Journal article
The impact of COVID-19 infection on outcomes after injury in a state trauma system
The journal of trauma and acute care surgery, v 91(3), pp 559-565
01 Sep 2021
PMID: 34074996
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
BACKGROUND The COVID-19 pandemic reshaped the health care system in 2020. COVID-19 infection has been associated with poor outcomes after orthopedic surgery and elective, general surgery, but the impact of COVID-19 on outcomes after trauma is unknown. METHODS We conducted a retrospective cohort study of patients admitted to Pennsylvania trauma centers from March 21 to July 31, 2020. The exposure of interest was COVID-19 (COV+) and the primary outcome was inpatient mortality. Secondary outcomes were length of stay and complications. We compared demographic and injury characteristics between positive, negative, and not-tested patients. We used multivariable regression with coarsened exact matching to estimate the impact of COV+ on outcomes. RESULTS Of 15,550 included patients, 8,170 (52.5%) were tested for COVID-19 and 219 (2.7%) were positive (COV+). Compared with COVID-19-negative (COV-) patients, COV+ patients were similar in terms of age and sex, but were less often white (53.5% vs. 74.7%, p < 0.0001), and more often uninsured (10.1 vs. 5.6%, p = 0.002). Injury severity was similar, but firearm injuries accounted for 11.9% of COV+ patients versus 5.1% of COV- patients (p < 0.001). Unadjusted mortality for COV+ was double that of COV- patients (9.1% vs. 4.7%, p < 0.0001) and length of stay was longer (median, 5 vs. 4 days; p < 0.001). Using coarsened exact matching, COV+ patients had an increased risk of death (odds ratio [OR], 6.05; 95% confidence interval [CI], 2.29-15.99), any complication (OR, 1.85; 95% CI, 1.08-3.16), and pulmonary complications (OR, 5.79; 95% CI, 2.02-16.54) compared with COV- patients. CONCLUSION Patients with concomitant traumatic injury and COVID-19 infection have elevated risks of morbidity and mortality. Trauma centers must incorporate an understanding of these risks into patient and family counseling and resource allocation during this pandemic.
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Details
- Title
- The impact of COVID-19 infection on outcomes after injury in a state trauma system
- Creators
- Elinore J. Kaufman - Taylor UniversityAdrian W. Ong - Philadelphia UniversityMark D. Cipolle - Taylor UniversityGregory Whitehorn - Bethlehem Area School DistrictAsanthi Ratnasekera - Bethlehem Area School DistrictStanislaw P. Stawicki - Taylor UniversityNiels D. Martin - Reading Museum
- Publication Details
- The journal of trauma and acute care surgery, v 91(3), pp 559-565
- Publisher
- Lippincott Williams & Wilkins
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000693463000024
- Scopus ID
- 2-s2.0-85114612286
- Other Identifier
- 991022020636704721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Critical Care Medicine
- Surgery