• Mitchell L S Driessen, Leontien M Sturms, Frank W Bloemers, DuisHenk Jan TenHJTRetired Medical Professor., EdwardsMichael J RMJRDepartment of Trauma Surgery, Radboud University Medical Center, Nijmegen, The Netherlands., Dennis den Hartog, E J Kuipers, Peter A Leenhouts, Martijn Poeze, Inger B Schipper, Richard W Spanjersberg, Klaus W Wendt, Ralph J de Wit, van ZutphenStefan W A MSWAMDepartment of Surgery, Elisabeth Two Cities Hospital, Tilburg, The Netherlands., de JonghMariska A CMACNetwork Emergency Care Brabant, Tilburg, The Netherlands., and LeenenLuke P HLPHDepartment of Surgery, University Medical Center Utrecht, Utrecht, The Netherlands..
• Dutch Network for Emergency Care (LNAZ), Utrecht, The Netherlands.
• Ann. Surg. 2022 Feb 1; 275 (2): 252258252-258.

ObjectiveTo evaluate the impact of the COVID-19 pandemic on the outcome of major trauma patients in the Netherlands.Summary Background DataMajor trauma patients highly rely on immediate access to specialized services, including ICUs, shortages caused by the impact of the COVID-19 pandemic may influence their outcome.MethodsA multi-center observational cohort study, based on the Dutch National Trauma Registry was performed. Characteristics, resource usage, and outcome of major trauma patients (injury severity score ≥16) treated at all trauma-receiving hospitals during the first COVID-19 peak (March 23 through May 10) were compared with those treated from the same period in 2018 and 2019 (reference period).ResultsDuring the peak period, 520 major trauma patients were admitted, versus 570 on average in the pre-COVID-19 years. Significantly fewer patients were admitted to ICU facilities during the peak than during the reference period (49.6% vs 55.8%; P=0.016). Patients with less severe traumatic brain injuries in particular were less often admitted to the ICU during the peak (40.5% vs 52.5%; P=0.005). Moreover, this subgroup showed an increased mortality compared to the reference period (13.5% vs 7.7%; P=0.044). These results were confirmed using multivariable logistic regression analyses. In addition, a significant increase in observed versus predicted mortality was recorded for patients who had a priori predicted mortality of 50% to 75% (P=0.012).ConclusionsThe COVID-19 peak had an adverse effect on trauma care as major trauma patients were less often admitted to ICU and specifically those with minor through moderate brain injury had higher mortality rates.Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc.

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