Thomas, Arielle C.Campbell, Brendan T.Subacius, HarisOrlas, Claudia P.Bulger, EileenStewart, Ronald M.Stey, Anne M.Jang, AngieHamad, DouliaBilimoria, Karl Y.Nathens, Avery B.2024-11-212024-11-212022Thomas AC, Campbell BT, Subacius H, et al. National evaluation of the association between stay-at-home orders on mechanism of injury and trauma admission volume. Injury. 2022;53(11):3655-3662. doi:10.1016/j.injury.2022.09.012https://hdl.handle.net/1805/44656Background: The COVID-19 pandemic had numerous negative effects on the US healthcare system. Many states implemented stay-at-home (SAH) orders to slow COVID-19 virus transmission. We measured the association between SAH orders on the injury mechanism type and volume of trauma center admissions during the first wave of the COVID-19 pandemic. Methods: All trauma patients aged 16 years and older who were treated at the American College of Surgeons Trauma Quality Improvement Program participating centers from January 2018-September 2020. Weekly trauma patient volume, patient demographics, and injury characteristics were compared across the corresponding SAH time periods from each year. Patient volume was modeled using harmonic regression with a random hospital effect. Results: There were 166,773 patients admitted in 2020 after a SAH order and an average of 160,962 patients were treated over the corresponding periods in 2018-2019 in 474 centers. Patients presenting with a pre-existing condition of alcohol misuse increased (13,611 (8.3%) vs. 10,440 (6.6%), p <0.001). Assault injuries increased (19,056 (11.4%) vs. 15,605 (9.8%)) and firearm-related injuries (14,246 (8.5%) vs. 10,316 (6.4%)), p<0.001. Firearm-specific assault injuries increased (10,748 (75.5%) vs. 7,600 (74.0%)) as did firearm-specific unintentional injuries (1,318 (9.3%) vs. 830 (8.1%), p<0.001. In the month preceding the SAH orders, trauma center admissions decreased. Within a week of SAH implementation, hospital admissions increased (p<0.001) until a plateau occurred 10 weeks later above predicted levels. On regional sub-analysis, admission volume remained significantly elevated for the Midwest during weeks 11-25 after SAH order implementation, (p<0.001).en-USPublisher PolicyCOVID-19Trauma epidemiologyTrauma systemsInterpersonal violenceFirearm violenceArticle