Impact of the COVID-19 Pandemic on an Emergency Traumatology Service: Experience at a Tertiary Trauma Centre in Spain

Injury. 2020 Jul;51(7):1414-1418. doi: 10.1016/j.injury.2020.05.016. Epub 2020 May 13.

Abstract

Introduction: The severe disruptions caused by the SARS-CoV-2 coronavirus have necessitated a redistribution of resources to meet hospitals' current service needs during this pandemic. The aim of this study was to provide an overview of the impact of the pandemic, and its corresponding State of Emergency, on a tertiary traumatology emergency service.

Methods: An observational study was performed at a tertiary hospital within the Spanish National Health System. Four different periods were studied, including the first 20 days of Spain's current State of Emergency, from March 14 to April 02, 2020 (Period 4). This period was compared to the 20-day period prior to the State of Emergency (Period 3), and to matching periods in the two previous years (Periods 1 and 2). A total of 6,565 patient visits were analyzed: 1909 in Period 1 (29.1%), 2161 in Period 2 (32.9%), 1983 in Period 3 (30.2%), and 512 in Period 4 (7.8%). Variables collected included patient age and sex, insurance type, discharge destination and reason for hospital admission.

Results: The patients' mean age was 55.1 years old (Standard Deviation (SD): 22.1), and 51.8% were women (3495/6565). During the COVID-19 pandemic, there were significant reductions in total visits to the trauma emergency department, workplace accidents, traffic accidents and number of hospital admissions, particularly during Period 4. However, no statistically-significant differences were found in the number of osteoporotic hip fractures admitted between the four periods. The numbers of hospital admissions for osteoporotic hip fracture were 42 during Period 1, 41 during Period 2, 43 during Period 3 and 36 during Period 4.

Conclusions: While most traumatological presentations decreased in frequency over the course of the outbreak, the number of osteoporotic hip fractures remained stable. Thus, contingency plans in times of crisis need to be carefully targeted, and to keep in mind certain public health issues that do not decrease, despite a State of Emergency, like osteoporotic hip fractures.

Keywords: COVID-19; Pandemic; hip fractures; trauma.

Publication types

  • Observational Study

MeSH terms

  • Betacoronavirus / pathogenicity
  • Coronavirus Infections / epidemiology*
  • Critical Pathways
  • Delivery of Health Care
  • Emergency Service, Hospital / organization & administration*
  • Female
  • Health Care Rationing / organization & administration*
  • Health Services Research
  • Hip Fractures / epidemiology*
  • Hip Fractures / surgery
  • Humans
  • Infection Control / organization & administration
  • Male
  • Middle Aged
  • Osteoporotic Fractures / epidemiology*
  • Osteoporotic Fractures / surgery
  • Pandemics*
  • Pneumonia, Viral / epidemiology*
  • Resource Allocation
  • Spain / epidemiology
  • Tertiary Care Centers
  • Trauma Centers / organization & administration*
  • Wounds and Injuries / epidemiology*
  • Wounds and Injuries / surgery

Supplementary concepts

  • COVID-19
  • severe acute respiratory syndrome coronavirus 2