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Urban Trends in Upper Extremity Trauma During Coronavirus Disease-19 (COVID-19) Global Pandemic
Julia A. Cook, MD, and Joshua M. Adkinson, MD
Indiana University
2022-01-14
Presenter: Julia A. Cook, MD
Affidavit:
I certify that the material proposed for presentation has not been previously published or presented and represents original work. The authors worked collaboratively on this project.
Director Name: William Wooden, MD
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Hand
INTRODUCTION: The coronavirus disease-19 (COVID-19) pandemic introduced a series of challenges for healthcare systems. Initial COVID-19 case surges, accompanied by the cancellation of elective surgeries, led to withdrawal of new surgeon contracts and surgeon redeployment. These alterations did not account for potential increases in traumatic injuries that may require surgical intervention. This study sought to evaluate the incidence of upper extremity injuries at a Level-I urban trauma center through the initial COVID-19 pandemic.
METHODS: The Eskenazi Health Trauma Database was retrospective reviewed from 04/01/2015 to 12/31/2020. Patients were identified with ICD-10 codes for upper extremity traumatic wounds, excluding superficial injury (S41-49, S51-59, S61-69). Variables included injury details, trauma activation level, admission level, and discharge status. Patients were grouped for comparison of time before (2015-2019) and during (2020) COVID-19. Time series trends and magnitudes were evaluated using a seasonal Mann-Kendall Trend Test and Sen's slope.
RESULTS: 2846 patients were identified; 1703 patients had blunt injuries, and 1143 patients had penetrating injuries. Average patient age was 39.6±3.2 years; 76.1% of patients were male. Number of injuries per month increased from 2015 through 2020 (τ=0.628, p<0.001, slope=7.3). More injuries per month were sustained during COVID-19 compared to before (64.7±20.1 and 36.3±12.4, respectively; p<0.001). Injury type before and during COVID-19 was not significantly different (Χ2=0.16, p=0.69).
DISCUSSION: A significant increase in the incidence of upper extremity trauma was noted during the COVID-19 pandemic. While this increase is multifactorial, healthcare systems should consider these findings to ensure adequate staffing of surgical services for non-elective cases.
