Emergency medicine

Demography

Blunt trauma

Interquartile range

Surgery

Blunt

Coronavirus disease 2019 (COVID-19)

Physics

Retrospective cohort study

Optics

Infectious disease (medical specialty)

Internal medicine

Sociology

Medicine

Pandemic

Trauma center

Disease

Incidence (geometry)

JAMA Network Open

<h3>Importance</h3> Describing the changes in trauma volume and injury patterns during the course of the coronavirus disease 2019 (COVID-19) pandemic could help to inform policy development and hospital resource planning. <h3>Objective</h3> To examine trends in trauma admissions throughout Los Angeles County (LAC) during the pandemic. <h3>Design, Setting, and Participants</h3> In this cohort study, all trauma admissions to the 15 verified level 1 and level 2 trauma centers in LAC from January 1 to June 7, 2020 were reviewed. All trauma admissions from the same period in 2019 were used as historical control. For overall admissions, the study period was divided into 3 intervals based on daily admission trend analysis (January 1 through February 28, March 1 through April 9, April 10 through June 7). For the blunt trauma subgroup analysis, the study period was divided into 3 similar intervals (January 1 through February 27, February 28 through April 5, April 6 through June 7). <h3>Exposures</h3> COVID-19 pandemic. <h3>Main Outcomes and Measures</h3> Trends in trauma admission volume and injury patterns. <h3>Results</h3> A total of 6777 patients in 2020 and 6937 in 2019 met inclusion criteria. Of those admitted in 2020, the median (interquartile range) age was 42 (28-61) years and 5100 (75.3%) were men. Mechanisms of injury were significantly different between the 2 years, with a higher incidence of penetrating trauma and fewer blunt injuries in 2020 compared with 2019 (penetrating: 1065 [15.7%] vs 1065 [15.4%]; blunt: 5309 [78.3%] vs 5528 [79.7%]). Overall admissions by interval in 2020 were 2681, 1684, and 2412, whereas in 2019 they were 2462, 1862, and 2613, respectively. There was a significant increase in overall admissions per week during the first interval (incidence rate ratio [IRR], 1.02; 95% CI, 1.002-1.04;<i>P</i> = .03) followed by a decrease in the second interval (IRR, 0.92; 95% CI, 0.90-0.94;<i>P</i> &lt; .001) and, finally, an increase in the third interval (IRR, 1.05; CI, 1.03-1.07;<i>P</i> &lt; .001). On subgroup analysis, blunt admissions followed a similar pattern to overall admissions, while penetrating admissions increased throughout the study period. <h3>Conclusions and Relevance</h3> In this study, trauma centers throughout LAC experienced a significant change in injury patterns and admission trends during the COVID-19 pandemic. A transient decrease in volume was followed by a quick return to baseline levels. Trauma centers should prioritize maintaining access, capacity, and functionality during pandemics and other national emergencies.

Trends in Trauma Admissions During the COVID-19 Pandemic in Los Angeles County, California