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SHELTER-IN-PLACE DID NOT REDUCE BURN SERVICE VOLUME IN A REGIONAL BURN CENTER
S Lee, T Orzechowski, J Faris, A Isaacson, H Dolman, R Mansour, J McGee, A Baylor III, J Tyburski, M White
Wayne State University

Background
During the COVID-19 pandemic of 2020, the state of Michigan experienced an increase in the rates of the severe respiratory syndrome coronavirus 2 (SARS-CoV-2) in February and March of 2020, with the Shelter-In-Place orders taking effect on March 11, 2020. According to the Michigan Department of Health and Human Services, there has been an increase in drug/alcohol abuse during the pandemic. This coincides with a 30% increase in burn fatalities after initiation of the Shelter-In-Place orders compared to the previous year.

Methods
This IRB-approved retrospective review compares the patients seen at an inpatient urban burn center from March 1 to August 31, 2020 to the same time period in 2019, prior to the pandemic and Shelter-In-Place orders. Data was collected from the electronic medical record and the centerís burn registry. Patient demographics, type/severity of burn sustained, toxicology screen, hospital length of stay (LOS), and discharge disposition between the pre-SARS-CoV-2 (PCOV) group vs. patients in the Shelter-In-Place (SIP) group were evaluated. Statistical analysis was performed using SPSS vs.17.0.

Results
Our burn center saw 365 patients in the PCOV group vs. 384 in the SIP group. The median age for both groups was 40 years old. There was an increased rate of illegal substance use, 11.5% vs.6.6% (p=0.020) in the SIP group compared to the PCOV group. Contact burns followed by flash/flame burns were the most predominate for both groups. There were significantly more non-burn injuries (i.e. Stevenís Johnson, toxic epidermal necrolysis, DRESS syndrome, etc.) in the SIP group (p<0.05). The hospital LOS was 5 days vs. 1 day in the SIP group compared to the PCOV group (p<0.005). There was no difference in the ICU LOS, duration of mechanical ventilation, or discharge disposition between the two groups.

Conclusion
The overall number of burn patients seen by the burn surgery service increased after the Shelter-In-Place order was mandated. Use of illegal substance and hospital LOS increased during the Shelter-In-Place time frame. Alcohol use remained the same between the two groups, a finding consistent with other published burn literature.


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