Veränderungen der Verletzungsepidemiologie in der Schwerverletztenversorgung durch die COVID-19-Pandemie: eine retrospektive Analyse des Traumaregisters DGU®

The COVID-19 pandemic not only led to a major burden on the German healthcare system in 2020 but was also accompanied by a change in social life as a result of epidemic related measures. The increased number of COVID-19 patients also resulted in changes to treatment structures in hospitals, including a significant increase in the utilization of intensive care beds. This retrospective registry analysis of the TraumaRegister DGU® examines the extent to which the epidemiology and causes of accidents involving severely injured patients changed in the first year of the COVID-19 pandemic in Germany in 2020 and whether there was a change in the severity of injuries or mortality of trauma patients.

In a retrospective register analysis of the TraumaRegister DGU®, all registered trauma patients from 2018–2020 were included. The years 2018/2019 were used as a common comparison group and was compared with the first pandemic year 2020. In addition to comparing the epidemiological data, the causes and influences of accidents in particular were analyzed. A mortality analysis was also carried out. We also performed a subgroup analysis of the individual time periods regarding to the COVID-19 infection waves in 2020.

A total of 71,943 patients were included in the analysis. The injury severity score (ISS) was almost the same in both groups (2020: 17.6 vs. 2018/2019: 17.3). The analysis of the course of the accident showed a reduction in car-associated trauma (2020: 17.2% vs. 2018/2019: 20.7%) and at the same time an increase in bicycle-associated trauma (2020: 13.1% vs. 2018/2019: 10.4%). The proportion of trauma patients who had an accident under the influence of alcohol decreased significantly in 2020. Overall, there was a reduction from 22.3% in 2018/2019 to 19.3% in 2020. In terms of mortality, there was an increase in patients who died in hospital (2020: 11.5% vs. 2018/2019: 10.3%).

The COVID-19 pandemic had an impact in Germany in the first pandemic year 2020, compared to the two previous years, particularly on the course of accidents in trauma patients. The observed increase in mortality must be analyzed in further studies with regard to possible changes in care processes in hospitals due to the COVID-19 pandemic.