The influence of a statewide "Stay-at-Home" order on trauma volume and patterns at a level 1 trauma center in the united states.
Identifieur interne : 000B27 ( Main/Exploration ); précédent : 000B26; suivant : 000B28The influence of a statewide "Stay-at-Home" order on trauma volume and patterns at a level 1 trauma center in the united states.
Auteurs : Stefan W. Leichtle [États-Unis] ; Edgar B. Rodas [États-Unis] ; Levi Procter [États-Unis] ; Jonathan Bennett [États-Unis] ; Robin Schrader [États-Unis] ; Michel B. Aboutanos [États-Unis]Source :
- Injury [ 1879-0267 ] ; 2020.
Abstract
The COVID pandemic of 2020 resulted in unprecedented restrictions of public life in most countries around the world, and many hospital systems experienced dramatic decreases in non-COVID related patient admissions. We aimed to compare trauma volumes, patient characteristics, and trauma mechanisms at a large, urban Level 1 trauma center in the United States during a state-wide "State of Emergency" and "stay-at-home" order to corresponding historic dates. All adult trauma activations from March 1 through April 30, 2020 and a historic control from March 1 through April 30, 2018 and 2019 were reviewed in the institution's trauma registry. Trauma volumes, patient characteristics, and trauma mechanisms were compared over time as increasingly stricter COVID-related restrictions were enacted in the Commonwealth of Virginia. After declaration of a state-wide "Public Health Emergency" on March 17, 2020, the daily number of trauma activations significantly declined to a mean of 4.7 (standard deviation, SD = 2.6), a decrease by 43% from a mean of 8.2 (SD = 0.3) for the same dates in 2018 and 2019. Trauma activations during COVID restrictions vs. historic control were characterized by significantly higher prevalence of chronic alcohol use (15.5% vs. 6.8%, p < 0.01), higher median (25th - 75th percentile) Injury Severity Score of 9 (5 - 16) vs. 6 (4 - 14), p = 0.01, and shorter median (25th - 75th percentile) length of hospital stay of 2 (1 - 6) days vs. 3 (1 - 7) days, p = 0.03. The COVID-related Public Health Emergency and "stay-at-home" order in the Commonwealth of Virginia dramatically reduced overall trauma volumes with minor but interesting changes in trauma patterns.
DOI: 10.1016/j.injury.2020.08.014
PubMed: 32798035
PubMed Central: PMC7414300
Affiliations:
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Leichtle</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States. Electronic address: stefan.leichtle@vcuhealth.org.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Rodas, Edgar B" sort="Rodas, Edgar B" uniqKey="Rodas E" first="Edgar B" last="Rodas">Edgar B. Rodas</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Procter, Levi" sort="Procter, Levi" uniqKey="Procter L" first="Levi" last="Procter">Levi Procter</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Bennett, Jonathan" sort="Bennett, Jonathan" uniqKey="Bennett J" first="Jonathan" last="Bennett">Jonathan Bennett</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Schrader, Robin" sort="Schrader, Robin" uniqKey="Schrader R" first="Robin" last="Schrader">Robin Schrader</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author><author><name sortKey="Aboutanos, Michel B" sort="Aboutanos, Michel B" uniqKey="Aboutanos M" first="Michel B" last="Aboutanos">Michel B. Aboutanos</name><affiliation wicri:level="2"><nlm:affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA</wicri:regionArea><placeName><region type="state">Virginie</region></placeName></affiliation></author></analytic><series><title level="j">Injury</title><idno type="eISSN">1879-0267</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The COVID pandemic of 2020 resulted in unprecedented restrictions of public life in most countries around the world, and many hospital systems experienced dramatic decreases in non-COVID related patient admissions. We aimed to compare trauma volumes, patient characteristics, and trauma mechanisms at a large, urban Level 1 trauma center in the United States during a state-wide "State of Emergency" and "stay-at-home" order to corresponding historic dates. All adult trauma activations from March 1 through April 30, 2020 and a historic control from March 1 through April 30, 2018 and 2019 were reviewed in the institution's trauma registry. Trauma volumes, patient characteristics, and trauma mechanisms were compared over time as increasingly stricter COVID-related restrictions were enacted in the Commonwealth of Virginia. After declaration of a state-wide "Public Health Emergency" on March 17, 2020, the daily number of trauma activations significantly declined to a mean of 4.7 (standard deviation, SD = 2.6), a decrease by 43% from a mean of 8.2 (SD = 0.3) for the same dates in 2018 and 2019. Trauma activations during COVID restrictions vs. historic control were characterized by significantly higher prevalence of chronic alcohol use (15.5% vs. 6.8%, p < 0.01), higher median (25th - 75th percentile) Injury Severity Score of 9 (5 - 16) vs. 6 (4 - 14), p = 0.01, and shorter median (25th - 75th percentile) length of hospital stay of 2 (1 - 6) days vs. 3 (1 - 7) days, p = 0.03. The COVID-related Public Health Emergency and "stay-at-home" order in the Commonwealth of Virginia dramatically reduced overall trauma volumes with minor but interesting changes in trauma patterns.</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">32798035</PMID><DateRevised><Year>2021</Year><Month>01</Month><Day>27</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1879-0267</ISSN><JournalIssue CitedMedium="Internet"><Volume>51</Volume><Issue>11</Issue><PubDate><Year>2020</Year><Month>Nov</Month></PubDate></JournalIssue><Title>Injury</Title><ISOAbbreviation>Injury</ISOAbbreviation></Journal><ArticleTitle>The influence of a statewide "Stay-at-Home" order on trauma volume and patterns at a level 1 trauma center in the united states.</ArticleTitle><Pagination><MedlinePgn>2437-2441</MedlinePgn></Pagination><ELocationID EIdType="pii" ValidYN="Y">S0020-1383(20)30686-0</ELocationID><ELocationID EIdType="doi" ValidYN="Y">10.1016/j.injury.2020.08.014</ELocationID><Abstract><AbstractText>The COVID pandemic of 2020 resulted in unprecedented restrictions of public life in most countries around the world, and many hospital systems experienced dramatic decreases in non-COVID related patient admissions. We aimed to compare trauma volumes, patient characteristics, and trauma mechanisms at a large, urban Level 1 trauma center in the United States during a state-wide "State of Emergency" and "stay-at-home" order to corresponding historic dates. All adult trauma activations from March 1 through April 30, 2020 and a historic control from March 1 through April 30, 2018 and 2019 were reviewed in the institution's trauma registry. Trauma volumes, patient characteristics, and trauma mechanisms were compared over time as increasingly stricter COVID-related restrictions were enacted in the Commonwealth of Virginia. After declaration of a state-wide "Public Health Emergency" on March 17, 2020, the daily number of trauma activations significantly declined to a mean of 4.7 (standard deviation, SD = 2.6), a decrease by 43% from a mean of 8.2 (SD = 0.3) for the same dates in 2018 and 2019. Trauma activations during COVID restrictions vs. historic control were characterized by significantly higher prevalence of chronic alcohol use (15.5% vs. 6.8%, p < 0.01), higher median (25th - 75th percentile) Injury Severity Score of 9 (5 - 16) vs. 6 (4 - 14), p = 0.01, and shorter median (25th - 75th percentile) length of hospital stay of 2 (1 - 6) days vs. 3 (1 - 7) days, p = 0.03. The COVID-related Public Health Emergency and "stay-at-home" order in the Commonwealth of Virginia dramatically reduced overall trauma volumes with minor but interesting changes in trauma patterns.</AbstractText><CopyrightInformation>Copyright © 2020 Elsevier Ltd. All rights reserved.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Leichtle</LastName><ForeName>Stefan W</ForeName><Initials>SW</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States. Electronic address: stefan.leichtle@vcuhealth.org.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rodas</LastName><ForeName>Edgar B</ForeName><Initials>EB</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Procter</LastName><ForeName>Levi</ForeName><Initials>L</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bennett</LastName><ForeName>Jonathan</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schrader</LastName><ForeName>Robin</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Aboutanos</LastName><ForeName>Michel B</ForeName><Initials>MB</Initials><AffiliationInfo><Affiliation>Division of Acute Care Surgical Services, Department of Surgery, Virginia Commonwealth University, 1200 E Broad Street, West Hospital, 15th Floor, East Wing, Richmond, VA, United States.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>08</Day></ArticleDate></Article><MedlineJournalInfo><Country>Netherlands</Country><MedlineTA>Injury</MedlineTA><NlmUniqueID>0226040</NlmUniqueID><ISSNLinking>0020-1383</ISSNLinking></MedlineJournalInfo><CitationSubset>IM</CitationSubset><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">Covid pandemic</Keyword><Keyword MajorTopicYN="N">Lockdown</Keyword><Keyword MajorTopicYN="N">State of emergency</Keyword><Keyword MajorTopicYN="N">Trauma center</Keyword><Keyword MajorTopicYN="N">Trauma volume</Keyword><Keyword MajorTopicYN="N">United states</Keyword></KeywordList><CoiStatement>Declaration of Competing Interest This research did not receive any specific grant from funding agencies. Declarations of interest: none.</CoiStatement></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>05</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="revised"><Year>2020</Year><Month>07</Month><Day>17</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>08</Month><Day>07</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2020</Year><Month>8</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>17</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">32798035</ArticleId><ArticleId IdType="pii">S0020-1383(20)30686-0</ArticleId><ArticleId IdType="doi">10.1016/j.injury.2020.08.014</ArticleId><ArticleId IdType="pmc">PMC7414300</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Virginie</li></region></list><tree><country name="États-Unis"><region name="Virginie"><name sortKey="Leichtle, Stefan W" sort="Leichtle, Stefan W" uniqKey="Leichtle S" first="Stefan W" last="Leichtle">Stefan W. Leichtle</name></region><name sortKey="Aboutanos, Michel B" sort="Aboutanos, Michel B" uniqKey="Aboutanos M" first="Michel B" last="Aboutanos">Michel B. Aboutanos</name><name sortKey="Bennett, Jonathan" sort="Bennett, Jonathan" uniqKey="Bennett J" first="Jonathan" last="Bennett">Jonathan Bennett</name><name sortKey="Procter, Levi" sort="Procter, Levi" uniqKey="Procter L" first="Levi" last="Procter">Levi Procter</name><name sortKey="Rodas, Edgar B" sort="Rodas, Edgar B" uniqKey="Rodas E" first="Edgar B" last="Rodas">Edgar B. Rodas</name><name sortKey="Schrader, Robin" sort="Schrader, Robin" uniqKey="Schrader R" first="Robin" last="Schrader">Robin Schrader</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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