BACKGROUND: The COVID-19 pandemic resulted in a statewide stay-at-home (SAH) order in California beginning March 19 , 2020, forcing large-scale behavioral changes and taking an emotional and economic toll . The effects of SAH orders on the trauma population remains unknown . We hypothesized an increase in rates of penetrating trauma, gunshot wounds, suicide attempts, and domestic violence in the Southern California trauma population after the SAH order .
METHODS: A multicenter retrospective analysis of all trauma patients presenting to 11 American College of Surgeons (ACS) Level I and II trauma centers spanning seven counties in California was performed . Demographic data, injury characteristics, clinical data, and outcomes were collected . Patients were divided into three groups based on injury date: before SAH from 1/1/2020-3/18/2020 (PRE), after SAH from 3/19/2020-6/30/2020 (POST), and a historical control from 3/19/2019-6/30/2019 (CONTROL). POST was compared to both PRE and CONTROL in two separate analyses .
RESULTS: Across all time periods, 20,448 trauma patients were identified (CONTROL : 7,707, PRE : 6,022, POST : 6,719). POST had a significantly increased rate of penetrating trauma (13.0% vs. 10.3%, p <0.001 and 13.0% vs. 9.9%, p <0.001) and gunshot wounds (4.5% vs. 2.4%, p=0.002 and 4.5% vs. 3.7%, p=0.025) compared to PRE and CONTROL, respectively . POST had a suicide attempt rate of 1.9% and a domestic violence rate of 0.7%, which were similar to PRE (p=0.478, p=0.514) and CONTROL (p=0.160, p=0.618).
CONCLUSIONS: This multicenter Southern California study demonstrated an increased rate of penetrating trauma and gunshot wounds after the COVID-19 SAH orders, but no difference in attempted suicide or domestic violence rates . These findings may provide useful information regarding resource utilization and a target for societal intervention during the current or future pandemic (s). LEVEL OF EVIDENCE: IV.