Comparative analysis of the trauma care profile before and during the COVID-19 pandemic: a cross-sectional study in a tertiary university hospital

ABSTRACT Objectives: to evaluate the profile of emergency care of trauma patients at Hospital Universitário Evangélico Mackenzie (HUEM) during the period of restrictive measures due to COVID-19 (03/13/2021 to 04/05/2021), and compare to the same period at the beginning of the pandemic, in 2020, and before the pandemic, in 2019. Methods: quantitative and descriptive observational cross-sectional study. The final sample of 8,338 was analyzed in terms of date, gender, age and service responsible for providing care; the traumas were analyzed according to the etiology and conduct of the treatment and outcome. Results: there was a percentage increase in non-traumatic emergency care during the pandemic, and the medical clinic held a third of admissions in 2021. There was a reduction in trauma care, since in 2019 traumas were responsible for 44.9% of admissions and by 23.5% in 2021. There was a significant difference in the proportion between the attendance of men and women, and the percentage of men victims of trauma was higher than in the pre-pandemic periods. There was a reduction in absolute numbers, with statistical significance, in traffic accidents, falls from the same level, burns, general blunt trauma and sports and leisure trauma. The proportion of conservative treatments with hospital discharge reduced. There was a significant difference in the number of deaths, decreasing in 2020 but increasing in 2021. Conclusion: there was a reduction in trauma care during the pandemic, but the profile remained the adult male victim of a traffic accident. More severe traumas were admitted, resulting in an increase in surgical treatment, hospitalizations and deaths.

摘要：目的：评估2021年3月13日至2021年4月5日新冠疫情限制性措施期间，麦肯齐福音大学附属医院（Hospital Universitário Evangélico Mackenzie, HUEM）创伤患者的急诊诊疗概况，并与2020年疫情初期同期及2019年疫情前同期数据进行对比。方法：本研究为定量描述性观察性横断面研究。最终纳入8338例样本，分析维度包括就诊日期、性别、年龄及负责诊疗的科室；创伤病例则按病因、诊疗处置及转归进行分析。结果：疫情期间非创伤性急诊诊疗占比上升，2021年内科门诊收治病例占总收治量的三分之一。创伤诊疗量出现下降：2019年创伤病例占收治总量的44.9%，2021年该比例降至23.5%。男女就诊比例存在显著差异，2021年创伤男性患者占比高于疫情前各时期。交通事故、平地跌倒、烧伤、一般性钝性创伤及运动休闲相关创伤的绝对数量均出现具有统计学意义的下降。保守治疗后出院的病例占比有所降低。死亡病例数存在显著差异：2020年死亡数有所下降，但2021年死亡数回升。结论：疫情期间创伤诊疗量有所减少，但创伤患者的核心特征仍为成年男性交通事故伤者。本次研究收治的创伤患者病情更为严重，导致外科治疗比例、住院率及死亡率均有所上升。