase in the need for hospital- and intensive care support for COVID-19 patients. As a result, surgical care was restricted to urgent cases of surgery. However, the care for trauma patients is not suitable for reduction or delayed treatment. The influence of the pandemic on the burden of disease of trauma care remains to be elucidated.

Methods

All patients with traumatic injuries that were presented to the emergency departments (ED) of the Amsterdam University Medical Center, Location Academic Medical Center (AMC) and VU medical center (VUMC) and the Northwest Clinics (NWC) between March 10, 2019 and May 10, 2019 (non-COVID) and March 10, 2020 and May 10, 2020 (COVID-19 period) were included. The primary outcome was the difference in ED admissions for trauma patients between the non-COVID and COVID-19 study period. Additionally, patient- and injury characteristics, health care consumption, and 30-day mortality were evaluated.

Results

A 37% reduction of ED admissions for trauma patients was seen during the COVID-19 pandemic (non-COVID n = 2423 and COVID cohort n = 1531). Hospital admission was reduced by 1.6 trauma patients per day. Fewer patients sustained car- and sports-related injuries. Injuries after high energetic trauma were more severe in the COVID-19 period (Injury Severity Score 17.3 vs. 12.0, p = 0.006). Relatively more patients were treated operatively (21.4% vs. 16.6%, p < 0.001) during the COVID-19 period. Upper-(17.6 vs. 12.5%, p = 0.002) and lower extremity injuries (30.7 vs. 23.0%, p = 0.002) mainly accounted for this difference. The 30-day mortality rate was higher during the pandemic (1.0 vs. 2.3%, p = 0.001).

Conclusion

The burden of disease and healthcare consumption of trauma patients remained high during the COVID-19 pandemic. Results of this study can be used to optimize the use of hospital capacity and anticipate health care planning in future outbreaks.
Literature
1.
Chesser TJS, Handley R, Kloos J, De Wachter G, Putzeys G, Gómez-Vallejo J, et al. International trauma care: initial European approaches during the COVID 19 pandemic. OTA Int. 2021;4(1S):e112.CrossRef
2.
3.
Huang CC, Yen DH, Huang HH, Kao WF, Wang LM, Huang CI, Lee CH. Impact of severe acute respiratory syndrome (SARS) outbreaks on the use of emergency department medical resources. J Chin Med Assoc. 2005;68(6):254–9.CrossRef
4.
Man CY, Yeung RS, Chung JY, Cameron PA. Impact of SARS on an emergency department in Hong Kong. Emerg Med (Fremantle). 2003;15(5–6):418–22.CrossRef
5.
Barten DG, Latten GHP, van Osch FHM. Reduced emergency department utilization during the early phase of the COVID-19 pandemic: viral fear or lockdown effect? Dis Med Public Health Prepared. 2020;6:66.
6.
Nuñez JH, Sallent A, Lakhani K, Guerra-Farfan E, Vidal N, Ekhtiari S, Minguell J. Impact of the COVID-19 Pandemic on a emergency traumatology service: experience at a tertiary trauma centre in Spain. Injury. 2020;51:1414–8.CrossRef
7.
von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4:296.CrossRef
8.
Richtlijn Triage op de spoedeisende hulp. CRCA 5: 5 (2008).
9.
Nakahara S, Uchida Y, Oda J, Yokota J. Bridging classification for injury diagnoses that can be converted to both the International Classification of Diseases and the Abbreviated Injury Scale. Acute Med Surg. 2013;1(1):10–6.CrossRef
10.
Valadka AB, Dannenbaum MJ. Traumatic brain injury: pathophysiology, clinical diagnosis, and prehospital and emergency center care. Curr Ther Trauma Surg Crit Care. 2008;6:66.
11.
Leichtle SW, Rodas EB, Procter L, Bennett J, Schrader R, Aboutanos MB. The influence of a statewide “Stay-at-Home” order on trauma volume and patterns at a level 1 trauma center in the united states. Injury. 2020;51(11):2437–41.CrossRef
12.
Sherman WF, Khadra HS, Kale NN, Wu VJ, Gladden PB, Lee OC. How did the number and type of injuries in patients presenting to a regional level i trauma center change during the COVID-19 pandemic with a stay-at-home order? Clin Orthop Relat Res. 2021;479(2):266–75.CrossRef
13.
James PB, Wardle J, Steel A, Adams J. Post-Ebola psychosocial experiences and coping mechanisms among Ebola survivors: a systematic review. Trop Med Int Health. 2019;24(6):671–91.CrossRef
14.
Cheung YT, Chau PH, Yip PS. A revisit on older adults suicides and Severe Acute Syndrome (SARS) epidemic in Hong Kong. Int J Geriatr Psychiatry. 2008;23(12):1231–8.CrossRef
15.
Hao F, Tan W, Jiang L, Zhang L, Zhao X, Zou Y, et al. Do psychiatric patients experience more psychiatric symptoms during COVID-19 pandemic and lockdown? A case–control study with service and research implications for immunopsychiatry. Brain Behav Immun. 2020;87:100–6.CrossRef
16.
Rizzi AM, Polachek WS, Dulas M, Strelzow JA, Hynes KK. The new “normal”: rapid adoption of telemedicine in orthopaedics during the COVID-19 pandemic. Injury. 2020;6:66.
Metadata
Title
Trauma care during the COVID-19 pandemic in the Netherlands: a level 1 trauma multicenter cohort study
Authors
Nadia A. G. Hakkenbrak
Sverre A. I. Loggers
Eva Lubbers
Jarik de Geus
Stefan F. van Wonderen
Eva Berkeveld
Sarah Mikdad
Georgios F. Giannakopoulos
Kees J. Ponsen
Frank W. Bloemers
COVID-trauma collaborator group
Publication date
01-12-2021
Publisher
BioMed Central
Keywords
Care
COVID-19
DOI
https://doi.org/10.1186/s13049-021-00942-x

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