1445: THE IMPACT OF COVID-19 ON THE DEVELOPMENT AND OUTCOMES OF TRAUMA-RELATED SEPSIS

Le résumé fourni par la source

Introduction: Sepsis is a major complication of trauma and is associated with high mortality in affected patients. The COVID-19 pandemic has been associated with a rise in hospital-acquired infections and with increased trauma- and sepsis-related mortality. We aim to examine the impact of the pandemic on the population-level development and outcomes of trauma-related sepsis. Methods: We used a statewide dataset to identify hospitalizations aged ≥18 years with a principal diagnosis of trauma in Texas from April 1-December 31 for each year of 2016-2020 (to align each year with the date of introduction of COVID-19-specific ICD-10 code [U07.1] in the United States), using previously reported ICD-10 code-based taxonomy. Sepsis was defined by “explicit” ICD-10 codes and hospitalizations with COVID-19 were excluded. Hierarchical, mixed-effects negative binomial regression was used on the 2016-2019 data to forecast the prevalence of trauma-related sepsis in 2020, with annual changes expressed as annual percent change (APC). The observed and predicted number of sepsis events in 2020 were then compared. A hierarchical, mixed-effects logistic regression model was fit to estimate the association of hospitalization in 2020 (vs 2019) with short-term mortality (defined as in-hospital death or discharge to hospice) among those with sepsis. Results: There were 316,920 trauma hospitalizations during 2016-2019, of which 4,333 (1.4%) have developed sepsis. The annual prevalence of trauma-related sepsis did not change during 2016-2019 (APC +2.5% [95% CI -0.2% to +5.3%]). The observed vs predicted number of trauma-related sepsis hospitalizations in 2020 was 706 (1.4% of trauma hospitalizations) vs 749 (95% CI 695-802), respectively. Short-term mortality among hospitalizations with trauma-related sepsis in 2019 and 2020 was 25.7% vs 28.6%, respectively. On adjusted analysis, the odds of short-term mortality of sepsis-related trauma in 2020 did not differ statistically compared to 2019 (adjusted odds ratio 1.27 [95% CI 0.99-1.62]; p=0.062). Conclusions: The prevalence of trauma-related sepsis and short-term mortality among septic patients did not change during the first year of the COVID-19 pandemic. However, our estimates do not preclude an adverse prognostic impact of the pandemic on the outcomes of trauma-related sepsis.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.