- 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
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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
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J Trauma Inj. 2023;36(3):224-230. Published online December 21, 2022
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DOI: https://doi.org/10.20408/jti.2022.0055
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- 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.
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Summary
- A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system
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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
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J Trauma Inj. 2022;35(Suppl 1):S27-S30. Published online June 15, 2022
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DOI: https://doi.org/10.20408/jti.2022.0012
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- 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.
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Summary
- Major Causes of Preventable Death in Trauma Patients
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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
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J Trauma Inj. 2021;34(4):225-232. Published online July 29, 2021
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DOI: https://doi.org/10.20408/jti.2020.0074
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8,549
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16
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Abstract
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- 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.
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Summary
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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 - 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
- The Management of Open Pelvic Fractures: A Report of 2 Cases
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Byungchul Yu, Giljae Lee, Min A Lee, Kangkook Choi, Jihun Gwak, Youngeun Park, Yong-Cheol Yoon, Jungnam Lee
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J Trauma Inj. 2020;33(4):269-274. Published online June 2, 2020
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DOI: https://doi.org/10.20408/jti.2020.008
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16,738
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Open pelvic fractures are rare, but pose challenges for trauma surgeons due to their high morbidity and mortality. Generally, early death results from uncontrolled exsanguination and late death is related to pelvic sepsis. Therefore, management of these injuries should prioritize hemostasis and contamination control starting in the initial phase of treatment. We report two cases of unstable open pelvic fractures with perineal wounds that were managed successfully.
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Summary
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Citations
Citations to this article as recorded by
- Open Pelvic Fractures with a Faringer I Zone Injury: a Set of 3 Case Reports Treated in 2020
J POMETLOVÁ, V JEČMÍNEK, R JEČMÍNKOVÁ Acta chirurgiae orthopaedicae et traumatologiae Ce.2022; 89(2): 164. CrossRef
- Analysis of Aspiration Risk Factors in Severe Trauma Patients: Based on Findings of Aspiration Lung Disease in Chest Computed Tomography
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Gyu Jin Heo, Jungnam Lee, Woo Sung Choi, Sung Youl Hyun, Jin-Seong Cho
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J Trauma Inj. 2020;33(2):88-95. Published online June 30, 2020
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DOI: https://doi.org/10.20408/jti.2020.0003
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5,259
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2
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Abstract
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- Purpose
The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not.
Methods
We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed.
Results
425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024–8.647), and the severe group showed an OR of 5.073 (CI, 2.442–10.539).
Conclusions
Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.
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Summary
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Citations
Citations to this article as recorded by
- Rapid Sequence Intubation Using the SEADUC Manual Suction Unit in a Contaminated Airway
Matthew Stampfl, David Tillman, Nicholas Borelli, Tikiri Bandara, Andrew Cathers Air Medical Journal.2023; 42(4): 296. CrossRef - Incidence and Predictors of Aspiration Pneumonia Among Traumatic Brain Injury in Northwest Ethiopia
Sahlu Mitku Shiferaw, Emiru Ayalew Mengistie, Getasew Mulatu Aknaw, Abraham Tsedalu Amare, Kefyalew Amogne Azanaw Open Access Emergency Medicine.2022; Volume 14: 85. CrossRef
- Trauma Volume and Performance of a regional Trauma Center in Korea: Initial 5-year analysis
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Byungchul Yu, Giljae Lee, Min A Lee, Kangkook Choi, Sungyoul Hyun, Yangbin Jeon, Yong-Cheol Yoon, Jungnam Lee
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J Trauma Inj. 2020;33(1):31-37. Published online March 30, 2020
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DOI: https://doi.org/10.20408/jti.2020.004
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5,865
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9
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Abstract
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- Purpose
We aimed to evaluate the trauma volume and performance indicators during the first 5-year period of operation in a single regional trauma center.
Methods
We analyzed prospectively collected data from the Korean Trauma Data Bank for a single regional trauma center between January 2014 and December 2018. More than 250 variables were analyzed. We calculated the predicted survival rates using the trauma and injury severity score (TRISS) method.
Results
In total, there were 16,103 trauma admissions during the first 5 years; trauma activation was performed in 5,105 of these cases. Over 70% of the patients were men, and most of the admitted patients were within the age groups of 55–59 years for men and 75–79 years for women. Analyses were performed considering two patient groups: the total patient group and the group of those with severe trauma (injury severity score [ISS] >15). The median ISS, revised trauma score, and TRISS of the two groups were 5 (interquartile range [IQR] 4–10), 22 (IQR 17–27), and 7.6±0.99 and 6.74±1.9, 0.95±0.13, 0.81±2.67, respectively. Of the total patient group, 801 patients (5%) died in the hospital, whereas of the group of patients with ISS >15, 526 (19.5%) died. The direct transportation of patients to the regional trauma center increased year by year. The emergency room stay time and time to entering the operating room showed a decrease until 2017; however, these parameters increased again in 2018.
Conclusions
The trauma volume in the regional trauma center is appropriate, and some improvements could be observed after its establishment. However, performance indicators reveal the prematurity of the trauma center and its potential for further improvements. Moreover, the development of a national trauma system, beyond regional trauma centers, is required.
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Citations
Citations to this article as recorded by
- Prioritization of Injury Prevention and Management Programs and Research and Development (R&D) Projects: Survey Using the Delphi Technique and Analytic Hierarchy Process
Won Kyung Lee, Minsu Ock, Ju Ok Park, Changsoo Kim, Beom Sok Seo, Jeehee Pyo, Hyun Jin Park, Ui Jeong Kim, Eun Jeong Choi, Shinyoung Woo, Hyesook Park Asia Pacific Journal of Public Health.2024; 36(1): 78. CrossRef - Trauma Registry: Trauma Quality indicators analysis in hospitalized patients
LUCA GIOVANNI ANTONIO PIVETTA, PEDRO DE SOUZA LUCARELLI ANTUNES, GIOVANNA MENNITTI SHIMODA, JOSÉ GUSTAVO PARREIRA, JACQUELINE ARANTES GIANNINNI PERLINGEIRO, JOSE CESAR ASSEF Revista do Colégio Brasileiro de Cirurgiões.2024;[Epub] CrossRef - Registro de Trauma: análise dos Filtros de Qualidade nos pacientes internados
LUCA GIOVANNI ANTONIO PIVETTA, PEDRO DE SOUZA LUCARELLI ANTUNES, GIOVANNA MENNITTI SHIMODA, JOSÉ GUSTAVO PARREIRA, JACQUELINE ARANTES GIANNINNI PERLINGEIRO, JOSE CESAR ASSEF Revista do Colégio Brasileiro de Cirurgiões.2024;[Epub] CrossRef - Positive impact of trauma center to exsanguinating pelvic bone fracture patient survival: A Korean trauma center study
Mina Lee, Byungchul Yu, Giljae Lee, Jungnam Lee, Kangkook Choi, Youngeun Park, Jihun Gwak, Myung Jin Jang Hong Kong Journal of Emergency Medicine.2023; 30(4): 225. CrossRef - Understanding Regional Trauma Centers and managing a trauma care system in South Korea: a systematic review
Jeehye Im, Eun Won Seo, Kyoungwon Jung, Junsik Kwon Annals of Surgical Treatment and Research.2023; 104(2): 61. CrossRef - Multifaceted Analysis of the Environmental Factors in Severely Injured Trauma: A 30-Day Survival Analysis
Sung Woo Jang, Hae Rim Kim, Pil Young Jung, Jae Sik Chung Healthcare.2023; 11(9): 1333. CrossRef - Changes in the Deceased-Donor Trend in Korea: Establishment of Regional Trauma Centers and KODA
Jeong-Moo Lee Journal of Clinical Medicine.2022; 11(5): 1239. CrossRef - An Evaluation of the Effect of Performance Improvement and Patient Safety Program Implemented in a New Regional Trauma Center of Korea
Yo Huh, Junsik Kwon, Jonghwan Moon, Byung Hee Kang, Sora Kim, Jayoung Yoo, Seoyoung Song, Kyoungwon Jung Journal of Korean Medical Science.2021;[Epub] CrossRef - Artificial intelligence to predict in-hospital mortality using novel anatomical injury score
Wu Seong Kang, Heewon Chung, Hoon Ko, Nan Yeol Kim, Do Wan Kim, Jayun Cho, Hongjin Shim, Jin Goo Kim, Ji Young Jang, Kyung Won Kim, Jinseok Lee Scientific Reports.2021;[Epub] CrossRef
- Type B Aortic Dissection with Visceral Artery Involvement Following Blunt Trauma: A Case Report
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Ahram Han, Min A Lee, Youngeun Park, Jin Mo Kang, Jung Ho Kim, Jungnam Lee
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J Trauma Inj. 2017;30(4):206-211. Published online December 30, 2017
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DOI: https://doi.org/10.20408/jti.2017.30.4.206
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Aortic dissection caused by blunt trauma is a rare injury that can be complicated by malperfusion syndrome resulting from obstruction of branch vessels of the aorta. Here, we present a case of traumatic type B aortic dissection with right renal and small bowel ischemia, successfully managed by endovascular fenestration.
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