Impact of COVID-19 on trauma care in trauma and non-trauma centers in New York State: a SPARCS 2016-2022 analysis.

Abstract

There were concerns about depleting trauma care capabilities due to the significant strain on healthcare services and resources during the COVID-19 pandemic. We aimed to describe the epidemiology of trauma care in New York State (NYS) during this period to elucidate how a healthcare crisis, such as a pandemic, can alter trauma care delivery. We conducted a retrospective review of trauma and non-trauma hospital discharges in New York State from 2016 to 2022 using the Statewide Planning and Research Cooperative System (SPARCS) database. The years 2016-2019 served as the baseline, March 2020 to December 2021 as the COVID period, and 2022 as the post-COVID recovery period. Changes in case volumes were analyzed by trauma center levels and non-trauma centers, presenting demographic characteristics, injury mechanisms, health services areas, illness severity, and in-hospital fatalities. Level 1 trauma centers accounted for the highest percentage of trauma admissions, making up 44 % of the total, and also had the majority of non-trauma cases. During this period, pediatric trauma admissions decreased in these centers. However, trauma admissions for individuals categorized as Black or African American, Multi-racial, and Other increased. There was a notable rise in motorcycle-related injuries, other land transport injuries, and assaults involving firearms during the COVID period, which increased by up to 53 %, 49 %, and 48 %, respectively. Severity of illness scores revealed a significant increase in extreme cases. Additionally, trauma-related fatalities rose in trauma centers during the COVID period, whereas they decreased in most non-trauma centers during the same time frame. During the COVID-19 pandemic, trauma centers in NYS continued to treat critically injured patients despite increased healthcare strain. There was a disproportionate impact across age groups and racial backgrounds, with a rise in violent injuries observed in both trauma and non-trauma centers. Higher fatality rates in trauma centers may be due to the admission of more severely injured patients. We recommend that regional and local trauma stakeholders tailor trauma care services preparedness to the vulnerability of their served communities to anticipate the accommodation of resources in the face of future healthcare crises.