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

被引：8

作者：

Yeates, Eric O. ^{[1
]}

Grigorian, Areg ^{[1
,2
]}

Schellenberg, Morgan ^{[2
]}

Owattanapanich, Natthida ^{[2
]}

Barmparas, Galinos ^{[3
]}

Margulies, Daniel ^{[3
]}

Juillard, Catherine ^{[4
]}

Garber, Kent ^{[4
]}

Cryer, Henry ^{[4
]}

Tillou, Areti ^{[4
]}

Burruss, Sigrid ^{[5
]}

Penaloza-Villalobos, Liz ^{[5
]}

Lin, Ann ^{[5
]}

Figueras, Ryan Arthur ^{[5
]}

Coimbra, Raul ^{[5
,6
]}

Brenner, Megan ^{[7
]}

Costantini, Todd ^{[8
]}

Santorelli, Jarrett ^{[8
]}

Curry, Terry ^{[8
]}

Wintz, Diane ^{[9
]}

Biffl, Walter L. ^{[10
]}

Schaffer, Kathryn B. ^{[10
]}

Duncan, Thomas K. ^{[11
]}

Barbaro, Casey ^{[11
]}

Diaz, Graal ^{[11
]}

Johnson, Arianne ^{[12
]}

Chinn, Justine ^{[1
]}

Naaseh, Ariana ^{[1
]}

Leung, Amanda ^{[1
]}

Grabar, Christina ^{[1
]}

Nahmias, Jeffry ^{[1
]}

机构：

[1] Univ Calif Irvine UCI, Dept Surg, Orange, CA USA

[2] Univ Southern Calif USC, Dept Surg, Los Angeles, CA USA

[3] Cedars Sinai Med Ctr, Dept Surg, Los Angeles, CA 90048 USA

[4] Univ Calif Los Angeles UCLA, Dept Surg, Los Angeles, CA USA

[5] Loma Linda Univ, Dept Surg, Loma Linda, CA 92350 USA

[6] Riverside Univ Hlth Syst, Med Ctr, Moreno Valley, CA USA

[7] Univ Calif Riverside, Riverside Univ Hlth Syst, Dept Surg, Moreno Valley, CA USA

[8] Univ Calif San Diego UCSD, Dept Surg, San Diego, CA USA

[9] Sharp Mem Hosp & Rehabil Ctr, Dept Surg, San Diego, CA USA

[10] Scripps Mem Hosp La Jolla, Trauma Dept, La Jolla, CA USA

[11] Ventura Cty Med Ctr, Dept Surg, Ventura, CA USA

[12] Santa Barbara Cottage Hosp, Cottage Hlth Res Inst, Santa Barbara, CA USA

来源：

AMERICAN JOURNAL OF SURGERY | 2022年 / 224卷 / 01期

关键词：

Length of stay; Trauma; Blunt; Intensive care unit; COVID-19; CORONAVIRUS DISEASE 2019; PREDICTING MORTALITY; INJURY; VOLUME; IMPACT;

D O I：

10.1016/j.amjsurg.2022.02.055

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

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.

引用

页码：90 / 95

页数：6

共 42 条

[1] Managing ICU surge during the COVID-19 crisis: rapid guidelines
Aziz, Shadman
Arabi, Yaseen M.
Alhazzani, Waleed
Evans, Laura
Citerio, Giuseppe
Fischkoff, Katherine
Salluh, Jorge
Meyfroidt, Geert
Alshamsi, Fayez
Oczkowski, Simon
Azoulay, Elie
Price, Amy
Burry, Lisa
Dzierba, Amy
Benintende, Andrew
Morgan, Jill
Grasselli, Giacomo
Rhodes, Andrew
Moller, Morten H.
Chu, Larry
Schwedhelm, Shelly
Lowe, John J.
Bin, Du
Christian, Michael D.
[J]. INTENSIVE CARE MEDICINE, 2020, 46 (07) : 1303 - 1325
[2] Begun J W., 2020, NEJM Catalyst Innovations in Care Delivery, V1, DOI DOI 10.1056/CAT.20.0541
[3] Decreased adult trauma admission volumes and changing injury patterns during the COVID-19 pandemic at 85 trauma centers in a multistate healthcare system
Berg, Gina M.
Wyse, Ransom J.
Morse, Jennifer L.
Chipko, John
Garland, Jeneva M.
Slivinski, Andrea
Lieser, Mark
Biswas, Saptarshi
Carrick, Matthew M.
Rhodes, Heather
Acuna, David
Watts, Dorraine D.
Wilson, Nina Y.
Shen, Yan
Deas, Shenequa
Fakhry, Samir M.
[J]. TRAUMA SURGERY & ACUTE CARE OPEN, 2021, 6 (01)
[4] Association of Intensive Care Unit Patient Load and Demand With Mortality Rates in US Department of Veterans Affairs Hospitals During the COVID-19 Pandemic
Bravata, Dawn M.
Perkins, Anthony J.
Myers, Laura J.
Arling, Greg
Zhang, Ying
Zillich, Alan J.
Reese, Lindsey
Dysangco, Andrew
Agarwal, Rajiv
Myers, Jennifer
Austin, Charles
Sexson, Ali
Leonard, Samuel J.
Dev, Sharmistha
Keyhani, Salomeh
[J]. JAMA NETWORK OPEN, 2021, 4 (01)
[5] General surgery and COVID-19: review of practical recommendations in the first pandemic phase
Bresadola, Vittorio
Biddau, Carlo
Puggioni, Alessandro
Tel, Alessandro
Robiony, Massimo
Hodgkinson, Jonathan
Leo, Cosimo Alex
[J]. SURGERY TODAY, 2020, 50 (10) : 1159 - 1167
[6] US Clinicians' Experiences and Perspectives on Resource Limitation and Patient Care During the COVID-19 Pandemic
Butler, Catherine R.
Wong, Susan P. Y.
Wightman, Aaron G.
O'Hare, Ann M.
[J]. JAMA NETWORK OPEN, 2020, 3 (11)
[7] Geographic Differences in COVID-19 Cases, Deaths, and Incidence - United States, February 12-April 7, 2020
[J]. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT, 2020, 69 (15): : 465 - 471
[8] Centers for Disease Control and Prevention, US COVID 19 CAS DEAT
[9] COVID19.CA.GOV, 2021, LAT NEWS COVID 19
[10] How a Pandemic Changes Trauma: Epidemiology and Management of Trauma Admissions in the UK during COVID-19 Lockdown
Dass, Debashis
Ramhamadany, Eamon
Govilkar, Siddarth
Rhind, John-Henry
Ford, David
Singh, Rohit
Thomas, Geraint
Cool, Paul
[J]. JOURNAL OF EMERGENCIES TRAUMA AND SHOCK, 2021, 14 (02) : 75 - 79

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