The Detrimental Impact of the COVID-19 Pandemic on Major Trauma Outcomes in the Netherlands: A Comprehensive Nationwide Study.

Autor:	Driessen MLS; Dutch Network for Emergency Care (LNAZ), Utrecht, The Netherlands., Sturms LM; Dutch Network for Emergency Care (LNAZ), Utrecht, The Netherlands., Bloemers FW; Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands., Duis HJT; Retired Medical Professor., Edwards MJR; Department of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands., den Hartog D; Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands., Kuipers EJ; Dutch Network for Emergency Care (LNAZ), Utrecht, The Netherlands., Leenhouts PA; Department of Surgery, Amsterdam University Medical Center, Amsterdam, The Netherlands., Poeze M; Department of Surgery, Maastricht University Medical Center, Maastricht, The Netherlands., Schipper IB; Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands., Spanjersberg RW; Department of Trauma Surgery, Isala Hospitals, Zwolle, The Netherlands., Wendt KW; Department of Trauma Surgery, University Medical Center, Groningen, The Netherlands., de Wit RJ; Department of Trauma Surgery, Medical Spectrum Twente, Enschede, The Netherlands., van Zutphen SWAM; Department of Surgery, Elisabeth Two Cities Hospital, Tilburg, The Netherlands., de Jongh MAC; Network Emergency Care Brabant, Tilburg, The Netherlands., Leenen LPH; Department of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Annals of surgery [Ann Surg] 2022 Feb 01; Vol. 275 (2), pp. 252-258.
DOI:	10.1097/SLA.0000000000005300
Abstrakt:	Objective: To evaluate the impact of the COVID-19 pandemic on the outcome of major trauma patients in the Netherlands. Summary Background Data: Major trauma patients highly rely on immediate access to specialized services, including ICUs, shortages caused by the impact of the COVID-19 pandemic may influence their outcome. Methods: A multi-center observational cohort study, based on the Dutch National Trauma Registry was performed. Characteristics, resource usage, and outcome of major trauma patients (injury severity score ≥16) treated at all trauma-receiving hospitals during the first COVID-19 peak (March 23 through May 10) were compared with those treated from the same period in 2018 and 2019 (reference period). Results: During the peak period, 520 major trauma patients were admitted, versus 570 on average in the pre-COVID-19 years. Significantly fewer patients were admitted to ICU facilities during the peak than during the reference period (49.6% vs 55.8%; P=0.016). Patients with less severe traumatic brain injuries in particular were less often admitted to the ICU during the peak (40.5% vs 52.5%; P=0.005). Moreover, this subgroup showed an increased mortality compared to the reference period (13.5% vs 7.7%; P=0.044). These results were confirmed using multivariable logistic regression analyses. In addition, a significant increase in observed versus predicted mortality was recorded for patients who had a priori predicted mortality of 50% to 75% (P=0.012). Conclusions: The COVID-19 peak had an adverse effect on trauma care as major trauma patients were less often admitted to ICU and specifically those with minor through moderate brain injury had higher mortality rates. Competing Interests: The authors report no conflicts of interest. (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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