missions , and discharge disposition . Demographic data and medical history were collected , which included sex , age , comorbidities , and body mass index ( BMI ). Injury characteristics and clinical data were collected and included Injury Severity Score ( ISS ), mechanism of injury , Glasgow Coma Score ( GCS ), and vital signs upon arrival . Three specific groups of patients were noted : COVID-19 positive ( COV +), COVID-19 negative ( COV- ), and non-tested .
Eligible patient data was collected starting March 30 , 2020 , six days after the WV governor declared a stay-at-home order allowing a gap in time for the population to properly follow guidelines . 13 Records were included up until December 21 , 2021 , to allow adequate time for post-discharge outcomes . Chi-square tests and Kruskal-Wallis tests were done for analysis of univariate associations for categorical and continuous variables , respectively . Fisher ’ s exact test was applied to univariate categorical variables when Chi-square expected frequencies were less than five . P values were two-sided and considered significant if less than 0.05 . This analysis was done using Python programming language ( Python Software Foundation , version 3.7 . Available at https :// www . python . org /).
TABLE 2 : Percent Mortality by Injury Severity Score and Age Results
ISS Covid - % Covid + % P-value ISS < 9 0.73 0.00 1.00 ISS 9-15 2.36 6.25 0.34 ISS 16-24 1.90 8.33 0.23 ISS > 24 14.94 25.00 0.49 Age < 65 1.63 0.00 1.00 Age 65 + 3.53 13.04 0.053 ISS : Injury Severity Score
FIGURE 1 : Mechanism of Injury for All Presenting Trauma Patients
Motor Vehicle Crash Fall Struck Firearm Injury Cut or Stabbed Pedestrian / Pedal Cyclist Other
Mechanism of Injury for Trauma Patients Presenting to Ruby Memorial Hospital March 30 , 2020 - December 21 , 2020
1,597 ( 45 %)
1,305 ( 37 %)
214 ( 6 %)
64 ( 2 %) 85 ( 2 %) 102 ( 3 %)
203 ( 6 %)
RESULTS
There was a total of 3,594 patients that presented to Ruby Memorial Hospital after March 30 , 2020 , to December 21 , 2021 ; 24 patients were excluded due to missing data . Of the remaining 3,570 patients , 2,118 ( 59.3 %) patients were tested for COVID-19 , with a total of 61 ( 1.7 %) patients testing positive ( Table 1 ).
Compared to COV- patients , COV + patients ’ characteristics were similar with regard to age , sex , GCS , and BMI . Both groups had similar rates of heart disease , lung disease , liver disease , renal failure , diabetes , cancer , coagulopathies , use of antiplatelet or anticoagulant medications , dementia , and obesity ( p > 0.05 ) ( Table 1 ). ISS were also similar between COV + and COV- groups ( median , 10 vs . 9 , p = 0.171 ). There were no significant differences regarding mechanism of injury between the two groups , and motor vehicle accidents and falls were the most common means of injury ( Figure 1 ). When comparing death rates between pa-
Note : With no significant difference between COV + and COV- groups regarding mechanism of injury , the total number of trauma patients presenting to Ruby Memorial Hospital is depicted in this pie chart . COV +: Positive test for COVID-19 ; COV- : Negative test for COVID-19 .
25 20 15 10 5 0
FIGURE 2 : Mortality Percentages Comparison of Injury Severity Scores and Age Based on COVID Results
Covid Neg
Mortality by Injury Severity and Age
Covid Pos
ISS < 9 ISS 9-15 ISS 16-24 ISS > 24 Age < 65 Age 65 +
Note : This compares the mortality rate of COV + and COV- patients based on two different independent variables . To the left of the vertical line is Injury Severity Scores ( ISS ), categorized in severity ranges sequentially . To the right of the vertical line , mortality rate was shown by age groups ( geriatric patients versus non-geriatric status ).
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