Citation

Way TL, Tarrant SM, Balogh ZJ. Med. J. Aust. 2020; ePub(ePub): ePub.

Copyright

(Copyright © 2020, Australian Medical Association, Publisher Australasian Medical Publishing)

DOI

10.5694/mja2.50843

PMID

33174251

Abstract

The coronavirus disease 2019 (COVID‐19) pandemic has posed a variety of significant challenges. Since March 2020, the Australian government has introduced a series of social mobility restrictions, including supervised quarantine for returning overseas travellers. In health care, resources have been re‐allocated, intensive care capacity increased, staff re‐trained, and elective surgery postponed. It was suggested that major trauma volume would decline markedly during the pandemic, so that specialist trauma staff could be deployed elsewhere.1 The frequency of self‐harm and domestic violence, however, was expected to increase.2

The purpose of our observational study was to compare major trauma volumes at the John Hunter Hospital, Newcastle, during the period 1 March - 31 May before (2011-2019; to provide a large control group) and during the COVID‐19 pandemic (2020). As the only level 1 trauma centre in the Hunter region, our hospital receives most patients from this area requiring trauma care. We analysed data routinely collected for the New South Wales trauma registry; our statistical analysis is described in the online Supporting Information. The study was granted formal ethics approval waiver by the Hunter New England Human Research Ethics Committee (reference, AU202004‐17).

Our analysis included 3315 patients from the control period and 259 from the COVID‐19 period. The age, sex, and injury severity score distributions were similar in the two groups (Box 1), as were those of mechanism of injury by month (Box 2). During the COVID‐19 period, the number of admissions (259) was lower than the control mean (368; [standard deviation (SD), 73]; P < 0.002), as were the numbers of severely injured patients (96 v 124 [SD, 16]; P < 0.001), intensive care admissions (35 v 56 [SD, 10]; P < 0.001), patients requiring ventilation (23 v 35 [SD, 9]; P = 0.006), patients requiring surgery (106 v 142 [SD, 30]; P < 0.001), and deaths (4 v 11 [SD, 3]; P = 0.004). COVID‐19 restrictions were strictest during April; the numbers of severely injured patients, patients requiring ventilation, and deaths were similar during April in the control and COVID‐19 periods...

Language: en

Keywords

Infectious diseases; Wounds and injuries; COVID-19; Respiratory tract infections; Trauma surgery; Traumatology