Changes in the characteristics of trauma patients after the early COVID-19 outbreak A retrospective study of a regional level 1 trauma center in Republic of Korea

Abstract

Gyeonggi-do (Gyeonggi province) has the second highest number of coronavirus disease (COVID-19) cases in the Republic of Korea after Seoul, with approximately 25% of the COVID-19 patients as of January 2021. Our center is a level I trauma center located in south Gyeonggi-do, and we aimed to evaluate whether the characteristics of trauma patients changed after the COVID-19 pandemic.We retrospectively reviewed the trauma patients registered with the Korea Trauma Database of the Center from February 2019 to January 2021. The patients were dichotomized into pre-coronavirus disease (pre-COVID) and coronavirus disease (COVID) groups, and their trauma volumes, injury characteristics, intentionality, and outcomes were compared.A total of 2628 and 2636 patients were included in the pre-COVID and COVID groups, respectively. During the COVID-19 period, motorcycle accidents, bicycle accidents, and penetrating injury cases increased, and pedestrian traffic accidents, slips, and injury by machines decreased. The average daily number of patients in the COVID group was lower in March (5.6 +/- 2.6/day vs 7.2 +/- 2.4/day, P = .014) and higher in September (9.9 +/- 3.2/day vs 7.7 +/- 2.0/day, P = .003) compared to the pre-COVID group. The COVID group also had a higher ratio of direct admissions (67.5% vs 57.2%, P < .001), proportion of suicidal patients (4.1% vs 2.7%, P = .005), and injury severity scores (14 [9-22] vs 12 [4-22], P < .001) than the pre-COVID group. The overall mortality (4.7% vs 4.9%, P = .670) and intensive care unit length of stay (2 [0-3] days vs 2 [0-4] days, P = .153) was not different between the 2 groups.Although the total number of patients did not change, the COVID-19 pandemic affected the number of monthly admissions and the injury mechanisms changed. More severely injured patients were admitted directly to the trauma center.