1427 The effect of the COVID-19 pandemic on major trauma presentations and patient outcomes in English hospitals

Vollständiger Abstract

Worum geht es in dieser Arbeit?

Aims, Objectives and Background There is evidence that COVID-19 ‘lockdowns’ may have contributed to increased non-accidental injury, domestic violence and self-harm related to deteriorating mental health. Internationally, there is also evidence that the diversion of health care resources may led to worse outcomes for patients presenting with major trauma. There has been no previous national evaluation of ‘lockdown’ measures impact on the characteristics, treatment pathways and outcomes of trauma patients in England We aimed to assess the impact of successive lockdowns on the volume, demographics, injury mechanism, severity, treatment and outcomes of major trauma in England. Method and Design Demographic characteristics and clinical pathways of TARN eligible patients in the first lockdown (24th March to 3rd July 2020 inclusive) and second lock down (1st November 2020 to 16th May 2021 inclusive) were compared to equivalent pre-COVID-19 periods in 2018–2019. A segmented regression model predicting the weekly risk adjusted survival was estimated and a discontinuity in the gradient (trend) or intercept (level) of the fitted model was tested for at the weekly time point of implementation of each lockdown. Abstract 1427 Figure 1 Strobe diagram for inclusion of study population Abstract 1427 Figure 2 Interrupted time series analysis assessing the impact of COVID restrictions on likelihood of survival (red horizontal lines indicate introduction and relaxation of ‘lockdown’ measures) Abstract 1427 Table 1 Comparison of demographics ‘lockdown’ and pre-COVID periods Period Period 24Mar19 – 03Jul19 (comparator) 24Mar20 – 03Jul20 (lockdown 1) Absolute change [percentage point change (95%CI)] p-value 01Nov18 – 16May19 (comparator) 01Nov20 – 16May21 (lockdown 1) Absolute change [percentage point change (95%CI)] p-value Total 22243 17510 -4733 (-21%) p