Changes in adult trauma at a level 1 trauma center before and during the COVID-19 pandemic
Garcia A,
Walter D,
Chan H K,
Walia S,
Hoot N,
Huebinger R,
Ugalde I,
Chavez S
Affiliations
Garcia A
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
Walter D
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
Chan H K
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, USA
Walia S
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
Hoot N
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, USA
Huebinger R
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, USA
Ugalde I
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Texas Emergency Medicine Research Center, McGovern Medical School, Houston, TX, USA
Chavez S
Department of Emergency Medicine, McGovern Medical School at the University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA; Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX, USA; Corresponding author. Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, 5055 Medical Circle, Room 1316, Houston, TX, 77204, USA.
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.
