Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID-19 level 4 l
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ORIGINAL ARTICLE
Epidemiology of trauma presentations to a major trauma centre in the North West of England during the COVID‑19 level 4 lockdown Kunal Rajput1 · Ajay Sud1 · Michael Rees1 · Olga Rutka1 Received: 29 June 2020 / Accepted: 18 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
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 · Lockdown · Pandemic · Trauma · Emergency surgery
Introduction COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The British government’s response to the pandemic included measures to reduce transmission and the reallocation of healthcare provisions to address the burden of the disease. This healthcare rearrangement had the potential to compromise trauma care. Guidelines have been published by the American College of Surgeons (ACS), the Royal College of Surgeons (RCS) and European Society of Trauma and Emergency Surgery (ESTES), collectively outlining the collateral impact COVID-19 potentiates to trauma services [1–3]. Trauma
* Kunal Rajput [email protected] 1
Aintree University Hospital, Liverpool L9 7AL, UK
services in the worst hit areas in northern Italy, during the pandemic, re-designed their practice to centralise trauma services, to enable local hospitals to focus on COVID-19 [4]. The expected mortality of up to 38% in surgical patients from the COVIDSurg collaborative gave
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