Association of Substance Use With Trauma Outcomes Throughout the COVID-19 Pandemic at a New York City Level II Trauma...

Studies have demonstrated that the COVID-19 pandemic caused increased stress associated with higher substance abuse and mental health crises that disproportionately affected minority populations. A New York City (NYC) Level II trauma center registry was used to determine if there was an association between substance use, patient demographics, and injury severity measures for patients admitted before, during, one, and two years after the pandemic.

A retrospective review of 3,172 patients was conducted using the NYC Level II trauma center registry. Cohorts included PreCOVID (2019) (N=704), COVID (2020) (N=787), 1yrPostCOVID (one year post-COVID, 2021) (N=883), and 2yrsPostCOVID (two years post-COVID, 2022) (N=798). Demographics and injury severity measures were analyzed using IBM SPSS Statistics v27 (IBM Corp., Armonk, United States) with p<0.05 indicating significance.

Substance use significantly increased from PreCOVID to COVID and stayed elevated 1yrPostCOVID before returning to PreCOVID levels by 2yrsPostCOVID. Both men and women had increased rates of admission with positive substance use during COVID; however, the men recovered faster, with levels returning close to pre-pandemic levels by 2yrsPostCOVID. The admissions of women with positive substance use remained increased for 2yrsPostCOVID. The age group that was most affected by positive substance use was 25-34 years, which had a significant 4% increase from PreCOVID to COVID, and then steadily declined over 1yrPostCOVID and 2yrsPostCOVID. Minority populations, including Black Hispanic (BH), Black Non-Hispanic (BNH), and White Hispanic (WH), had increased substance use during COVID and 1yrPostCOVID compared to White Non-Hispanic (WNH). Positive substance use related to penetrating trauma increased during COVID, stayed increased 1yrPostCOVID, and then returned to PreCOVID levels by 2yrsPostCOVID. Positive substance use related to injury severity score, New Injury Severity Score (NISS), and Glasgow Coma Score (GCS) showed variable trends throughout the COVID timeline.

Results indicate that the pandemic led to an increase in substance use-related trauma admissions during and one year after the pandemic, which predominantly affected minority populations. This finding is consistent with the many other disparities minority populations faced during the pandemic.