This study was to analyze clinical and epidemiological characteristics of elderly patients who were admitted to the emergency department (ED) due to falls by separating male and female.

We retrospectively analyzed the fall patients aged 65 years or older from the data of the in-depth surveillance study of injured patients visit to the ED under the supervision of the Korea Centers for Disease Control and Prevention (KCDC) from 2011 to 2016 by separating male and female.

A total of 361,588 elderly fall patients were analyzed and, among them, 14,429 (37.3%) were males and 24,208 (62.7%) were females. Male and female showed similar frequency of damage happening season. However, they showed falling accident mostly on winter. The time of injury occurrence is mostly from 12:00 to 18:00 with 4,949 (34.3%) male and 8,564 (35.4%) female. Most falls occurred in daily activities, accounting for 7,614 (52.8%) in males and 14,957 (61.8%) in females, respectively. Unintentional damage accounted for the most part and 7,395 (51.2%) of male and 15,343 (63.4%) of female were injured indoors. Head and neck were the most common site of injuring, with 8,392 (58.2%) in males and 7,851 (32.4%) in females. According to ED examination outcomes, most of the patients were discharged, while the majority of the hospitalized patients were admitted to the general patient room.

The elderly falls occurred mostly from 12:00 to 18:00, during winter and to elderly women. Also, they happened unintentionally indoors in everyday life, mostly. Proved clinical, epidemiological characteristics from this research will be used as useful indicator at validity research of development of prevent program of falling accident for elderly people.

The interest in the personal mobility started to grow and as the interest increases, there are growing concerns about the safety of it. The purpose of the study is to look at the types and dynamics of patients injured by the personal mobilities.

This was a retrospective 2-year observational study, from January 2016 to December 2017, on the patients who visited the emergency center and the trauma center, with an injury related to driving the personal mobility. Cases of the personal mobility-related accident were collected based on electronic medical records and hospital emergency department-based injury in-depth surveillance data.

A total of 65 patients visited the emergency center and the trauma center, during this study period. Six patients of 50 adults admitted the alcohol consumption (12%) and two adult patients wore the helmet as the protection gear (3.1%). The number of the patients in 2017 rises three times more than the number of patients in 2016 (51 vs. 14). Injuries to the head and neck region (67.7%) was the most common, followed by the upper extremity (46.2%). Eleven patients (16.9%) were admitted to the hospital, of whom three were admitted to the intensive care unit due to intracranial hemorrhage. Nine patients underwent surgery.

The use of the personal mobility will continue to grow and the accidents, caused by the vehicle, will increase along with it. The study showed the damage is worse than expected. Personal mobility currently has a limited safety laws and the riders are not yet fully aware of its danger. The improvement of the regulation of the personal mobility, safety education is needed.

When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision.

This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017.

Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226).

Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

We have implemented a multi-disciplinary Screening, Brief Intervention and Referral to Treatment (SBIRT) protocol to prevent individuals who sustained alcohol-related traumatic injuries. We therefore conducted this single-center, prospective, randomized, controlled trial (RCT) to assess its efficacy.

All the enrolled patients (n=30) were randomized to either the SBIRT group or the control group. In the current RCT, the proportion of the patients who reduced the amount of alcohol consumption and those who received a specialized treatment served as primary outcome measures. Moreover, changes in a 3-item version of the Alcohol Use Disorders Identification Test Consumption (AUDIT-C), Severity of Dependence Scale (SDS) and Kessler Psychological Distress Scale (K-6) scores at 3 months from baseline served as secondary outcome measures.

At 3 months, the proportion of the patients who reduced the amount of alcohol consumption was significantly higher in the SBIRT group as compared with the control group (86.7% vs. 57.1%, p=0.02). Moreover, the proportion of the patients who received a specialized treatment was also significantly higher as compared with the control group (26.7% vs. 1.4%, p=0.01). Furthermore, there were significant differences in changes in the AUDIT, SDS and K-6 scores at 3 months from baseline between the two groups (p<0.05).

In conclusion, our results indicate that the SBIRT is effective in reducing hazardous and harmful levels of drinking, the degree of alcohol dependence and that of psychological distress in at-risk drinkers.

The regional emergency medical centers manage the patients with major blunt trauma according to the process appropriate to each hospital rather than standardized protocol of the major trauma centers. The primary purpose of this study is to evaluate the effectiveness and influence on prognosis of additional cervical-thoracic-lumbar-spine computed tomography (CTL-spine CT) scan in diagnosis of spinal injury from the victim of major blunt trauma with impaired consciousness.

The study included patients visited the urban emergency medical center with major blunt trauma who were over 18 years of age from January 2013 to December 2016. Data were collected from retrospective review of medical records. Sensitivity, specificity, positive predictive value, and negative predictive value were measured for evaluation of the performance of diagnostic methods.

One hundred patients with Glasgow coma scale ≤13 underwent additional CTL-spine CT scan. Mechanism of injury was in the following order: driver, pedestrian traffic accident, fall and passenger accident. Thirty-one patients were diagnosed of spinal injury, six of them underwent surgical management. The sensitivity of chest, abdomen and pelvis CT (CAP CT) was 72%, specificity 97%, false positive rate 3%, false negative rate 28% and diagnostic accuracy 87%. Eleven patients were not diagnosed of spinal injury with CAP CT and C-spine lateral view, but all of them were diagnosed of stable fractures.

C-spine CT scan be actively considered in the initial examination process. When CAP CT scan is performed in major blunt trauma patients with impaired consciousness, CTL-spine CT scan or simple spinal radiography has no significant effect on the prognosis of the patient and can be performed if necessary.

Spinning-induced rhabdomyolysis (SIR) has been increasing in recent years and accounts for a large proportion of exercise-induced rhabdomyolysis (EIR). The purpose of this study was to compare the clinical features between SIR and non-spinning exercise-induced rhabdomyolysis (NSIR), and to analyze each of these clinical features.

A retrospective chart review was conducted on patients treated due to EIR from January 2006 to March 2018. Patients were divided into the SIR and NSIR groups, and their clinical factors, outcome, and blood chemistries were compared and analyzed.

Sixty-two patients were enrolled in this study, with 23 (37.1%) and 39 (62.9%) patients categorized in the SIR and NSIR groups, respectively. The SIR group were mostly women (78.3% vs. 38.5%, p=0.002), more f requent EIR occurrence in the first exercise class (60.9% vs. 15.4%, p=0.001), and had most complaints of thigh pain (91.3% vs. 43.6%, p=0.001). The SIR group had a higher incidence rate despite its shorter exercise duration (90.5% vs. 62.9%, p=0.024), longer hospital stay (6.0 [4.5?7.0] vs. 5.0 [3.5?6.0] days, p=0.080), and higher rate of peak CPK (15,000 U/L or higher) (91.3% vs. 74.4%, p=0.182) compared to the NSIR group.

SIR occurs at a higher rate during the first exercise class in women compared to NSIR, and the incidence rate is higher in SIR than in NSIR despite its shorter exercise duration (less than 60 minutes). It is necessary to recognize these risks during spinning exercises and to perform these exercises sequentially and systematically.

Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients.

This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient’s blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week.

A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ≥15). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups.

MIF may be considered as a predictive factor for sepsis in trauma patients.