ABSTRACT
The governor of Tennessee issued an order on March 30, 2020, directing Tennesseans to stay home in response to the COVID-19 pandemic. Recent studies demonstrated a decrease in emergency department (ED) visits and in trauma during the pandemic. We wanted to see the effect of the COVID-19 pandemic on the East Tennessee trauma population presentation patterns and outcomes. The trauma population at an American College of Surgeons-verified Level-I trauma center in East Tennessee was examined 6 months before and after the stay-home executive order was issued. The data examined included demographic information, patient disposition, complications, and mortality. 7,587 patients were reviewed, with 3,509 (46.3%) patients presenting prior to shelter in place vs 4,078 (53.7%) patients presenting after shelter in place. Following stay-home orders, the trauma population was younger (54.55 vs 51.85, p = .001) and more likely to be male (p = .016). There was a higher rate of penetrating injuries post the stay-home order (p = .001). Patients were more likely to be admitted from the ED (65.4% vs 65.9%, p = .009) and less likely to be discharged home from the ED (30.3% vs 29.3%, p = .009). Admitted patients were less likely to be discharged to a skilled nursing facility (15.4% vs. 10.3%, p < .001) and more likely to be discharged home with services (6.5% vs 10.4%, p < .001). There was no difference in mortality between groups. Trauma volume was sustained during the pandemic. Demographics and dispositions were statistically different. Penetrating trauma increased following stay-home orders, which may prompt preventative measures in future pandemics. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
The governor of Tennessee issued an order on March 30, 2020, directing Tennesseans to stay home in response to the COVID-19 pandemic. Recent studies demonstrated a decrease in emergency department (ED) visits and in trauma during the pandemic. We wanted to see the effect of the COVID-19 pandemic on the East Tennessee trauma population presentation patterns and outcomes. The trauma population at an American College of Surgeons-verified Level-I trauma center in East Tennessee was examined 6 months before and after the stay-home executive order was issued. The data examined included demographic information, patient disposition, complications, and mortality. 7,587 patients were reviewed, with 3,509 (46.3%) patients presenting prior to shelter in place vs 4,078 (53.7%) patients presenting after shelter in place. Following stay-home orders, the trauma population was younger (54.55 vs 51.85, p = .001) and more likely to be male (p = .016). There was a higher rate of penetrating injuries post the stay-home order (p = .001). Patients were more likely to be admitted from the ED (65.4% vs 65.9%, p = .009) and less likely to be discharged home from the ED (30.3% vs 29.3%, p = .009). Admitted patients were less likely to be discharged to a skilled nursing facility (15.4% vs. 10.3%, p < .001) and more likely to be discharged home with services (6.5% vs 10.4%, p < .001). There was no difference in mortality between groups. Trauma volume was sustained during the pandemic. Demographics and dispositions were statistically different. Penetrating trauma increased following stay-home orders, which may prompt preventative measures in future pandemics. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
ABSTRACT
BACKGROUND: During the coronavirus disease 2019 pandemic, trauma presentations to the emergency room decreased across the country. The goal of this study is to analyze the educational impact of coronavirus disease 2019 on trauma education and training at a level I trauma center. METHODS: Trauma patient presentations were analyzed 6 months before a Tennessee executive stay-at-home order and 6 months after the state executive order. To control for the seasonal trauma volumes, an additional 6 months before the executive order was then analyzed comparing month to month. Total number of presentations, demographics, procedures, airway management, and coronavirus disease 2019 status of patients and residents were analyzed. RESULTS: The number of trauma presentations were sustained after executive orders at our level I trauma center. There was no significant difference in intubations, central line placements, and chest tube placements before and during the pandemic. Blunt trauma decreased after stay-at-home orders. Of the 36 residents, no residents tested positive during the study period. CONCLUSION: Trauma-focused surgical education was not affected at an academic level I trauma center. Understanding that it is region, city, and hospital specific, this study shows that quality trauma education can continue throughout the coronavirus disease 2019 pandemic while keeping trainees safe. Proper airway management, personal protective equipment, social distancing, and coronavirus disease 2019-preventative protocols seem to protect residents from potential harm while allowing them to participate and continue in quality trauma education and training.