Post-Disaster Critical Care Demand Exceeds Initial Acuity: Tree-Related Trauma at a Rural Appalachian Level 1 Trauma...

Area of Science:

• Trauma Surgery
• Disaster Medicine
• Public Health

Background:

• Hurricane Helene caused a surge in tree-related injuries at a rural Level 1 trauma center.
• Assessing post-disaster inpatient resource utilization for trauma patients is crucial.

Purpose of the Study:

• To compare inpatient resource needs for tree-related trauma patients before and after Hurricane Helene.
• To determine if disaster-related trauma patients require more resources than predicted by initial injury severity.

Main Methods:

• Retrospective study of adult patients with tree-related injuries using trauma registry and ICD-10 E codes.
• Comparison of pre-Helene (n=176) and post-Helene (n=25) cohorts.
• Outcomes analyzed: ICU admission, ICU length of stay, mechanical ventilation, operative intervention, and discharge disposition.

Main Results:

• Post-Helene patients had higher rates of mechanical ventilation (24% vs 9.1%) and longer ICU stays (6 days vs 3 days).
• Discharge to extended care facilities was more frequent post-Helene (36% vs 15.9%).
• Post-Helene patients presented with a higher burden of cardiopulmonary and renal comorbidities.

Conclusions:

• Tree-related trauma patients in a rural disaster setting place increased demands on critical care, ventilation, and post-acute resources.
• Rural Level 1 trauma centers need to enhance preparedness plans to address the disparity between triage acuity and downstream resource utilization.