Quality of care was not compromised during the COVID‐19 pandemic at a level‐1 trauma centre

Saxon, Leanne; Fazio, Timothy N; Gumm, Kellie; Tong, Steven Y. C.; Read, David J

BACKGROUND: The COVID‐19 pandemic has had a profound effect on the presentation and management of trauma at the Royal Melbourne Hospital, a level 1 Adult Major Trauma Service, and a designated COVID‐19 hospital. This study compares the changes in epidemiology and trauma patient access to emergency imaging and surgery during the pandemic response. METHODS: The population of interest was all trauma patients captured in the hospital's Trauma Registry from March 16(th) ‐September 10(th), 2016‐2020. Regression modelling assessed changes in mechanism and severity of the injury, and mortality during two lockdowns compared with the proceeding four years. Cases were matched with Hospital Administrative databases, to assess median time from admission to emergency CT scan, operating theatre, length of stay, and immediate surgery (OPSTAT). RESULTS: Throughout 2020, the hospital treated 525 COVID‐19 patients. Compared with previous years, there was up to a 34% reduction in major trauma and a 28% reduction in minor trauma admissions during the pandemic (p<0.05). ICU admissions were almost half of predicted. Some of the largest reductions were seen in motor vehicle crashes (49%) and falls (28%) (p<0.05). Time to CT, surgery and immediate surgery (OPSTAT) showed no change and having a suspected COVID‐19 diagnosis did not prolong any of these times except for the length of stay. Mortality was similar to previous years. CONCLUSION: The COVID‐19 pandemic has had widespread societal changes, resulting in a substantial decrease in trauma presentations. Despite COVID's immense impact on the hospital's trauma service, the quality of care was not impaired.