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

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.