Jean-Denis Moyer1, Arthur James2, Clément Gakuba3, Mathieu Boutonnet4, Emeline Angles5, Emmanuel Rozenberg6, Jean Bardon7, Thomas Clavier8, Vincent Legros9, Marie Werner10, Quentin Mathais11, Véronique Ramonda12, Pierre Le Minh13, Yann Berthelot14, Clélia Colas14, Julien Pottecher15, Tobias Gauss13. 1. Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP.Nord, 100 boulevard du General Leclerc, F92110, Clichy, France. Jean-denis.moyer@aphp.fr. 2. Department of Anaesthesiology and critical care, Pitié-Salpêtrière Hospital, Sorbonne University, GRC 29, AP-HP, DMU DREAM, Paris, France. 3. Department of Anesthesiology and Critical Care Medicine, Caen University Hospital, Avenue de la cote de Nacre, Caen, France. 4. Intensive Care Unit, Percy Military Teaching Hospital. 101 avenue Henri Barbusse 92140, Clamart, Val de Grace Academy, place Alphonse Laveran, 75005, Paris, France. 5. Department of Anesthesiology and Critical Care, Bordeaux University Hospital, Pellegrin, Bordeaux, France. 6. Department of Anesthesiology and Critical Care, Hôpital Européen Georges Pompidou, Paris, France. 7. Department of Anesthesiology and Critical Care, Hôpital Henri Mondor, Créteil, France. 8. Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. 9. Department of Anesthesiology and Critical Care, Hopital Maison Blanche - CHU de Reims, Reims, France. 10. Department of Anesthesiology and Critical Care, APH-HP, Bicêtre Hôpitaux Universitaires Paris-Sud, Université Paris Saclay, Le Kremlin Bicêtre, France. 11. Department of Anesthesiology and Critical Care, Military Teaching Hospital, Sainte-Anne, Toulon, France. 12. Department of Anesthesiology and Critical Care, University Toulouse 3-Paul-Sabatier, University Hospital of Toulouse, Hôpital Pierre-Paul Riquet, CHU Toulouse-Purpan, 31059, Toulouse, France. 13. Department of Anesthesiology and Critical Care, Beaujon Hospital, DMU Parabol, AP-HP.Nord, 100 boulevard du General Leclerc, F92110, Clichy, France. 14. Capgemini Invent, Insight Driven Enterprise, focused on Data & Artificial Intelligence services, Issy-les-Moulineaux, France. 15. Hôpitaux Universitaires de Strasbourg, Pôle d'Anesthésie-Réanimation & Médecine Péri-Opératoire, Service d'Anesthésie-Réanimation & Médecine Péri-Opératoire Hôpital de Hautepierre - Université de Strasbourg, Faculté de Médecine, Fédération de Médecine Translationnelle de Strasbourg (FMTS), UR3072, Strasbourg, France.
Abstract
BACKGROUND: Emerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system. This study describes the epidemiology and the outcome of major trauma patients admitted to centers in France during the first wave of the COVID-19 outbreak. METHODS: This retrospective observational study included all consecutive trauma patients aged 15 years and older admitted into 15 centers contributing to the TraumaBase® registry during the first wave of the SARS-CoV-2 pandemic in France. This COVID-19 trauma cohort was compared to historical cohorts (2017-2019). RESULTS: Over a 4 years-study period, 5762 patients were admitted between the first week of February and mid-June. This cohort was split between patients admitted during the first 2020 pandemic wave in France (pandemic period, 1314 patients) and those admitted during the corresponding period in the three previous years (2017-2019, 4448 patients). Trauma patient demographics changed substantially during the pandemic especially during the lockdown period, with an observed reduction in both the absolute numbers and proportion exposed to road traffic accidents and subsequently admitted to traumacenters (348 annually 2017-2019 [55.4% of trauma admissions] vs 143 [36.8%] in 2020 p < 0.005). The in-hospital observed mortality and predicted mortality during the pandemic period were not different compared to the non-pandemic years. CONCLUSIONS: During this first wave of COVID-19 in France, and more specifically during lockdown there was a significant reduction of patients admitted to designated trauma centers. Despite the reallocation and reorganization of medical resources this reduction prevented the saturation of the trauma rescue chain and has allowed maintaining a high quality of care for trauma patients.
BACKGROUND: Emerging evidence suggests that the reallocation of health care resources during the COVID-19 pandemic negatively impacts health care system. This study describes the epidemiology and the outcome of major traumapatients admitted to centers in France during the first wave of the COVID-19 outbreak. METHODS: This retrospective observational study included all consecutive traumapatients aged 15 years and older admitted into 15 centers contributing to the TraumaBase® registry during the first wave of the SARS-CoV-2 pandemic in France. This COVID-19trauma cohort was compared to historical cohorts (2017-2019). RESULTS: Over a 4 years-study period, 5762 patients were admitted between the first week of February and mid-June. This cohort was split between patients admitted during the first 2020 pandemic wave in France (pandemic period, 1314 patients) and those admitted during the corresponding period in the three previous years (2017-2019, 4448 patients). Traumapatient demographics changed substantially during the pandemic especially during the lockdown period, with an observed reduction in both the absolute numbers and proportion exposed to road traffic accidents and subsequently admitted to traumacenters (348 annually 2017-2019 [55.4% of trauma admissions] vs 143 [36.8%] in 2020 p < 0.005). The in-hospital observed mortality and predicted mortality during the pandemic period were not different compared to the non-pandemic years. CONCLUSIONS: During this first wave of COVID-19 in France, and more specifically during lockdown there was a significant reduction of patients admitted to designated trauma centers. Despite the reallocation and reorganization of medical resources this reduction prevented the saturation of the trauma rescue chain and has allowed maintaining a high quality of care for traumapatients.
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