Analysis of the Impact of sars-cov-2 on Emergency Department Visits for Traumatic Brain Injury

Research Objectives: To examine the characteristics of individuals with traumatic brain injury (TBI) presenting to Level I and II Trauma Centers and the rate of TBI-related emergency department visits before and after the COVID-19 pandemic.

Design: Retrospective cohort study.

Setting: Level I and Level II Trauma Centers participating in the American College of Surgeons Trauma Quality Program.

Participants: Admissions with an ICD-10-CM code indicating TBI, over the age of 18, admitted to a participating facility.

Interventions: Not Applicable

Main Outcome Measures: Injury Severity Score (ISS), Glasgow Coma Scale at admission.

Results: We observed a decline in the number of admissions to the ED in 2020 compared to other years. In a comparative analysis between pre-COVID (2017-2019) and pandemic years (2020-2021), we noted a higher proportion of people presenting to the ED with moderate to severe GCS scores and severe to profound ISS scores, as compared to milder injuries. This suggests a shift toward more severe injuries after the start of the pandemic.

Conclusions: After the start of the COVID-19 pandemic, the population of individuals with TBI presenting to trauma center emergency departments has a relative increase the proportion of those with severe injuries compared to mild injuries. As observed in other studies, this may be associated with hesitancy in seeking care for mild injuries due to fear of acquiring COVID-19 or a desire to avoid overburdening the healthcare system. We observed a decrease in the number of admissions in 2020, which rebounded in 2021; however, the distribution of injury severity remained consistent. It is unclear whether changes in emergency department utilization will impact long-term recovery or access to healthcare services along the continuum.

Author(s) Disclosures: None.