TY  - JOUR
PY  - 2022//
TI  - National evaluation of the association between stay-at-home orders on mechanism of injury and trauma admission volume
JO  - Injury
A1  - Thomas, Arielle C.
A1  - Campbell, Brendan T.
A1  - Subacius, Haris
A1  - Orlas, Claudia P.
A1  - Bulger, Eileen
A1  - Stewart, Ronald M.
A1  - Stey, Anne M.
A1  - Jang, Angie
A1  - Hamad, Doulia
A1  - Bilimoria, Karl Y.
A1  - Nathens, Avery B.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: The COVID-19 pandemic had numerous negative effects on the US healthcare system. Many states implemented stay-at-home (SAH) orders to slow COVID-19 virus transmission. We measured the association between SAH orders on the injury mechanism type and volume of trauma center admissions during the first wave of the COVID-19 pandemic. <br><br>METHODS: All trauma patients aged 16 years and older who were treated at the American College of Surgeons Trauma Quality Improvement Program participating centers from January 2018-September 2020. Weekly trauma patient volume, patient demographics, and injury characteristics were compared across the corresponding SAH time periods from each year. Patient volume was modeled using harmonic regression with a random hospital effect. <br><br>RESULTS: There were 166,773 patients admitted in 2020 after a SAH order and an average of 160,962 patients were treated over the corresponding periods in 2018-2019 in 474 centers. Patients presenting with a pre-existing condition of alcohol misuse increased (13,611 (8.3%) vs. 10,440 (6.6%), p <0.001). Assault injuries increased (19,056 (11.4%) vs. 15,605 (9.8%)) and firearm-related injuries (14,246 (8.5%) vs. 10,316 (6.4%)), p<0.001. Firearm-specific assault injuries increased (10,748 (75.5%) vs. 7,600 (74.0%)) as did firearm-specific unintentional injuries (1,318 (9.3%) vs. 830 (8.1%), p<0.001. In the month preceding the SAH orders, trauma center admissions decreased. Within a week of SAH implementation, hospital admissions increased (p<0.001) until a plateau occurred 10 weeks later above predicted levels. On regional sub-analysis, admission volume remained significantly elevated for the Midwest during weeks 11-25 after SAH order implementation, (p<0.001).<p />  <p>Language: en</p>
LA  - en
SN  - 0020-1383
UR  - http://dx.doi.org/10.1016/j.injury.2022.09.012
ID  - ref1
ER  -