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Gil Jae Lee 19 Articles
Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study
Youngmin Kim, Byungchul Yu, Se-Beom Jeon, Seung Hwan Lee, Jayun Cho, Jihun Gwak, Youngeun Park, Kang Kook Choi, Min A Lee, Gil Jae Lee, Jungnam Lee
J Trauma Inj. 2023;36(3):224-230.   Published online December 21, 2022
DOI: https://doi.org/10.20408/jti.2022.0055
  • 1,666 View
  • 47 Download
AbstractAbstract PDF
Purpose
Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.
Methods
Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.
Results
Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.
Conclusions
Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.
Summary
A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system
Byungchul Yu, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Youngeun Park, Yong-Cheol Yoon, Jayun Cho, Seung Hwan Lee, Jungnam Lee
J Trauma Inj. 2022;35(Suppl 1):S27-S30.   Published online June 15, 2022
DOI: https://doi.org/10.20408/jti.2022.0012
  • 2,386 View
  • 75 Download
AbstractAbstract PDF
In certain circumstances, invasive procedures such as creation of a surgical airway, insertion of a chest drain, intraosseous puncture, or amputation in the field are necessary. These invasive procedures can save lives. However, emergency medical service teams cannot perform such procedures according to the law in Korea. The upper arm of a 29-year-old male patient was stuck in a huge machine and the emergency medical service team could not rescue the patient. A doctor-car team was dispatched to the scene and the team performed the filed amputation to extricate the patient. He was brought to the trauma center immediately and underwent formal above-elbow amputation. Here we describe a case of field amputation to rescue a patient through a “doctor car” system, along with a literature review.
Summary
Salvation of a solitary kidney in a patient with grade IV renal trauma: a case report
Hyuntack Shin, Ae Jin Sung, Min A Lee, Jayun Cho, Gil Jae Lee, Byungchul Yu, Kang Kook Choi
J Trauma Inj. 2022;35(Suppl 1):S18-S22.   Published online June 17, 2022
DOI: https://doi.org/10.20408/jti.2021.0091
  • 1,737 View
  • 49 Download
AbstractAbstract PDF
There are many reasons for solitary kidney. Congenital causes include renal agenesis and dysplasia. Acquired causes include nephrectomy performed for reasons including traumatic kidney injury, disease (e.g., renal cell carcinoma), and donation for kidney transplantation. According to the European Association of Urology, the World Society of Emergency Surgery, and the American Association for the Surgery of Trauma guidelines, it is important to preserve the remaining renal function as much as possible when a solitary kidney patient has suffered a traumatic kidney injury. The authors present a case of kidney preservation in a solitary kidney patient with a traumatic grade IV renal injury through non-operative management involving superselective renal artery angioembolization.
Summary
Major Causes of Preventable Death in Trauma Patients
Youngeun Park, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Sung Youl Hyun, Yang Bin Jeon, Yong-Cheol Yoon, Jungnam Lee, Byungchul Yu
J Trauma Inj. 2021;34(4):225-232.   Published online July 29, 2021
DOI: https://doi.org/10.20408/jti.2020.0074
  • 8,829 View
  • 233 Download
  • 17 Citations
AbstractAbstract PDF
Purpose

Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care.

Methods

We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review.

Results

The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding.

Conclusions

Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

Summary

Citations

Citations to this article as recorded by  
  • Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
    Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • TiME OUT: Time-specific machine-learning evaluation to optimize ultramassive transfusion
    Courtney H. Meyer, Jonathan Nguyen, Andrew ElHabr, Nethra Venkatayogi, Tyler Steed, Judy Gichoya, Jason D. Sciarretta, James Sikora, Christopher Dente, John Lyons, Craig M. Coopersmith, Crystal Nguyen, Randi N. Smith
    Journal of Trauma and Acute Care Surgery.2024; 96(3): 443.     CrossRef
  • Progressive Reduction in Preventable Mortality in a State Trauma System Using Continuous Preventable Mortality Review to Drive Provider Education: Results of Analyzing 1,979 Trauma Deaths from 2015 to 2022
    Charles D Mabry, Benjamin Davis, Michael Sutherland, Ronald Robertson, Jennifer Carger, Deidre Wyrick, Terry Collins, Austin Porter, Kyle Kalkwarf
    Journal of the American College of Surgeons.2024; 238(4): 426.     CrossRef
  • Emergency department laparotomy for patients with severe abdominal trauma: a retrospective study at a single regional trauma center in Korea
    Yu Jin Lee, Soon Tak Jeong, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Kyounghwan Kim, Sung Jin Park, Jihun Gwak, Wu Seong Kang
    Journal of Trauma and Injury.2024; 37(1): 20.     CrossRef
  • Angioembolization performed by trauma surgeons for trauma patients: is it feasible in Korea? A retrospective study
    Soonseong Kwon, Kyounghwan Kim, Soon Tak Jeong, Joongsuck Kim, Kwanghee Yeo, Ohsang Kwon, Sung Jin Park, Jihun Gwak, Wu Seong Kang
    Journal of Trauma and Injury.2024; 37(1): 28.     CrossRef
  • Nomogram for predicting in-hospital mortality in trauma patients undergoing resuscitative endovascular balloon occlusion of the aorta: a retrospective multicenter study
    Byungchul Yu, Jayun Cho, Byung Hee Kang, Kyounghwan Kim, Dong Hun Kim, Sung Wook Chang, Pil Young Jung, Yoonjung Heo, Wu Seong Kang
    Scientific Reports.2024;[Epub]     CrossRef
  • Preventable trauma deaths in the Western Cape of South Africa: A consensus-based panel review
    Julia Dixon, Shaheem de Vries, Chelsie Fleischer, Smitha Bhaumik, Chelsea Dymond, Austin Jones, Madeline Ross, Julia Finn, Heike Geduld, Elmin Steyn, Hendrick Lategan, Lesley Hodsdon, Janette Verster, Suzan Mukonkole, Karlien Doubell, Navneet Baidwan, Nee
    PLOS Global Public Health.2024; 4(5): e0003122.     CrossRef
  • Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients
    Sarah Guigues, Jean Cotte, Jean-Baptiste Morvan, Henry de Lesquen, Bertrand Prunet, Mathieu Boutonnet, Nicolas Libert, Pierre Pasquier, Eric Meaudre, Julien Bordes, Michael Cardinale
    European Journal of Trauma and Emergency Surgery.2023; 49(3): 1425.     CrossRef
  • Incidence and predictors of mortality among adult trauma patients admitted to the intensive care units of comprehensive specialized hospitals in Northwest Ethiopia
    Mengistu Abebe Messelu, Ambaye Dejen Tilahun, Zerko Wako Beko, Hussien Endris, Asnake Gashaw Belayneh, Getayeneh Antehunegn Tesema
    European Journal of Medical Research.2023;[Epub]     CrossRef
  • Characteristics and Clinical Outcomes of Elderly Patients with Trauma Treated in a Local Trauma Center
    Kwanhoon Park, Geonjae Cho, Sungho Lee, Kang Yoon Lee, Ji Young Jang
    Journal of Acute Care Surgery.2023; 13(1): 13.     CrossRef
  • An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
    Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
    Journal of Medical Internet Research.2023; 25: e49283.     CrossRef
  • Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center
    Kwanhoon Park, Wooram Choi, Sungho Lee, Kang Yoon Lee, Dongbeen Choi, Han-Gil Yoon, Ji Young Jang
    Journal of Acute Care Surgery.2023; 13(3): 118.     CrossRef
  • Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy
    Elisa Reitano, Roberto Bini, Margherita Difino, Osvaldo Chiara, Stefania Cimbanassi
    Updates in Surgery.2022; 74(4): 1445.     CrossRef
  • Decision support by machine learning systems for acute management of severely injured patients: A systematic review
    David Baur, Tobias Gehlen, Julian Scherer, David Alexander Back, Serafeim Tsitsilonis, Koroush Kabir, Georg Osterhoff
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Flat Inferior Vena Cava on Computed Tomography for Predicting Shock and Mortality in Trauma: A Meta-Analysis
    Do Wan Kim, Hee Seon Yoo, Wu Seong Kang
    Diagnostics.2022; 12(12): 2972.     CrossRef
  • Model for Predicting In-Hospital Mortality of Physical Trauma Patients Using Artificial Intelligence Techniques: Nationwide Population-Based Study in Korea
    Seungseok Lee, Wu Seong Kang, Sanghyun Seo, Do Wan Kim, Hoon Ko, Joongsuck Kim, Seonghwa Lee, Jinseok Lee
    Journal of Medical Internet Research.2022; 24(12): e43757.     CrossRef
  • Thoracic injuries in trauma patients: epidemiology and its influence on mortality
    Andrea Lundin, Shahzad K. Akram, Lena Berg, Katarina E. Göransson, Anders Enocson
    Scandinavian Journal of Trauma, Resuscitation and .2022;[Epub]     CrossRef
Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center
Min A Lee, Seung Hwan Lee, Kang Kook Choi, Youngeun Park, Gil Jae Lee, Byungchul Yu
J Trauma Inj. 2021;34(3):177-182.   Published online September 30, 2021
DOI: https://doi.org/10.20408/jti.2021.0070
  • 2,766 View
  • 89 Download
AbstractAbstract PDF
Purpose

Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries.

Methods

We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records.

Results

A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3).

Conclusions

For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

Summary
Comparison of Resting Energy Expenditure Using Indirect Calorimetry and Predictive Equations in Trauma Patients: A Pilot Study
Dae Sung Ma, Gil Jae Lee
J Trauma Inj. 2021;34(1):13-20.   Published online March 31, 2021
DOI: https://doi.org/10.20408/jti.2021.0023
  • 3,453 View
  • 124 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Nutritional therapy in the intensive care unit is an essential factor for patient progress. The purpose of this study was to compare resting energy expenditure (REE) calculated by prediction equations (PEs) to the REE measured by indirect calorimetry (IC) in trauma patients.

Methods

Patients admitted to the trauma intensive care unit who received mechanical ventilation between January and December 2015 were enrolled. REE was measured by IC (CCM Express, MGC Diagnostics) and calculated by the following PEs: Harris-Benedict, Fleisch, Robertson and Reid, Ireton-Jones, and the maximum value (25 kcal/kg/ day) of the European Society for Clinical Nutrition and Metabolism (ESPEN). All patients were ventilated at a fraction of inspired oxygen (FiO2) below 60%.

Results

Of the 31 patients included in this study, 24 (77.4%) were men and seven (22.6%) were women. The mean age of the patients was 49.7±13.2 years, their mean weight was 68.1±9.6 kg, and their mean Injury Severity Score was 26.1±11.3. The mean respiratory quotient on IC was 0.93±0.19, and their mean FiO2 was 38.72%±6.97%. The mean REE measured by IC was 2,146±444.36 kcal/day, and the mean REE values calculated by the PEs were 1,509.39±205.34 kcal/day by the Harris and Benedict equation, 1,509.39±154.33 kcal/day by the Fleisch equation, and 1,443.39±159.61 kcal/day by the Robertson and Reid equation. The Ireton-Jones equation yielded a higher value (2,278.90±202.35 kcal/ day), which was not significantly different from the value measured using IC (p=0.53). The ESPEN maximum value (1,704.03±449.36 kcal/day) was lower, but this difference was likewise not significant (p=0.127).

Conclusions

The REE measured by IC was somewhat higher than that calculated using PEs. Further studies are needed to determine the proper nutritional support for trauma patients.

Summary

Citations

Citations to this article as recorded by  
  • Determining the appropriate resting energy expenditure requirement for severe trauma patients using indirect calorimetry in Korea: a retrospective observational study
    Hak-Jae Lee, Sung-Bak Ahn, Jung Hyun Lee, Ji-Yeon Kim, Sungyeon Yoo, Suk-Kyung Hong
    Journal of Trauma and Injury.2023; 36(4): 337.     CrossRef
Part 4. Clinical Practice Guideline for Surveillance and Imaging Studies of Trauma Patients in the Trauma Bay from the Korean Society of Traumatology
Sung Wook Chang, Kang Kook Choi, O Hyun Kim, Maru Kim, Gil Jae Lee
J Trauma Inj. 2020;33(4):207-218.   Published online December 31, 2020
DOI: https://doi.org/10.20408/jti.2020.0084
  • 3,432 View
  • 89 Download
AbstractAbstract PDF

The following recommendations are presented herein: All trauma patients admitted to the resuscitation room should be constantly (or periodically) monitored for parameters such as blood pressure, heart rate, respiratory rate, oxygen saturation, body temperature, electrocardiography, Glasgow Coma Scale, and pupil reflex (1C). Chest AP and pelvic AP should be performed as the standard initial trauma series for severe trauma patients (1B). In patients with severe hemodynamically unstable trauma, it is recommended to perform extended focused assessment with sonography for trauma (eFAST) as an initial examination (1B). In hemodynamically stable trauma patients, eFAST can be considered as the initial examination (2B). For the diagnosis of suspected head trauma patients, brain computed tomography (CT) should be performed as an initial examination (1B). Cervical spine CT should be performed as an initial imaging test for patients with suspected cervical spine injury (1C). It is not necessary to perform chest CT as an initial examination in all patients with suspected chest injury, but in cases of suspected vascular injury in patients with thoracic or high-energy damage due to the mechanism of injury, chest CT can be considered for patients in a hemodynamically stable condition (2B). CT of the abdomen is recommended for patients suspected of abdominal trauma with stable vital signs (1B). CT of the abdomen should be considered for suspected pelvic trauma patients with stable vital signs (2B). Whole-body CT can be considered in patients with suspicion of severe trauma with stable vital signs (2B). Magnetic resonance imaging can be considered in hemodynamically stable trauma patients with suspected spinal cord injuries (2B).

Summary
Case Series of Zone III Resuscitative Endovascular Balloon Occlusion of the Aorta in Traumatic Shock Patients
Byungchul Yu, Gil Jae Lee, Kang Kook Choi, Min A Lee, Jihun Gwak, Youngeun Park, Jung Nam Lee
J Trauma Inj. 2020;33(3):162-169.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0031
  • 3,729 View
  • 67 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

There is increasing evidence in the literature regarding resuscitative endovascular balloon occlusion of the aorta (REBOA) globally, but few cases have been reported in Korea. We aimed to describe our experience of successful Zone III REBOA and to discuss its algorithm, techniques, and related complications.

Methods

We reviewed consecutive cases who survived from hypovolemic shock after Zone III REBOA placement for 4 years. We reviewed patients’ baseline characteristics, physiological status, procedural data, and outcomes.

Results

REBOA was performed in 44 patients during the study period, including 10 patients (22.7%) who underwent Zone III REBOA, of whom seven (70%) survived. Only one patient was injured by a penetrating mechanism and survived after cardiopulmonary resuscitation. All patients underwent interventions to stop bleeding immediately after REBOA placement.

Conclusions

This case series suggests that Zone III REBOA is a safe and feasible procedure that could be applied to traumatic shock patients with normal FAST findings who receive a chest X-ray examination at the initial resuscitation.

Summary

Citations

Citations to this article as recorded by  
  • On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma
    A. I. Zhukov, N. N. Zadneprovsky, P. A. Ivanov, L. S. Kokov
    Russian Sklifosovsky Journal "Emergency Medical Ca.2024; 13(1): 14.     CrossRef
To Celebrate the Publication of a Special Topic for REBOA
Min A Lee, Gil Jae Lee
J Trauma Inj. 2020;33(3):139-139.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0055
  • 3,051 View
  • 69 Download
PDF
Summary
An Early Experience of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in the Republic of Korea: A Retrospective Multicenter Study
Joonhyeon Park, Sung Woo Jang, Byungchul Yu, Gil Jae Lee, Sung Wook Chang, Dong Hun Kim, Ye Rim Chang, Pil Young Jung
J Trauma Inj. 2020;33(3):144-152.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0051
  • 4,500 View
  • 109 Download
  • 6 Citations
AbstractAbstract PDF
Purpose

This retrospective multicenter study analyzed trauma patients who underwent resuscitative endovascular balloon occlusion of the aorta (REBOA) in the Republic of Korea.

Methods

This study was conducted from February 2017 to May 2018 at three regional trauma centers in the Republic of Korea. The patients were divided into two groups (cardiopulmonary resuscitation [CPR] and No-CPR) for comparative analysis based on two criteria (complication and mortality) for logistic regression analysis (LRA).

Results

There were significant differences between the CPR and No-CPR groups in mortality (p=0.003) and treatment administered (p=0.016). By LRA for complications, total occlusion has significantly lesser risk than intermittent or partial occlusion in both univariate (odds ratio [OR] 0.06, 95% confidence interval [CI] 0.00-0.36, p=0.01) and multivariate (OR 0.05, 95% CI 0.00-0.38, p=0.01) analyses. The Rescue had a higher risk than the Coda or Reliant in univariate analysis (OR 4.91, 95% CI 1.14-34.25, p=0.05); however, it was not statistically significant in multivariate analysis (OR 6.98, 95% CI 1.03-74.52, p=0.07). By LRA for mortality, the CPR group was the only variable that had a significantly higher risk of mortality than the No-CPR group in both univariate (OR 17.59, 95% CI 3.05-335.25, p=0.01), and multivariate (OR 24.92, 95% CI 3.77-520.51, p=0.01) analyses.

Conclusions

This study was conducted in the early stages of REBOA implementation in the Republic of Korea and showed conflicting results from studies conducted by multiple institutions. Therefore, additional research with more accumulated data is needed.

Summary

Citations

Citations to this article as recorded by  
  • Complications associated with the use of resuscitative endovascular balloon occlusion of the aorta (REBOA): an updated review
    Marcelo Augusto Fontenelle Ribeiro Junior, Salman M Salman, Sally M Al-Qaraghuli, Farah Makki, Riham A Abu Affan, Shahin Reza Mohseni, Megan Brenner
    Trauma Surgery & Acute Care Open.2024; 9(1): e001267.     CrossRef
  • Contemporary Utilization and Outcomes of Resuscitative Endovascular Balloon Occlusion of the Aorta for Traumatic Noncompressible Torso Hemorrhage in Korea: A Retrospective Multi-Center Study
    Yoonjung Heo, Sung Wook Chang, Byungchul Yu, Byung Hee Kang, Pil Young Jung, Kyounghwan Kim, Dong Hun Kim
    Journal of Acute Care Surgery.2024; 14(1): 16.     CrossRef
  • On the Feasibility of Using REBOA Technology for the Treatment of Patients with Polytrauma
    A. I. Zhukov, N. N. Zadneprovsky, P. A. Ivanov, L. S. Kokov
    Russian Sklifosovsky Journal "Emergency Medical Ca.2024; 13(1): 14.     CrossRef
  • Editor's Choice – Systematic Review and Meta-Analysis of Lower Extremity Vascular Complications after Arterial Access for Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA): An Inevitable Concern?
    Megan Power Foley, Stewart R. Walsh, Nathalie Doolan, Paul Vulliamy, Morgan McMonagle, Christopher Aylwin
    European Journal of Vascular and Endovascular Surg.2023; 66(1): 103.     CrossRef
  • Early experience with resuscitative endovascular balloon occlusion of the aorta for unstable pelvic fractures in the Republic of Korea: a multi-institutional study
    Dong Hun Kim, Jonghwan Moon, Sung Wook Chang, Byung Hee Kang
    European Journal of Trauma and Emergency Surgery.2023; 49(6): 2495.     CrossRef
  • Comparison between external fixation and pelvic binder in patients with pelvic fracture and haemodynamic instability who underwent various haemostatic procedures
    Ji Young Jang, Keum Soek Bae, Byung Hee Kang, Gil Jae Lee
    Scientific Reports.2022;[Epub]     CrossRef
Part 3. Clinical Practice Guideline for Airway Management and Emergency Thoracotomy for Trauma Patients from the Korean Society of Traumatology
Chan Yong Park, O Hyun Kim, Sung Wook Chang, Kang Kook Choi, Kyung Hak Lee, Seong Yup Kim, Maru Kim, Gil Jae Lee
J Trauma Inj. 2020;33(3):195-203.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0050
  • 10,349 View
  • 185 Download
AbstractAbstract PDF

The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).

Summary
Pulmonary Contusion Similar to COVID-19 Pneumonia
Seung Hwan Lee, Sung Youl Hyun, Yang Bin Jeon, Jung Nam Lee, Gil Jae Lee
J Trauma Inj. 2020;33(2):119-123.   Published online June 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0014
  • 10,553 View
  • 214 Download
  • 1 Citations
AbstractAbstract PDF

The Coronavirus disease 2019 (COVID-19) has rapidly spread across the world and caused a pandemic. It can be transmitted by an infected person or an asymptomatic carrier and is a highly contagious disease. Prevention and early identification of COVID-19 are important to minimize the transmission of COVID-19. Chest computed tomography (CT) has a high sensitivity for detecting COVID-19, but relatively low specificity. Therefore, chest CT may be difficult to distinguish COVID-19 findings from those of other infectious (notably viral types of pneumonia) or noninfectious disease. Pulmonary contusion has also a lot of similarities on chest CT with COVID-19 pneumonia. We present trauma patients with pulmonary contusion whose CT scans showed findings similar to those of COVID-19, and we report our experience in the management of trauma patients during the COVID-19 pandemic.

Summary

Citations

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  • Comparison of chest CT scan findings between COVID-19 and pulmonary contusion in trauma patients based on RSNA criteria: Established novel criteria for trauma victims
    Hossein Abdolrahimzadeh Fard, Salahaddin Mahmudi-Azer, Qusay Abdulzahraa Yaqoob, Golnar Sabetian, Pooya Iranpour, Zahra Shayan, Shahram Bolandparvaz, Hamid Reza Abbasi, Shiva Aminnia, Maryam Salimi, Mohammad Mehdi Mahmoudi, Shahram Paydar, Roham Borazjani
    Chinese Journal of Traumatology.2022; 25(3): 170.     CrossRef
Part 2. Clinical Practice Guideline for Trauma Team Composition and Trauma Cardiopulmonary Resuscitation from the Korean Society of Traumatology
Oh Hyun Kim, Seung Je Go, Oh Sang Kwon, Chan-Yong Park, Byungchul Yu, Sung Wook Chang, Pil Young Jung, Gil Jae Lee
J Trauma Inj. 2020;33(2):63-73.   Published online June 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0020
  • 6,103 View
  • 169 Download
  • 1 Citations
PDF
Summary

Citations

Citations to this article as recorded by  
  • An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
    Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
    Journal of Medical Internet Research.2023; 25: e49283.     CrossRef
The Suitability of the CdC field Triage for Korean Trauma Care
Kang Kook Choi, Myung Jin Jang, Min A Lee, Gil Jae Lee, Byungchul Yoo, Youngeun Park, Jung Nam Lee
J Trauma Inj. 2020;33(1):13-17.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.013
  • 5,308 View
  • 117 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea.

Methods

This retrospective cohort study evaluated trauma patients who presented at the authors’ regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step.

Results

Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively.

Conclusions

The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Summary

Citations

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  • Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
    Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Prehospital triage in emergency medical services system: A scoping review
    Kisook Kim, Booyoung Oh
    International Emergency Nursing.2023; 69: 101293.     CrossRef
  • Assessment of the Suitability of Trauma Triage According to Physiological Criteria in Korea
    Gil Hwan Kim, Jae Hun Kim, Hohyun Kim, Seon Hee Kim, Sung Jin Park, Sang Bong Lee, Chan Ik Park, Dong Yeon Ryu, Kang Ho Lee, Sun Hyun Kim, Na Hyeon Lee, Il Jae Wang
    Journal of Acute Care Surgery.2022; 12(3): 120.     CrossRef
Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum
Gil Jae Lee, Min A Lee, Byungchul Yoo, Youngeun Park, Myung Jin Jang, Kang Kook Choi
J Trauma Inj. 2020;33(1):38-42.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.014
  • 6,912 View
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AbstractAbstract PDF
Purpose

Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown.

Methods

In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy.

Results

The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay.

Conclusions

PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

Summary
Clinical Practice Guideline for the Treatment of Traumatic Shock Patients from the Korean Society of Traumatology
Pil Young Jung, Byungchul Yu, Chan-Yong Park, Sung Wook Chang, O Hyun Kim, Maru Kim, Junsik Kwon, Gil Jae Lee
J Trauma Inj. 2020;33(1):1-12.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.015
  • 18,539 View
  • 1,031 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

Despite recent developments in the management of trauma patients in South Korea, a standardized system and guideline for trauma treatment are absent.

Methods

Five guidelines were assessed using the Appraisal of Guidelines for Research and Evaluation II instrument.

Results

Restrictive volume replacement must be used for patients experiencing shock from trauma until hemostasis is achieved (1B). The target systolic pressure for fluid resuscitation should be 80–90 mmHg in hypovolemic shock patients (1C). For patients with head trauma, the target pressure for fluid resuscitation should be 100–110 mmHg (2C). Isotonic crystalloid fluid is recommended for initially treating traumatic hypovolemic shock patients (1A). Hypothermia should be prevented in patients with severe trauma, and if hypothermia occurs, the body temperature should be increased without delay (1B). Acidemia must be corrected with an appropriate means of treatment for hypovolemic trauma patients (1B). When a large amount of transfusion is required for trauma patients in hypovolemic shock, a massive transfusion protocol (MTP) should be used (1B). The decision to implement MTP should be made based on hemodynamic status and initial responses to fluid resuscitation, not only the patient’s initial condition (1B). The ratio of plasma to red blood cell concentration should be at least 1:2 for trauma patients requiring massive transfusion (1B). When a trauma patient is in life-threatening hypovolemic shock, vasopressors can be administered in addition to fluids and blood products (1B). Early administration of tranexamic acid is recommended in trauma patients who are actively bleeding or at high risk of hemorrhage (1B). For hypovolemic patients with coagulopathy non-responsive to primary therapy, the use of fibrinogen concentrate, cryoprecipitate, or recombinant factor VIIa can be considered (2C).

Conclusions

This research presents Korea's first clinical practice guideline for patients with traumatic shock. This guideline will be revised with updated research every 5 years.

Summary

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  • An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
    Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
    Journal of Medical Internet Research.2023; 25: e49283.     CrossRef
  • Nonselective versus Selective Angioembolization for Trauma Patients with Pelvic Injuries Accompanied by Hemorrhage: A Meta-Analysis
    Hyunseok Jang, Soon Tak Jeong, Yun Chul Park, Wu Seong Kang
    Medicina.2023; 59(8): 1492.     CrossRef
Isolated Dissection of the Celiac Artery after Blunt Trauma: A Case Report and Review of Literature
Ahram Han, Jihun Gwak, Gangkook Choi, Jae Jeong Park, Byungchul Yu, Gil Jae Lee, Jin Mo Kang
J Trauma Inj. 2017;30(4):220-226.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.220
  • 5,943 View
  • 104 Download
  • 7 Citations
AbstractAbstract PDF

Traumatic dissection of the celiac artery without aortic dissection is a rare event. Here we describe two cases of celiac artery dissection after blunt abdominal trauma managed conservatively without surgical or endovascular intervention.

Summary

Citations

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  • Isolated celiac artery injury: Brief report, review of literature, and suggested grading guidelines
    Kanani Fahim, Neeman Uri, Hashavia Eyal, Timor Idit, Soffer Dror, Shimonovich Shachar
    Trauma.2024;[Epub]     CrossRef
  • Endovascular Stenting in a Rare Case of Multiple Spontaneous Visceral Arterial Dissections
    Jacxelyn Moran, Naveen Galla, Mona Ranade
    Vascular and Endovascular Surgery.2021; 55(3): 269.     CrossRef
  • Evaluation of isolated abdominal visceral artery dissection with multi-scale spiral computed tomography: a retrospective case series
    Qizhou He, Fei Yu, Yajun Fu, Bin Yang, Ran Huo, Rong Xian, Shulan Liu, Kali Liang, Guangcai Tang
    Journal of Cardiothoracic Surgery.2021;[Epub]     CrossRef
  • Diagnosis and treatment of isolated celiac artery dissection following blunt trauma: A case report
    Tohru Ishimine, Takahiro Ishigami, Kohei Chida, Kyohei Kawasaki, Naoki Taniguchi, Toshiho Tengan
    International Journal of Surgery Case Reports.2021; 89: 106617.     CrossRef
  • Retrospective Analysis and Systematic Review of Isolated Traumatic Dissections of the Celiac Artery
    Jens Birkl, Thomas Kahl, Henryk Thielemann, Sven Mutze, Leonie Goelz
    Annals of Vascular Surgery.2020; 66: 250.     CrossRef
  • Traumatic dissection of the coeliac artery and splenic injury following blunt trauma
    Bobby Vincent Li, Ramesh Damodaran Prabha, Maruthi Narra, Hung Nguyen
    BMJ Case Reports.2019; 12(8): e229405.     CrossRef
  • Symptomatic Isolated Celiac Artery Dissection following Blunt Trauma
    Sang Bong Lee, Hyuk Jae Jung, Jae Hun Kim
    Journal of Acute Care Surgery.2019; 9(2): 76.     CrossRef
Management of High-grade Blunt Renal Trauma
Min A Lee, Myung Jin Jang, Gil Jae Lee
J Trauma Inj. 2017;30(4):192-196.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.192
  • 4,199 View
  • 162 Download
  • 5 Citations
AbstractAbstract PDF
Purpose

Blunt injury accounts for 80?95% of renal injury trauma in the United States. The majority of blunt renal injuries are low grade and 80?85% of these injuries can be managed conservatively. However, there is a debate on the management of patients with high-grade renal injury. We reviewed our experience of renal trauma at our trauma center to assess management strategy for high-grade blunt renal injury.

Methods

We reviewed blunt renal injury cases admitted at a single trauma center between August 2007 and December 2015. Computed tomography (CT) scan was used to diagnose renal injuries and high?grade (according to the American Association for the Surgery of Trauma [AAST] organ injury scale III?V) renal injury patients were included in the analysis.

Results

During the eight?year study period, there were 62 AAST grade III?V patients. 5 cases underwent nephrectomy and 57 underwent non-operative management (NOM). There was no difference in outcome between the operative group and the NOM group. In the NOM group, 24 cases underwent angioembolization with a 91% success rate. The Incidence of urological complications correlated with increasing grade.

Conclusions

Conservative management of high-grade blunt renal injury was considered preferable to operative management, with an increased renal salvage rate. However, high-grade injuries have higher complication rates, and therefore, close observation is recommended after conservative management.

Summary

Citations

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  • Functional range of the kidney after a low-severity injury: a randomized study
    K. A. Chiglintsev, A. V. Zyryаnov, A. Yu. Chiglintsev, A. A. Makarian
    Diagnostic radiology and radiotherapy.2023; 14(2): 74.     CrossRef
  • Outcome of Kidney Trauma Management: Experiences from a Tertiary Referral Hospital in East Indonesia
    Yufi Aulia Azmi, Danang Irsayanto, Kevin Muliawan Soetanto, Johan Renaldo, Soetojo Wirjopranoto
    Biomolecular and Health Science Journal.2023; 6(2): 135.     CrossRef
  • RENAL TRAUMA: PROFILE AND MANAGEMENT
    Vipul Bakshi, Tariq A Mir, Harmandeep Singh Chahal
    GLOBAL JOURNAL FOR RESEARCH ANALYSIS.2022; : 109.     CrossRef
  • Management of renal injury in a UK major trauma centre
    Robert Torrance, Abigail Kwok, David Mathews, Matthew Elliot, Andrew Baird, Marc A Lucky
    Trauma.2020; 22(1): 26.     CrossRef
  • Renal trauma: a 5-year retrospective review in single institution
    Syarif, Achmad M. Palinrungi, Khoirul Kholis, Muhammad Asykar Palinrungi, Syakri Syahrir, Reinaldo Sunggiardi, Muhammad Faruk
    African Journal of Urology.2020;[Epub]     CrossRef
Correlation between Optic Nerve Sheath Diameter Measured by Computed Tomography and Elevated Intracranial Pressure in Patients with Traumatic Brain Injury
Tae Kyoo Lim, Byug Chul Yu, Dae Sung Ma, Gil Jae Lee, Min A Lee, Sung Yeol Hyun, Yang Bin Jeon, Kang Kook Choi
J Trauma Inj. 2017;30(4):140-144.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.140
  • 5,248 View
  • 126 Download
  • 6 Citations
AbstractAbstract PDF
Purpose

The optic nerve sheath diameter (ONSD) measured by ultrasonography is among the indicators of intracranial pressure (ICP) elevation. However, whether ONSD measurement is useful for initial treatment remains controversial. Thus, this study aimed to investigate the relationship between ONSD measured by computed tomography (CT) and ICP in patients with traumatic brain injury (TBI).

Methods

A total of 246 patients with severe trauma from January 1, 2015 until December 31, 2015 were included in the study. A total of 179 patients with brain damage with potential for ICP elevation were included in the TBI group. The remaining 67 patients comprised the non-TBI group. A comparison was made between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to determine the accuracy of ONSD when used as a screening test for the TBI group including those with TBI with midline shift (with elevated ICP).

Results

The mean injury severity score (ISS) and glasgow coma scale (GCS) of all patients were 24.2±6.1 and 5.4±0.8, respectively. The mean ONSD of the TBI group (5.5±1.0 mm) was higher than that of the non-TBI group (4.7±0.6 mm). Some significant differences in age (55.3±18.1 vs. 49.0±14.8, p<0.001), GCS (11.7±4.1 versus 13.3±3.0, p<0.001), and ONSD (5.5±1.0 vs. 4.7±0.6, p<0.001) were observed between the TBI and the non-TBI group. An ROC analysis was used to assess the correlation between TBI and ONSD. Results showed an area under the ROC curve (AUC) value of 0.752. The same analysis was used in the TBI with midline shift group, which showed an AUC of 0.912.

Conclusions

An ONSD of >5.5 mm, measured on CT, is a good indicator of ICP elevation. However, since an ONSD is not sensitive enough to detect an increased ICP, it should only be used as one of the parameters in detecting ICP along with other screening tests.

Summary

Citations

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  • Correlation Between Optic Nerve Sheath Diameter at Initial Head CT and the Rotterdam CT Score
    Aletor O Amakhian, Elohor B Obi-Egbedi-Ejakpovi, Eghosa Morgan, Ademola A Adeyekun, Munir M Abubakar
    Cureus.2023;[Epub]     CrossRef
  • Sono-clinical decision rule for repeat head computed tomography scan in traumatic brain injury in emergency settings
    Priyanka Modi, Sanjeev Bhoi, Savan Pandey
    WFUMB Ultrasound Open.2023; 1(2): 100026.     CrossRef
  • Sonographic Measurement of the Optic Nerve Sheath Diameter to Improve Detection of Elevated Intracranial Pressure
    Faten Farid Awdallah, Islam Hassan Abulnaga, Suzy Fawzy Michael, Hassan Khaled Nagi, Mohamed Hosny Abdallah
    Biomedical and Pharmacology Journal.2022; 15(3): 1677.     CrossRef
  • Serial Optic Nerve Sheath Diameter via Radiographic Imaging
    Diane McLaughlin, Lisa Anderson, Jinhong Guo, Molly McNett
    Neurology Clinical Practice.2021;[Epub]     CrossRef
  • The association between intracranial pressure and optic nerve sheath diameter on patients with head trauma
    Kaan Çelik, Bekir Enes Demiryurek
    Arquivos de Neuro-Psiquiatria.2021; 79(10): 879.     CrossRef
  • MRI measurement of optic nerve sheath diameter using 3D driven equilibrium sequence as a non-invasive tool for the diagnosis of idiopathic intracranial hypertension
    Ahmed S. Abdelrahman, Mai M. K. Barakat
    Egyptian Journal of Radiology and Nuclear Medicine.2020;[Epub]     CrossRef

J Trauma Inj : Journal of Trauma and Injury