Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic - 20/06/22

Doi : 10.1016/j.amjsurg.2022.02.055

Eric O. Yeates ^a,^⁎ , Areg Grigorian ^a,^b , Morgan Schellenberg ^b , Natthida Owattanapanich ^b , Galinos Barmparas ^c , Daniel Margulies ^c , Catherine Juillard ^d , Kent Garber ^d , Henry Cryer ^d , Areti Tillou ^d , Sigrid Burruss ^e , Liz Penaloza-Villalobos ^e , Ann Lin ^e , Ryan Arthur Figueras ^e , Raul Coimbra ^e,^f , Megan Brenner ^g , Todd Costantini ^h , Jarrett Santorelli ^h , Terry Curry ^h , Diane Wintz ⁱ , Walter L. Biffl ^j , Kathryn B. Schaffer ^j , Thomas K. Duncan ^k , Casey Barbaro ^k , Graal Diaz ^k , Arianne Johnson ^l , Justine Chinn ^a , Ariana Naaseh ^a , Amanda Leung ^a , Christina Grabar ^a , Jeffry Nahmias ^a
^a University of California, Irvine (UCI), Department of Surgery, Orange, CA, USA
^b University of Southern California (USC), Department of Surgery, Los Angeles, CA, USA
^c Cedars-Sinai Medical Center, Department of Surgery, Los Angeles, CA, USA
^d University of California, Los Angeles (UCLA), Department of Surgery, Los Angeles, CA, USA
^e Loma Linda University, Department of Surgery, Loma Linda, CA, USA
^f Riverside University Health System Medical Center, Moreno Valley, CA, USA
^g University of California, Riverside/Riverside University Health System Department of Surgery, Moreno Valley, CA, USA
^h University of California, San Diego (UCSD), Department of Surgery, San Diego, CA, USA
ⁱ Sharp Memorial Hospital, Department of Surgery, San Diego, CA, USA
^j Scripps Memorial Hospital La Jolla, Trauma Department, La Jolla, CA, USA
^k Ventura County Medical Center, Department of Surgery, Ventura, CA, USA
^l Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA

^∗Corresponding author. The City Blvd West, Suite 1600, Orange, CA, USA 92868The City Blvd WestSuite 1600OrangeCA92868USA

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Abstract

Background

The COVID-19 pandemic overwhelmed hospitals, forcing adjustments including discharging patients earlier and limiting intensive care unit (ICU) utilization. This study aimed to evaluate ICU admissions and length of stay (LOS) for blunt trauma patients (BTPs).

Methods

A retrospective review of COVID (3/19/20-6/30/20) versus pre-COVID (3/19/19-6/30/19) BTPs at eleven trauma centers was performed. Multivariable analysis was used to identify risk factors for ICU admission.

Results

12,744 BTPs were included (6942 pre-COVID vs. 5802 COVID). The COVID cohort had decreased mean LOS (3.9 vs. 4.4 days, p = 0.029), ICU LOS (0.9 vs. 1.1 days, p < 0.001), and rate of ICU admission (22.3% vs. 24.9%, p = 0.001) with no increase in complications or mortality compared to the pre-COVID cohort (all p > 0.05). On multivariable analysis, the COVID period was associated with decreased risk of ICU admission (OR = 0.82, CI 0.75–0.90, p < 0.001).

Conclusions

BTPs had decreased LOS and associated risk of ICU admission during COVID, with no corresponding increase in complications or mortality.

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Highlights

•	Blunt trauma patients had a shorter length of stay during the COVID-19 pandemic.
•	Blunt trauma patients had lower risk of intensive care unit admissions during COVID.
•	Trauma centers decreased intensive care unit usage without additional complications.

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Keywords : Length of stay, Trauma, Blunt, Intensive care unit, COVID-19

Plan

Introduction

Materials and methods

Results

Demographics and comorbidities

Injury characteristics and vital signs

Outcomes

Primary outcomes of Level-I and II centers

Bivariate analysis for risk of ICU admission

Multivariable logistic regression analysis for risk of ICU admission

Discussion

Conclusions

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Vol 224 - N° 1PA

P. 90-95 - juillet 2022 Retour au numéro

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Decreased hospital length of stay and intensive care unit admissions for non-COVID blunt trauma patients during the COVID-19 pandemic - 20/06/22

Abstract

Background

Methods

Results

Conclusions

Highlights

Plan

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