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The influence of a statewide “Stay-at-Home” order on trauma volume and patterns at a level 1 trauma center in the united states

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.