Abstract
Introduction: Secondary Overtriage (SO) has been defined as transfer to a higher level of care, without operative intervention or ICU admission, and discharge from the accepting facility within 48 hours. The COVID-19 pandemic placed additional stressors on healthcare delivery. This study aimed to evaluate the effect of the COVID-19 pandemic on the rates of SO to our facility.
Materials/Methods: We define the beginning of the COVID-19 pandemic as March 18th, 2020. 15 months of data before and after this date were classified as pre-pandemic (PP) and intra-pandemic (IP), respectively. We included all patients ≥18 years transferred to our facility for trauma evaluation. Primary aim was comparing PP and IP rate of SO. Secondary outcomes were: most common interventions and consulting service after transfer, insurance status, transfer distance, and number of pre and post transfer computed tomography (CT) scans.
Results: 6774 patients were transferred to our facility. 1983 (29.3%) patients met the criteria for SO. 30.0% PP and 28.6% IP (p=0.19). The most common consultation was to Speech and Language Pathology (39.8% PP, 35.5% IP). The most common intervention was bedside laceration repair (6.4% PP, 4.1% IP). Patients had and average 2.5 pre-transfer CTs and 2.1 post-transfer CTs. Average transfer distance was 43.9 miles. Insurance status was not significantly different between the PP and IP groups. (p= 0.23)
Conclusion: Over a large cohort of transferred patients, our incidence of SO was 29.3%, consistent with previous data. The COVID-19 pandemic was associated with a lower, but not significant, change in SO rates.