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SARS-CoV-2 outbreak impact on a trauma unit
Sarah Mills1, Aitor Ibarzábal-Gil1, José M Martínez-Diez1
1Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain.
Insights
The coronavirus pandemic significantly impacted hospital admissions for trauma patients, nearly halving numbers in 2020. Patients with SARS-CoV-2 infection experienced longer hospital stays and higher mortality rates compared to pre-pandemic cohorts.
Area of Science:
- Orthopedics
- Trauma Surgery
- Infectious Diseases
Background:
- The COVID-19 pandemic caused widespread disruption to healthcare systems globally.
- Hospitals faced unprecedented challenges in managing patient care, including trauma and orthopedic cases.
- This study examines the impact of the pandemic on morbimortality in a trauma and orthopedic department.
Purpose of the Study:
- To assess the effect of the COVID-19 pandemic on morbimortality within a hospital department.
- To analyze demographic, admission, and treatment data for patients with hip fractures and polytrauma during the pandemic.
- To compare outcomes between pandemic and pre-pandemic patient cohorts.
Main Methods:
- A comparative study design was employed, analyzing data from March-April 2020 (pandemic) and March-April 2019 (pre-pandemic).
- Patient cohorts included those admitted for lower limb fractures or high-energy trauma.
- A minimum of six months follow-up was completed for both cohorts.
Main Results:
- Hospital admissions for trauma and orthopedic conditions were reduced by nearly half in 2020 compared to 2019.
- Elderly patients with hip fractures constituted a significant majority (52/73) of admissions in 2020.
- Patients testing positive for SARS-CoV-2 had longer hospital stays and increased mortality rates (P=0.02).
Conclusions:
- The 2020 cohort, during the pandemic, exhibited higher mortality and readmission rates compared to the 2019 pre-pandemic cohort.
- SARS-CoV-2 infection was associated with poorer outcomes in trauma patients.
- Conservative treatment was more frequently selected for hip fracture patients with severe respiratory symptoms (P=0.03).
Background:
From February 2020 onwards, our country has been hit by the coronavirus severe acute respiratory syndrome-2 (SARS-CoV-2) infection. At a glance, hospitals became overrun and had to reformulate all the assistance guidelines, focusing on the coronavirus disease 2019. One year after the start of the pandemic, we present the results of a morbimortality study.
Aim:
To analyze how our department was affected by the outbreak in terms of morbimortality, and to analyze demographic data, admission to hospital-related data, and subgroups analyses for patients with hip fractures and polytrauma.
Methods:
We designed a study comparing data from patients who were admitted to our unit due to a lower limb fracture or a high energy trauma during the pandemic (from March to April 2020) to those admitted during the same period in 2019 before the pandemic. during the pandemic situation. Both cohorts completed a minimum of 6 mo of follow-up.
Results:
The number of patients admitted to hospital in 2020 was nearly half of those in 2019. Hip fractures in the elderly represented 52 out of 73 of the admitted patients. Twenty patients had a positive test result for SARS-CoV-2 infection. Patients with SARS-CoV-2 infection were admitted to the hospital for a longer time than the non-infected (P < 0.001), and had a higher mortality rate during hospitalization and follow-up (P = 0.02). Patients with a hip fracture associated with a severe respiratory syndrome were mostly selected for conservative treatment (P = 0.03).
Conclusion:
Mortality and readmission rates were higher in the 2020 cohort and during follow-up, in comparison with the cohort in 2019.
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