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COVID-19 in trauma: a propensity-matched analysis of COVID and non-COVID trauma patients.
Yeates, Eric O; Grigorian, Areg; Schellenberg, Morgan; Owattanapanich, Natthida; Barmparas, Galinos; Margulies, Daniel; Juillard, Catherine; Garber, Kent; Cryer, Henry; Tillou, Areti; Burruss, Sigrid; Figueras, Ryan Arthur; Mladenov, Georgi; Brenner, Megan; Firek, Christopher; Costantini, Todd; Santorelli, Jarrett; Curry, Terry; Wintz, Diane; Biffl, Walter L; Schaffer, Kathryn B; Duncan, Thomas K; Barbaro, Casey; Diaz, Graal; Johnson, Arianne; Chinn, Justine; Naaseh, Ariana; Leung, Amanda; Grabar, Christina; Nahmias, Jeffry.
  • Yeates EO; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Grigorian A; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Schellenberg M; Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA.
  • Owattanapanich N; Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA.
  • Barmparas G; Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA.
  • Margulies D; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Juillard C; Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
  • Garber K; Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
  • Cryer H; Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
  • Tillou A; Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
  • Burruss S; Department of Surgery, University of California, Los Angeles (UCLA), Los Angeles, CA, USA.
  • Figueras RA; Department of Surgery, Loma Linda University, Loma Linda, CA, USA.
  • Mladenov G; Department of Surgery, Loma Linda University, Loma Linda, CA, USA.
  • Brenner M; Department of Surgery, Loma Linda University, Loma Linda, CA, USA.
  • Firek C; Department of Surgery, University of California, Riverside/Riverside University Health System, Moreno Valley, CA, USA.
  • Costantini T; Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Riverside University Health System, Moreno Valley, CA, USA.
  • Santorelli J; Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA.
  • Curry T; Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA.
  • Wintz D; Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA.
  • Biffl WL; Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA.
  • Schaffer KB; Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA.
  • Duncan TK; Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA.
  • Barbaro C; Department of Surgery, Ventura County Medical Center, Ventura, CA, USA.
  • Diaz G; Department of Surgery, Ventura County Medical Center, Ventura, CA, USA.
  • Johnson A; Department of Surgery, Ventura County Medical Center, Ventura, CA, USA.
  • Chinn J; Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA.
  • Naaseh A; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Leung A; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Grabar C; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
  • Nahmias J; Department of Surgery, University of California, Irvine (UCI), 333 The City Blvd West, Suite 1600, Orange, CA, 92868-3298, USA.
Eur J Trauma Emerg Surg ; 47(5): 1335-1342, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1241588
ABSTRACT

PURPOSE:

There is mounting evidence that surgical patients with COVID-19 have higher morbidity and mortality than patients without COVID-19. Infection is prevalent amongst the trauma population, but any effect of COVID-19 on trauma patients is unknown. We aimed to evaluate the effect of COVID-19 on a trauma population, hypothesizing increased mortality and pulmonary complications for COVID-19-positive (COVID) trauma patients compared to propensity-matched COVID-19-negative (non-COVID) patients.

METHODS:

A retrospective analysis of trauma patients presenting to 11 Level-I and II trauma centers in California between 1/1/2019-6/30/2019 and 1/1/2020-6/30/2020 was performed. A 12 propensity score model was used to match COVID to non-COVID trauma patients using age, blunt/penetrating mechanism, injury severity score, Glasgow Coma Scale score, systolic blood pressure, respiratory rate, and heart rate. Outcomes were compared between the two groups.

RESULTS:

A total of 20,448 trauma patients were identified during the study period. 53 COVID trauma patients were matched with 106 non-COVID trauma patients. COVID patients had higher rates of mortality (9.4% vs 1.9%, p = 0.029) and pneumonia (7.5% vs. 0.0%, p = 0.011), as well as a longer mean length of stay (LOS) (7.47 vs 3.28 days, p < 0.001) and intensive care unit LOS (1.40 vs 0.80 days, p = 0.008), compared to non-COVID patients.

CONCLUSION:

This multicenter retrospective study found increased rates of mortality and pneumonia, as well as a longer LOS, for COVID trauma patients compared to a propensity-matched cohort of non-COVID patients. Further studies are warranted to validate these findings and to elucidate the underlying pathways responsible for higher mortality in COVID trauma patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Eur J Trauma Emerg Surg Year: 2021 Document Type: Article Affiliation country: S00068-021-01699-9

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Randomized controlled trials Limits: Humans Language: English Journal: Eur J Trauma Emerg Surg Year: 2021 Document Type: Article Affiliation country: S00068-021-01699-9