The Effect of 2019 Coronavirus Stay-at-Home Order on Geriatric Trauma Patients in Southern California

Author:

Manasa Morgan1ORCID,Yeates Eric O1,Grigorian Areg2,Barrios Cristobal1,Schellenberg Morgan2,Owattanapanich Natthida2,Barmparas Galinos3,Margulies Daniel3,Juillard Catherine4,Garber Kent4,Cryer Henry4,Tillou Areti4,Burruss Sigrid5,Penaloza-Villalobos Liz5,Lin Ann5,Figueras Ryan Arthur5,Coimbra Raul6,Brenner Megan6,Costantini Todd7,Santorelli Jarrett7,Curry Terry7,Wintz Diane8,Biffl Walter L9,Schaffer Kathryn B9ORCID,Duncan Thomas K.10,Barbaro Casey10,Diaz Graal10,Johnson Arianne11,Tay-Lasso Erika1,Chinn Justine1,Naaseh Ariana1,Leung Amanda1,Grabar Christina1,Nahmias Jeffry1

Affiliation:

1. Department of Surgery, University of California, Irvine (UCI), Orange, CA, USA

2. Department of Surgery, University of Southern California (USC), Los Angeles, CA, USA

3. Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

4. Department of Surgery, University of California Los Angeles (UCLA), Los Angeles, CA, USA

5. Department of Surgery, Loma Linda University, Loma Linda, CA, USA

6. Riverside University Health System, Moreno Valley, CA, USA

7. Department of Surgery, University of California, San Diego (UCSD), San Diego, CA, USA

8. Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA

9. Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA

10. Department of Surgery, Ventura County Medical Center, Ventura, CA, USA

11. Santa Barbara Cottage Hospital, Santa Barbara, CA, USA

Abstract

Background California issued stay-at-home (SAH) orders to mitigate COVID-19 spread. Previous studies demonstrated a shift in mechanisms of injuries (MOIs) and decreased length of stay (LOS) for the general trauma population after SAH orders. This study aimed to evaluate the effects of SAH orders on geriatric trauma patients (GTPs), hypothesizing decreased motor vehicle collisions (MVCs) and LOS. Methods A post-hoc analysis of GTPs (≥65 years old) from 11 level-I/II trauma centers was performed, stratifying patients into 3 groups: before SAH (1/1/2020-3/18/2020) (PRE), after SAH (3/19/2020-6/30/2020) (POST), and a historical control (3/19/2019-6/30/2019) (CONTROL). Bivariate comparisons were performed. Results 5486 GTPs were included (PRE-1756; POST-1706; CONTROL-2024). POST had a decreased rate of MVCs (7.6% vs 10.6%, P = .001; vs 11.9%, P < .001) and pedestrian struck (3.4% vs 5.8%, P = .001; vs 5.2%, P = .006) compared with PRE and CONTROL. Other mechanisms of injury, LOS, mortality, and operations performed were similar between cohorts. However, POST had a lower rate of discharge to skilled nursing facility (SNF) (20% vs 24.5%, P = .001; and 20% vs 24.4%, P = .001). Conclusion This retrospective multicenter study demonstrated lower rates of MVCs and pedestrian struck for GTPs, which may be explained by decreased population movement as a result of SAH orders. Contrary to previous studies on the generalized adult population, no differences in other MOIs and LOS were observed after SAH orders. However, there was a lower rate of discharge to SNF, which may be related to a lack of resources due to the COVID-19 pandemic, and thus potentially negatively impacted recovery of GTPs. Keywords

Publisher

SAGE Publications

Subject

General Medicine

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