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Article ; Online: Optimization of a Patient Distribution Framework: Second Wave COVID-19 Preparedness and Challenges in the Amsterdam Region.

Berkeveld, Eva / Mikdad, Sarah / Terra, Maartje / Kramer, Mark H H / Bloemers, Frank W / Zandbergen, H Reinier

2023 Volume 21, Issue 1, Page(s) 4–10

Abstract: To meet surge capacity and to prevent hospitals from being overwhelmed with COVID-19 patients, a regional crisis task force was established during the first pandemic wave to coordinate the even distribution of COVID-19 patients in the Amsterdam region. ... ...

Abstract	To meet surge capacity and to prevent hospitals from being overwhelmed with COVID-19 patients, a regional crisis task force was established during the first pandemic wave to coordinate the even distribution of COVID-19 patients in the Amsterdam region. Based on a preexisting regional management framework for acute care, this task force was led by physicians experienced in managing mass casualty incidents. A collaborative framework consisting of the regional task force, the national task force, and the region's hospital crisis coordinators facilitated intraregional and interregional patient transfers. After hospital admission rates declined following the first COVID-19 wave, a window of opportunity enabled the task forces to create, standardize, and optimize their patient transfer processes before a potential second wave commenced. Improvement was prioritized according to 3 crucial pillars: process standardization, implementation of new strategies, and continuous evaluation of the decision tree. Implementing the novel "fair share" model as a straightforward patient distribution directive supported the regional task force's decisionmaking. Standardization of the digital patient transfer registration process contributed to a uniform, structured system in which every patient transfer was verifiable on intraregional and interregional levels. Furthermore, the regional task force team was optimized and evaluation meetings were standardized. Lines of communication were enhanced, resulting in increased situational awareness among all stakeholders that indirectly provided a safety net and an improved integral framework for managing COVID-19 care capacities. In this article, we describe enhancements to a patient transfer framework that can serve as an exemplary system to meet surge capacity demands during current and future pandemics.
MeSH term(s)	Humans ; COVID-19 ; Surge Capacity ; Critical Care ; Mass Casualty Incidents
Language	English
Publishing date	2023-01-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	2823049-8
ISSN	2326-5108 ; 2326-5094
ISSN (online)	2326-5108
ISSN	2326-5094
DOI	10.1089/hs.2022.0079
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Article ; Online: Variation in HbA1c in Patients with Obesity and type 2 Diabetes Mellitus 12 months after Laparoscopic One-Anastomosis Gastric Bypass and Laparoscopic Roux-en-Y Gastric Bypass: a Retrospective Matched Cohort Study.

van Rijswijk, Anne-Sophie / Meijnikman, Abraham S / Mikdad, Sarah / Hutten, Barbara A / van der Peet, Donald L / van de Laar, Arnold W / Gerdes, Victor E A / de Brauw, Maurits

Obesity surgery

2024 Volume 34, Issue 3, Page(s) 940–946

Abstract: Background: Glycemic control is an important goal of bariatric surgery in patients with type 2 diabetes mellitus (T2DM) and obesity. The laparoscopic one-anastomosis gastric bypass (OAGB) has potential metabolic benefits over the laparoscopic Roux-en-Y ... ...

Abstract	Background: Glycemic control is an important goal of bariatric surgery in patients with type 2 diabetes mellitus (T2DM) and obesity. The laparoscopic one-anastomosis gastric bypass (OAGB) has potential metabolic benefits over the laparoscopic Roux-en-Y gastric bypass (RYGB). Aim of this study is to examine whether RYGB or OAGB grants better glycemic control 12 months post-surgery. Methods: For this retrospective cohort study, patients with T2DM and obesity, who underwent primary OAGB between 2008 and 2017 were reviewed. For each OAGB patient, three primary RYGB patients were matched for age, gender and body mass index (BMI). Glycemic control was expressed by the glycated hemoglobin (HbA1c), which was measured pre- and 12 months post-operatively. Weight loss was reported in percentage total weight loss (%TWL). Results: A total of 152 patients, of whom 38 had OAGB and 114 RYGB, were included. Mean (standard deviation (SD)) HbA1c was 7.49 (1.51)% in the OAGB group and 7.56(1.23)% in the RYGB group at baseline. Twelve months after surgery the mean (SD) HbA1c dropped to 5.73 (0.71)% after OAGB and 6.09 (0.76)% after RYGB (adjusted p = 0.011). The mean (SD) BMI was reduced from 42.5(6.3) kg/m Conclusion: This study indicates that OAGB leads to lower HbA1c one year after surgery compared to RYGB, without a difference in weight loss. Prospective (randomized) studies are needed to ascertain the most optimal metabolic treatment for patients with obesity and T2DM.
MeSH term(s)	Humans ; Gastric Bypass/adverse effects ; Obesity, Morbid/surgery ; Glycated Hemoglobin ; Retrospective Studies ; Diabetes Mellitus, Type 2/complications ; Diabetes Mellitus, Type 2/surgery ; Prospective Studies ; Cohort Studies ; Obesity/surgery ; Obesity/etiology ; Laparoscopy ; Weight Loss
Chemical Substances	Glycated Hemoglobin
Language	English
Publishing date	2024-02-06
Publishing country	United States
Document type	Journal Article
ZDB-ID	1070827-3
ISSN	1708-0428 ; 0960-8923
ISSN (online)	1708-0428
ISSN	0960-8923
DOI	10.1007/s11695-024-07067-x
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Zs.A 3381: Show issues

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Article ; Online: In-House Attending Trauma Surgeon Does Not Reduce Mortality in Patients Presented to a Level 1 Trauma Center.

Hakkenbrak, Nadia Ag / Mikdad, Sarah / van Embden, Daphne / Giannakopoulos, Georgios F / Bloemers, Frank W / Schepers, Tim / Halm, Jens A

Prehospital and disaster medicine

2022 Volume 37, Issue 3, Page(s) 373–377

Abstract: Background: Trauma is the leading cause of death in the Western world. Trauma systems have been paramount in opposing this problem. Commonly, Level 1 Trauma Centers are staffed by in-house (IH) attending trauma surgeons available 24/7, whereas other ... ...

Abstract	Background: Trauma is the leading cause of death in the Western world. Trauma systems have been paramount in opposing this problem. Commonly, Level 1 Trauma Centers are staffed by in-house (IH) attending trauma surgeons available 24/7, whereas other institutions function on an on-call (OC) basis with defined response times. There is on-going debate about the value of an IH attending trauma surgeon compared to OC trauma surgeons regarding clinical outcome. Methods: This study was performed at a tertiary care facility complying with all requirements to be a designated Level 1 Trauma Center as defined by the American College of Surgeons Committee on Trauma (ACSCOT). Inclusion occurred from January 1, 2012 through December 31, 2013. Patients were assigned an identifier for IH trauma surgeon attendance versus OC attendance. The primary outcome variable studied was overall mortality in relation to IH or OC attending trauma surgeons. Additionally, time to operating theater, hospital length-of-stay (HLOS), and intensive care unit (ICU) admittance were investigated. Results: A total of 1,287 unique trauma cases in 1,285 patients were presented to the trauma team. Of all cases, 712 (55.3%) occurred between 1700h and 0800h. These 712 cases were treated by an IH attending in 66.3% (n = 472) and an OC attending in 33.7% (n = 240). In the group of patients treated by an IH attending trauma surgeon, the overall mortality rate was 5.5% (n = 26); in the group treated by an OC attending, the overall mortality rate was 4.6% (n = 11; P = .599). Cause of death was traumatic brain injury (TBI) in 57.6%. No significant difference was found in the time between initial presentation at the trauma room and arrival in the operating theater. Conclusion: In terms of trauma-related mortality during non-office hours, no benefit was demonstrated through IH trauma surgeons compared to OC trauma surgeons.
MeSH term(s)	Hospital Mortality ; Humans ; Injury Severity Score ; Retrospective Studies ; Surgeons ; Time Factors ; Trauma Centers
Language	English
Publishing date	2022-04-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	1025975-2
ISSN	1945-1938 ; 1049-023X
ISSN (online)	1945-1938
ISSN	1049-023X
DOI	10.1017/S1049023X22000656
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Zs.A 2859: Show issues

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Article ; Online: Operational experience of the Dutch helicopter emergency medical services (HEMS) during the initial phase of the COVID-19 pandemic: jeopardy on the prehospital care system?

Rikken, Quinten G H / Mikdad, Sarah / Mota, Mathijs T Carvalho / De Leeuw, Marcel A / Schober, Patrick / Schwarte, Lothar A / Giannakopoulos, Georgios F

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2021 Volume 47, Issue 3, Page(s) 703–711

Abstract: Purpose: The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since ... ...

Abstract	Purpose: The SARS-CoV-2 virus has disrupted global and local medical supply chains. To combat the spread of the virus and prevent an uncontrolled outbreak with limited resources, national lockdown protocols have taken effect in the Netherlands since March 13 Methods: A retrospective review of all HEMS and HEMS-ambulance 'Lifeliner 1' dispatches was performed from the start of Dutch nationwide lockdown orders from March 13th until May 13th, 2020 and the corresponding period one year prior. Dispatch-, operational-, patient-, injury-, and on-site treatment characteristics were extracted for analysis. In addition, the rate of COVID-19 positively tested HEMS personnel and the time physicians were unable to take call was described. Results: During the initial phase of the COVID-19 pandemic, the HEMS and HEMS-ambulance was requested in 528 cases. One year prior, a total of 620 requests were received. The HEMS (helicopter and ambulance) was cancelled after deployment in 56.4% of the COVID-19 cohort and 50.7% of the historical cohort (P = 0.05). Incident location type did not differ between the two cohorts, specifically, there was no significant difference in the number of injuries that occurred at home in pandemic versus non-pandemic circumstances. Besides a decrease in the number of falls, the distribution of mechanisms of injury remained similar during the COVID-19 study period. There was no difference in self-inflicted injuries observed. Prehospital interventions remained similar during the COVID-19 pandemic compared to one year prior. Specifically, prehospital intubation did not differ between the two cohorts. The rate of COVID-19 positively tested HEMS personnel was 23.1%. Physicians who tested positive were unable to take call for a mean of 25 days (range 8-53). Conclusion: A decrease in the number of deployments and increase in the number of cancelled missions was observed during the COVID-19 study period. No major differences in operational- and injury characteristics were found for HEMS and HEMS-ambulance dispatches between the initial phase of the COVID-19 pandemic in the Netherlands and the same period one year prior. These findings highlight the importance of continued operability of the HEMS, even during pandemic circumstances. Level of evidence: III, retrospective comparative study.
MeSH term(s)	Adult ; Air Ambulances/organization & administration ; Air Ambulances/statistics & numerical data ; COVID-19/epidemiology ; COVID-19/prevention & control ; Child ; Communicable Disease Control/methods ; Emergencies/epidemiology ; Emergency Medical Dispatcher/statistics & numerical data ; Emergency Medical Services/methods ; Emergency Medical Services/statistics & numerical data ; Emergency Medical Services/supply & distribution ; Female ; Humans ; Male ; Netherlands/epidemiology ; Occupational Health/statistics & numerical data ; Outcome and Process Assessment, Health Care ; SARS-CoV-2 ; Wounds and Injuries/epidemiology ; Wounds and Injuries/etiology ; Wounds and Injuries/therapy
Language	English
Publishing date	2021-01-12
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-020-01569-w
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Performance of the Emergency Surgery Score (ESS) Across Different Emergency General Surgery Procedures.

Gaitanidis, Apostolos / Breen, Kerry / Naar, Leon / Mikdad, Sarah / El Moheb, Mohamad / Kongkaewpaisan, Napaporn / El Hechi, Majed / Kaafarani, Haytham M A

The Journal of surgical research

2021 Volume 261, Page(s) 152–158

Abstract: Background: The Emergency Surgery Score (ESS) has been previously validated as a reliable tool to predict postoperative outcomes in emergency general surgery (EGS). The purpose of this study is to assess the differential performance of the ESS in ... ...

Abstract	Background: The Emergency Surgery Score (ESS) has been previously validated as a reliable tool to predict postoperative outcomes in emergency general surgery (EGS). The purpose of this study is to assess the differential performance of the ESS in specific EGS procedures. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was retrospectively analyzed for patients undergoing EGS between 2007 and 2017. Patients who underwent the following EGS procedures were identified: laparoscopic appendectomy, laparoscopic cholecystectomy, surgery for small bowel obstruction (SBO), colectomy, and incarcerated ventral or inguinal hernia repair. The performance of the ESS in predicting mortality in each procedure was assessed using receiver operating characteristic analyses. Results: A total of 467,803 patients underwent EGS (mean age 50 ± 19.9 y, females 241,330 [51.6%]), of which 191,930 (41%) underwent laparoscopic appendectomy, 40,353 (8.6%) underwent laparoscopic cholecystectomy, and 35,152 (7.5%) patients underwent surgery for SBO. The ESS correlated extremely well with mortality for patients who underwent laparoscopic appendectomy (area under the curve (AUC) 0.91), laparoscopic cholecystectomy (AUC 0.91), lysis of adhesions for SBO (AUC 0.83), colectomy (AUC 0.83), and incarcerated hernia repair (AUC 0.85). Conclusions: ESS performance accurately predicts mortality across a wide range of EGS procedures, and its use should be encouraged for preoperative patient counseling and for nationally benchmarking the quality of care of EGS.
MeSH term(s)	Adult ; Aged ; Emergency Treatment/mortality ; Female ; General Surgery/statistics & numerical data ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Risk Assessment ; Surgical Procedures, Operative/mortality
Language	English
Publishing date	2021-01-08
Publishing country	United States
Document type	Journal Article ; Validation Study
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2020.12.014
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Zs.A 178: Show issues

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Article ; Online: Prehospital extremity tourniquet placements-performance evaluation of non-EMS placement of a lifesaving device.

Mokhtari, Ava K / Mikdad, Sarah / Luckhurst, Casey / Hwabejire, John / Fawley, Jason / Parks, Jonathan J / Mendoza, April E / Kaafarani, Haytham M A / Velmahos, George C / Bloemers, Frank W / Saillant, Noelle N

European journal of trauma and emergency surgery : official publication of the European Trauma Society

2022 Volume 48, Issue 5, Page(s) 4255–4265

Abstract: Background: The education of civilians and first responders in prehospital tourniquet (PT) utilization has spread rapidly. We aimed to describe trends in emergency medical services (EMS) and non-EMS PT utilization, and their ability to identify proper ... ...

Abstract	Background: The education of civilians and first responders in prehospital tourniquet (PT) utilization has spread rapidly. We aimed to describe trends in emergency medical services (EMS) and non-EMS PT utilization, and their ability to identify proper clinical indications and to appropriately apply tourniquets in the field. Methods: A retrospective cohort study was conducted to evaluate all adult patients with PTs who presented at two Level I trauma centers between January 2015 and December 2019. Data were collected via an electronic patient query tool and cross-referenced with institutional Trauma Registries. Medically trained abstractors determined if PTs were clinically indicated (limb amputation, vascular hard signs, injury requiring hemostasis procedure, or significant documented blood loss). PTs were further designated as appropriately or inappropriately applied (based on tourniquet location, venous tourniquet, greater than 2-h ischemic time). Descriptive statistics and univariate analyses were performed. Results: 146 patients met inclusion criteria. The incidence of yearly PT placements increased between 2015 and 2019, with an increase in placement by non-EMS personnel (police, firefighter, bystander, and patient). Improvised PTs were frequently utilized by bystanders and patients, whereas first responders had high rates of commercial tourniquet use. A high proportion of tourniquets were placed without indication (72/146, 49%); however, the proportion of PTs placed without a proper indication across applier groups was not statistically different (p = 0.99). Rates of inappropriately applied PTs ranged from 21 to 46% across all groups applying PTs. Conclusions: PT placement was increasingly performed by non-EMS personnel. Present data indicate that non-EMS persons applied PTs at a similar performance level of those applied by EMS. Study LevelLevel III.
MeSH term(s)	Adult ; Emergency Medical Services/methods ; Extremities/injuries ; Humans ; Retrospective Studies ; Tourniquets ; Trauma Centers
Language	English
Publishing date	2022-05-10
Publishing country	Germany
Document type	Journal Article
ZDB-ID	2275480-5
ISSN	1863-9941 ; 1863-9933
ISSN (online)	1863-9941
ISSN	1863-9933
DOI	10.1007/s00068-022-01973-4
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Zs.A 1221: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Preperitoneal Pelvic Packing is Associated With Increased Risk of Venous Thromboembolism.

Parks, Jonathan J / Naar, Leon / Bokenkamp, Mary / van Erp, Inge A M / Mikdad, Sarah / Maurer, Lydia R / Fawley, Jason / Saillant, Noelle N / Kaafarani, Haytham M A / Velmahos, George C

The Journal of surgical research

2022 Volume 280, Page(s) 85–93

Abstract: Introduction: Preperitoneal pelvic packing (PPP) is an important intervention for control of severe pelvic hemorrhage in blunt trauma patients. We hypothesized that PPP is associated with an increased incidence of deep vein thrombosis (DVT) and ... ...

Abstract	Introduction: Preperitoneal pelvic packing (PPP) is an important intervention for control of severe pelvic hemorrhage in blunt trauma patients. We hypothesized that PPP is associated with an increased incidence of deep vein thrombosis (DVT) and pulmonary embolism (PE). Methods: A retrospective cohort analysis of blunt trauma patients with severe pelvic fractures (AIS ≥4) using the 2015-2017 American College of Surgeons-Trauma Quality Improvement Program database was performed. Patients who underwent PPP within four hours of admission were matched to patients who did not using propensity score matching. Matching was performed based on demographics, comorbidities, injury- and resuscitation-related parameters, vital signs at presentation, and initiation and type of prophylactic anticoagulation. The rates of DVT and PE were compared between the matched groups. Results: Out of 5129 patients with severe pelvic fractures, 157 (3.1%) underwent PPP within four h of presentation and were matched with 157 who did not. No significant differences were detected between the two matched groups in any of the examined baseline variables. Similarly, mortality and end-organ failure rates were not different. However, PPP patients were significantly more likely to develop DVT (12.7% versus 5.1%, P = 0.028) and PE (5.7% versus 0.0%, P = 0.003). Conclusions: PPP in severe pelvic fractures secondary to blunt trauma is associated with an increased risk of DVT and PE. A high index of suspicion and a low threshold for screening for these conditions should be maintained in patients who undergo PPP.
MeSH term(s)	Humans ; Venous Thromboembolism/epidemiology ; Venous Thromboembolism/etiology ; Venous Thromboembolism/prevention & control ; Retrospective Studies ; Pelvic Bones/injuries ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Pulmonary Embolism/prevention & control ; Fractures, Bone/etiology ; Fractures, Bone/complications ; Wounds, Nonpenetrating/complications ; Wounds, Nonpenetrating/diagnosis ; Wounds, Nonpenetrating/epidemiology ; Anticoagulants
Chemical Substances	Anticoagulants
Language	English
Publishing date	2022-08-11
Publishing country	United States
Document type	Journal Article
ZDB-ID	80170-7
ISSN	1095-8673 ; 0022-4804
ISSN (online)	1095-8673
ISSN	0022-4804
DOI	10.1016/j.jss.2022.06.075
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Zs.A 178: Show issues

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Article ; Online: The Emergency Surgery Score (ESS) accurately predicts outcomes in elderly patients undergoing emergency general surgery.

Gaitanidis, Apostolos / Mikdad, Sarah / Breen, Kerry / Kongkaewpaisan, Napaporn / Mendoza, April / Saillant, Noelle / Fawley, Jason / Parks, Jonathan / Velmahos, George / Kaafarani, Haytham

American journal of surgery

2020 Volume 220, Issue 4, Page(s) 1052–1057

Abstract: Background: The performance of the Emergency Surgery Score (ESS), a validated risk calculator, in the elderly emergency general surgery (EGS) patient remains unclear. We hypothesized that ESS accurately predicts outcomes in elderly EGS patients, ... ...

Abstract	Background: The performance of the Emergency Surgery Score (ESS), a validated risk calculator, in the elderly emergency general surgery (EGS) patient remains unclear. We hypothesized that ESS accurately predicts outcomes in elderly EGS patients, including octogenarians and nonagenarians. Methods: Using the 2007-2017 National Surgical Quality Improvement Program (NSQIP) database, we included all EGS patients ≥65 years old. The correlation between ESS, mortality and morbidity was assessed in the 3 patient cohorts (>65, octogenarians and nonagenarians), using the area under the curve (AUC). Results: A total of 124,335 patients were included, of which 34,215 (28%) were octogenarians and 7239 (6%) were nonagenarians. In patients ≥65 years, ESS accurately predicted mortality (AUC 0.81). For octogenarians and nonagenarians, ESS predicted mortality moderately well (AUC 0.77 and 0.69, respectively. Conclusion: ESS accurately predicts mortality and morbidity in the elderly EGS patient, but its accuracy in predicting morbidity decreases for nonagenarians.
MeSH term(s)	Aged ; Aged, 80 and over ; Data Management ; Emergencies/epidemiology ; Emergency Service, Hospital/statistics & numerical data ; Female ; Hospital Mortality/trends ; Humans ; Male ; Morbidity/trends ; Postoperative Complications/epidemiology ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment/methods ; Risk Factors ; Surgical Procedures, Operative/adverse effects ; Survival Rate/trends ; United States/epidemiology
Language	English
Publishing date	2020-02-17
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2953-1
ISSN	1879-1883 ; 0002-9610
ISSN (online)	1879-1883
ISSN	0002-9610
DOI	10.1016/j.amjsurg.2020.02.017
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Article ; Online: Experience of the Coronavirus Disease (COVID-19) Patient Care in the Amsterdam Region: Optimization of Acute Care Organization.

Berkeveld, Eva / Mikdad, Sarah / Zandbergen, Harmen R / Kraal, Adriaan / Terra, Maartje / Kramer, Mark H H / Bloemers, Frank W

Disaster medicine and public health preparedness

2020 Volume 16, Issue 3, Page(s) 1194–1198

Abstract: The coronavirus disease (COVID-19) pandemic causes a large number of patients to simultaneously be in need of specialized care. In the Netherlands, hospitals scaled up their intensive care unit and clinical admission capacity at an early stage of the ... ...

Abstract	The coronavirus disease (COVID-19) pandemic causes a large number of patients to simultaneously be in need of specialized care. In the Netherlands, hospitals scaled up their intensive care unit and clinical admission capacity at an early stage of the pandemic. The importance of coordinating resources during a pandemic has already been emphasized in the literature. Therefore, in order to prevent hospitals from being overwhelmed by COVID-19 admissions, national and regional task forces were established for the purpose of coordinating patient transfers. This review describes the experience of Regionaal Overleg Acute Zorg (ROAZ) region Noord-Holland Flevoland, in coordinating patient transfers in the Amsterdam region. In total, 130 patient transfers were coordinated by our region, of which 73% patients were transferred to a hospital within the region. Over a 2-month period, similarities regarding days with increased patient transfers were seen between our region and the national task force. In parallel, an increased incidence in hospital admissions in the Netherlands was observed. During a pandemic, an early upscale (an increase in surge spaces) of hospital admission capacity is imperative. Furthermore, it is preferred to establish national and regional task forces, coordinated by physicians experienced and trained in handling crisis situations, adhering full transparency regarding hospital admission capacity.
MeSH term(s)	Humans ; COVID-19/epidemiology ; SARS-CoV-2 ; Pandemics/prevention & control ; Intensive Care Units ; Hospitalization
Keywords	covid19
Language	English
Publishing date	2020-11-19
Publishing country	United States
Document type	Review ; Journal Article
ZDB-ID	2375268-3
ISSN	1938-744X ; 1935-7893
ISSN (online)	1938-744X
ISSN	1935-7893
DOI	10.1017/dmp.2020.446
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Article ; Online: Trauma care during the COVID-19 pandemic in the Netherlands: a level 1 trauma multicenter cohort study.

Hakkenbrak, Nadia A G / Loggers, Sverre A I / Lubbers, Eva / de Geus, Jarik / van Wonderen, Stefan F / Berkeveld, Eva / Mikdad, Sarah / Giannakopoulos, Georgios F / Ponsen, Kees J / Bloemers, Frank W

Scandinavian journal of trauma, resuscitation and emergency medicine

2021 Volume 29, Issue 1, Page(s) 130

Abstract: Purpose: The coronavirus (COVID-19) pandemic has caused major healthcare challenges worldwide resulting in an exponential increase in the need for hospital- and intensive care support for COVID-19 patients. As a result, surgical care was restricted to ... ...

Abstract	Purpose: The coronavirus (COVID-19) pandemic has caused major healthcare challenges worldwide resulting in an exponential increase in the need for hospital- and intensive care support for COVID-19 patients. As a result, surgical care was restricted to urgent cases of surgery. However, the care for trauma patients is not suitable for reduction or delayed treatment. The influence of the pandemic on the burden of disease of trauma care remains to be elucidated. Methods: All patients with traumatic injuries that were presented to the emergency departments (ED) of the Amsterdam University Medical Center, Location Academic Medical Center (AMC) and VU medical center (VUMC) and the Northwest Clinics (NWC) between March 10, 2019 and May 10, 2019 (non-COVID) and March 10, 2020 and May 10, 2020 (COVID-19 period) were included. The primary outcome was the difference in ED admissions for trauma patients between the non-COVID and COVID-19 study period. Additionally, patient- and injury characteristics, health care consumption, and 30-day mortality were evaluated. Results: A 37% reduction of ED admissions for trauma patients was seen during the COVID-19 pandemic (non-COVID n = 2423 and COVID cohort n = 1531). Hospital admission was reduced by 1.6 trauma patients per day. Fewer patients sustained car- and sports-related injuries. Injuries after high energetic trauma were more severe in the COVID-19 period (Injury Severity Score 17.3 vs. 12.0, p = 0.006). Relatively more patients were treated operatively (21.4% vs. 16.6%, p < 0.001) during the COVID-19 period. Upper-(17.6 vs. 12.5%, p = 0.002) and lower extremity injuries (30.7 vs. 23.0%, p = 0.002) mainly accounted for this difference. The 30-day mortality rate was higher during the pandemic (1.0 vs. 2.3%, p = 0.001). Conclusion: The burden of disease and healthcare consumption of trauma patients remained high during the COVID-19 pandemic. Results of this study can be used to optimize the use of hospital capacity and anticipate health care planning in future outbreaks.
MeSH term(s)	COVID-19 ; Cohort Studies ; Emergency Service, Hospital ; Humans ; Netherlands/epidemiology ; Pandemics ; Retrospective Studies ; SARS-CoV-2 ; Trauma Centers
Language	English
Publishing date	2021-09-08
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2455990-8
ISSN	1757-7241 ; 1757-7241
ISSN (online)	1757-7241
ISSN	1757-7241
DOI	10.1186/s13049-021-00942-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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