Trauma epidemiology after easing of lockdown restrictions: experience from a level-one major trauma centre in England

Abstract

Purpose: The COVID-19 pandemic transformed the delivery of trauma care. We examined the effect of lockdown easing on trauma presentation and management from one Major Trauma Centre (MTC). Methods: Data was retrospectively analysed from Trauma Audit and Research Network (TARN) on patients presenting to our MTC with trauma. The first 47 days of lockdown (23rd March–9th May 2020, period 1) were compared with the next 47 (10th May–26th June 2020, period 2) and last (27th June–13th August 2020, period 3). Data collected included demographics, mechanism and severity of injury, management and length of stay. Results: 1249 patients were included; 62.2% were male with a mean age of 57.73. Footfall declined in April 2020 compared with 2019 (56 vs. 143) but rebounded by May (123 vs. 120 patients). Road traffic collisions increased over periods one–three (18.8% vs. 23% vs. 30.1%, p = 0.038); deliberate self-harm (DSH) increased in period two compared with one and three (6.3% vs. 3.4% vs. 1.4%, p = 0.03), respectively. When compared with 2019, the 2020 patient age was lower, with less trauma relating to alcohol (7.3% vs. 13.2%, p = 0.009), but more from DSH (3.6% vs. 2.1%, p = 0.10). In 2020 less patients were assessed by a consultant and trauma team, with a shorter stay in hospital and critical care. Conclusion: This is the first study to document trauma trends through a lockdown and thereafter. After lockdown easing, trauma footfall rapidly rebounded to 2019 levels. This should be acknowledged in resource allocation decisions if future lockdowns are necessitated.