Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 lockdown

Eur J Trauma Emerg Surg. 2021 Jun;47(3):631-636. doi: 10.1007/s00068-020-01507-w. Epub 2020 Sep 30.

Abstract

Purpose: The COVID-19 pandemic has impacted healthcare systems globally, little is known about the trauma patterns during a national lockdown. The aim of this study is to delineate the trauma patterns and outcomes at Aintree University Teaching Hospital level 1 Major Trauma Centre (MTC) during the COVID-19 lockdown imposed by the U.K. government.

Methods: A retrospective cohort study data from the Merseyside and Cheshire Trauma Audit and Research Network database were analysed. The 7-week 'lockdown period' was compared to a 7-week period prior to the lockdown and also to an equivalent 7-week period corresponding to the previous year.

Results: A total of 488 patients were included in the study. Overall, there was 37.6% and 30.0% reduction in the number of traumatic injuries during lockdown. Road traffic collisions (RTC) reduced by 42.6% and 46.6%. RTC involving a car significantly reduced during lockdown, conversely, bike-related RTC significantly increased. No significant changes were noted in deliberate self-harm, trauma severity and crude mortality during lockdown. There was 1 mortality from COVID-19 infection in the lockdown cohort.

Conclusion: Trauma continues during lockdown, our MTC has continued to provide a full service during lockdown. However, trauma patterns have changed and departments should adapt to balance these alongside the COVID-19 pandemic. As the U.K. starts its cautious transition out of lockdown, trauma services are required to be flexible during changes in national social restrictions and changing trauma patterns. COVID-19 and lockdown state were found to have no significant impact on survival outcomes for trauma.

Keywords: COVID-19; Emergency surgery; Lockdown; Pandemic; Trauma.

MeSH terms

  • Accidents, Traffic / statistics & numerical data
  • Adult
  • COVID-19* / epidemiology
  • COVID-19* / prevention & control
  • Clinical Audit / methods
  • Clinical Audit / statistics & numerical data
  • Emergency Service, Hospital / statistics & numerical data*
  • Female
  • Humans
  • Infection Control* / methods
  • Infection Control* / organization & administration
  • Male
  • Retrospective Studies
  • SARS-CoV-2
  • Self-Injurious Behavior / epidemiology
  • Surgical Procedures, Operative / statistics & numerical data*
  • Trauma Centers / statistics & numerical data
  • Trauma Severity Indices
  • United Kingdom / epidemiology
  • Wounds and Injuries* / classification
  • Wounds and Injuries* / epidemiology
  • Wounds and Injuries* / etiology
  • Wounds and Injuries* / therapy