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Quality of care was not compromised during the COVID ‐19 pandemic at a level 1 trauma centre
Author(s) -
Saxon Leanne,
Fazio Timothy N.,
Gumm Kellie,
Tong Steven Y. C.,
Read David J.
Publication year - 2021
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.17154
Subject(s) - medicine , pandemic , emergency medicine , covid-19 , intensive care unit , epidemiology , trauma center , population , emergency department , trauma care , major trauma , injury severity score , medical emergency , trauma surgery , injury prevention , retrospective cohort study , poison control , intensive care medicine , surgery , orthopedic surgery , disease , environmental health , psychiatry , infectious disease (medical specialty)
Background The COVID‐19 pandemic has had a profound effect on the presentation and management of trauma at the Royal Melbourne Hospital, a level 1 adult major trauma service and a designated COVID‐19 hospital. This study compares the changes in epidemiology and trauma patient access to emergency imaging and surgery during the pandemic response. Methods The population of interest was all trauma patients captured in the hospital's trauma registry from 16 March 2016 to 10 September 2020. Regression modelling assessed changes in mechanism and severity of the injury, and mortality during two lockdowns compared with the proceeding 4 years. Cases were matched with hospital administrative databases to assess mean time from admission to emergency computed tomography (CT) scan, operating theatre, length of stay (LOS) and immediate surgery (OPSTAT). Results Throughout 2020, the hospital treated 525 COVID‐19 patients. Compared with previous years, there was up to 34% reduction in major trauma and a 28% reduction in minor trauma admissions during the pandemic ( p < 0.05). Intensive care unit admissions were almost half of predicted. Some of the largest reductions were seen in motor vehicle crashes (49%) and falls (28%) ( p < 0.05). Time to CT, surgery and immediate surgery (OPSTAT) showed no change and having a suspected COVID‐19 diagnosis did not prolong any of these times except for the LOS. Mortality was similar to previous years. Conclusion The COVID‐19 pandemic has had widespread societal changes, resulting in a substantial decrease in trauma presentations. Despite COVID's immense impact on the hospital's trauma service, the quality of care was not impaired.