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Volume 31(3); December 2018
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Original Articles
Epidemiological and Clinical Characteristics of Elderly Fall Patients Visit to the Emergency Department: A Comparison by Gender
Jun Kew Kim, Sun Pyo Kim, Sun Hyu Kim, Gyu Chong Cho, Min Joung Kim, Ji Sook Lee, Chul Han
J Trauma Inj. 2018;31(3):117-124.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.025
  • 3,200 View
  • 54 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Summary

Citations

Citations to this article as recorded by  
  • The moderating role of social factors in the relationship between an incident of fall and depressive symptoms: a study with a national sample of older adults in South Korea
    Min-Kyoung Rhee, Yuri Jang, Soo Young Kim, Sujie Chang
    Aging & Mental Health.2021; 25(6): 1086.     CrossRef
The New Recreational Transportation on the Street: Personal Mobility, Is It Safe?
Young Woo Kim, Won Bin Park, Jin Seong Cho, Sung Youl Hyun, Geun Lee
J Trauma Inj. 2018;31(3):125-134.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.040
  • 15,801 View
  • 81 Download
  • 13 Citations
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Summary

Citations

Citations to this article as recorded by  
  • Critical risk factors associated with fatal/severe crash outcomes in personal mobility device rider at-fault crashes: A two-step inter-cluster rule mining technique
    Reuben Tamakloe, Kaihan Zhang, Ahmed Hossain, Inhi Kim, Shin Hyoung Park
    Accident Analysis & Prevention.2024; 199: 107527.     CrossRef
  • The epidemiology and outcomes of severe road traffic injury by road user type in Korea: a nationwide retrospective observation study
    Gyeongmin Lee, Jeong Ho Park, Seung Chul Lee, Sanghun Lee, Kyoung Jun Song, Sang Do Shin
    Injury.2024; : 111732.     CrossRef
  • Typological index of alleyways: mapping the pattern of a forgotten urban form element
    Khaled Alawadi, Asim Khanal, Rawan Sohdy Abdelfattah
    Journal of Urban Design.2023; 28(2): 199.     CrossRef
  • Electric personal mobility device driver behaviors, their antecedents and consequences: A narrative review
    Clément Laverdet, Pascal Malola, Thierry Meyer, Patricia Delhomme
    Journal of Safety Research.2023; 86: 274.     CrossRef
  • Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea
    Maro Kim, Dongbum Suh, Jin Hee Lee, Hyuksool Kwon, Yujin Choi, Joo Jeong, Sola Kim, Soyun Hwang, Joong Wan Park, You Hwan Jo
    Journal of Trauma and Injury.2022; 35(1): 3.     CrossRef
  • Types of injuries caused by isolated electric scooter accidents
    Kyongwon Yoo, Hyung Il Kim
    Journal of Trauma and Injury.2022; 35(4): 232.     CrossRef
  • Revisiting transit-oriented development: Alleys as critical walking infrastructure
    Khaled Alawadi, Asim Khanal, Azhar Doudin, Rahma Abdelghani
    Transport Policy.2021; 100: 187.     CrossRef
  • Epidemiological trends of personal mobility devices and power-assisted bicycles-related fires and injuries in Singapore
    Jason Qi Wei Kwek, Qin Xiang Ng, Amelia Justina Lim, Li Feng Ang, Shalini Arulanandam
    Burns.2021; 47(4): 983.     CrossRef
  • Where to Ride? An Explorative Study to Investigate Potential Risk Factors of Personal Mobility Accidents
    Jihun Oh, Jeongseob Kim
    International Journal of Environmental Research an.2021; 18(3): 965.     CrossRef
  • Contextual risk factors in the use of electric kick scooters: An episode sampling inquiry
    Kyung-Jun Lee, Chan Hyeok Yun, Myung Hwan Yun
    Safety Science.2021; 139: 105233.     CrossRef
  • Survey on e-Powered Micro Personal Mobility Vehicles: Exploring Current Issues towards Future Developments
    Stefania Boglietti, Benedetto Barabino, Giulio Maternini
    Sustainability.2021; 13(7): 3692.     CrossRef
  • Identifying the Risk Factors in the Context-of-Use of Electric Kick Scooters Based on a Latent Dirichlet Allocation
    Kyung-Jun Lee, Chan Hyeok Yun, Ilsun Rhiu, Myung Hwan Yun
    Applied Sciences.2020; 10(23): 8447.     CrossRef
  • Challenges Caused by Increased Use of E-Powered Personal Mobility Vehicles in European Cities
    Jurgis Zagorskas, Marija Burinskienė
    Sustainability.2019; 12(1): 273.     CrossRef
Central Venous Catheterization before Versus after Computed Tomography in Hemodynamically Unstable Patients with Major Blunt Trauma: Clinical Characteristics and Factors for Decision Making
Ji Hun Kim, Sang Ook Ha, Young Sun Park, Jeong Hyeon Yi, Sun Beom Hur, Ki Ho Lee
J Trauma Inj. 2018;31(3):135-142.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.022
  • 3,295 View
  • 44 Download
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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).

Conclusions

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

Summary
A Prospective, Randomized, Controlled Trial to Assess the Efficacy of a Multi-Disciplinary Screening, Brief Intervention and Referral to Treatment Program for Patients with Fractures of the Oral and Maxillofacial Region Because of Alcohol-Related Injuries in the Emergency Department
Ja Heon Koo, Hyung Jun Song, Jun Hee Lee, Jae Hyun Kim, Jung Woo Nam, Jae Eun Im
J Trauma Inj. 2018;31(3):143-150.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.045
  • 10,656 View
  • 41 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

Summary

Citations

Citations to this article as recorded by  
  • Effectiveness of Brief Alcohol Intervention in Reducing Alcohol Consumption Among Patients With Alcohol-Related Facial Trauma in the Emergency Department: A Systematic Review and Meta-Analysis
    Ismail Azzam, Kai Lee
    Journal of Oral and Maxillofacial Surgery.2023; 81(9): 1102.     CrossRef
Utility of Spinal Injury Diagnosis Using C-Spine Lateral X-Ray and Chest, Abdomen and Pelvis Computed Tomography in Major Trauma Patients with Impaired Consciousness
Yoon Soo Jang, Byung Hak So, Won Jung Jeong, Kyung Man Cha, Hyung Min Kim
J Trauma Inj. 2018;31(3):151-158.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.042
  • 2,988 View
  • 56 Download
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Summary
Comparative Analysis between Spinning and Other Causes in Exercise-Induced Rhabdomyolysis
Do Won Shim, Sung Youl Hyun, Jae Hyug Woo, Jae Ho Jang, Jae Yeon Choi
J Trauma Inj. 2018;31(3):159-165.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.038
  • 3,591 View
  • 41 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusions

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.

Summary

Citations

Citations to this article as recorded by  
  • Clinical characteristics and outcomes of exertional rhabdomyolysis after indoor spinning: a systematic review
    Yoshio Masuda, Rachel Wam, Benjamin Paik, Clara Ngoh, Andrew MTL Choong, Jun Jie Ng
    The Physician and Sportsmedicine.2023; 51(4): 294.     CrossRef
Significance of Biomarkers as a Predictive Factor for Post-Traumatic Sepsis
Kyung-Wuk Lee, Sung-Hyuk Choi, Young-Hoon Yoon, Jung-Youn Kim, Young-Duck Cho, Han-Jin Cho, Sung-Jun Park
J Trauma Inj. 2018;31(3):166-173.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.027
  • 3,237 View
  • 43 Download
AbstractAbstract PDF
Purpose

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.

Methods

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.

Results

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.

Conclusions

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

Summary
Case Reports
Iatrogenic Delayed Aortic Injury Following a Surgical Stabilization of Flail Chest
Junepill Seok, Hyun Min Cho, Seon Hee Kim, Ho Hyun Kim
J Trauma Inj. 2018;31(3):174-176.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.037
  • 3,025 View
  • 42 Download
  • 1 Citations
AbstractAbstract PDF

Most of aortic injuries after blunt chest trauma usually occur at the aortic isthmus and are identified in the emergency department soon after arrival. Delayed aortic injures by fractured posterior ribs, however, are relatively rare and have been reported only a few times. We recently experienced an iatrogenic descending aortic injury sustained as a result of a direct puncture by a sharp rib end after surgical stabilization of rib fractures.

Summary

Citations

Citations to this article as recorded by  
  • Surgical Stabilisation of Traumatic Rib Fractures with Chronic, Residual Type A Aortic Dissection
    Kieran J. Matic, Rajkumar Cheluvappa, Selwyn Selvendran
    Healthcare.2021; 9(4): 392.     CrossRef
Heterotopic Ossification in the Abdominal Wall after Exploratory Laparotomy
Hohyun Kim
J Trauma Inj. 2018;31(3):177-180.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.047
  • 4,476 View
  • 108 Download
  • 2 Citations
AbstractAbstract PDF

Heterotopic bone formation in abdominal incisions is a recognized but uncommon sequela of abdominal surgery. On the other hand, the formation of ectopic bone is a well-recognized complication following arthroplasty of the hip. Heterotopic ossification of midline abdominal incision scars is a subtype of myositis ossificans traumatica. Ectopic bone formation of midline abdominal incisions may cause regional pain or discomfort in the patient after surgery. If symptomatic, treatment is complete excision with primary closure. Radiologically, it is important to distinguish this benign entity from postoperative complications. We report a 69-year-old male who underwent exploratory laparotomy for traumatic small bowel perforation. A segment of abnormal hard tissue was found in the abdominal wall. Heterotopic ossification may occur at various sites and is a recognized but infrequent sequela of exploratory laparotomy. This case high-lights clinical and etiological features of this finding.

Summary

Citations

Citations to this article as recorded by  
  • Heterotopic Ossification in the Midline Scar in Xiphoid and Sub-xiphoid Region
    Vadivalagianambi Sivakumar, Venkatraman Indiran
    Indian Journal of Surgery.2022;[Epub]     CrossRef
  • Unusual osseous metaplasia following hernia repair with Prolene mesh: a case report
    Awrad Nasralla, Bonnie Tsang
    Journal of Surgical Case Reports.2019;[Epub]     CrossRef
An Irreducible Hip Dislocation with Femoral Head Fracture
Tae-Seong Kim, Chang-Wug Oh, Joon-Woo Kim, Kyeong-Hyeon Park
J Trauma Inj. 2018;31(3):181-188.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.026
  • 7,849 View
  • 132 Download
  • 1 Citations
AbstractAbstract PDF

Urgent reduction is required in cases of traumatic hip dislocation to reduce the risk of avascular necrosis of the femoral head. However, in cases of femoral head fractures, the dislocated hip cannot be reduced easily, and in some cases, it can even be irreducible. This irreducibility may provoke further incidental iatrogenic fractures of the femoral neck. In an irreducible hip dislocation, without further attempting for closed reduction, an immediate open reduction is recommended. This can prevent iatrogenic femoral neck fracture or avascular necrosis of the femoral head, and save the natural hip joint.

Summary

Citations

Citations to this article as recorded by  
  • Safety and efficacy of surgical hip dislocation in managing femoral head fractures: A systematic review and meta-analysis
    Ahmed A Khalifa, Mohamed A Haridy, Ali Fergany
    World Journal of Orthopedics.2021; 12(8): 604.     CrossRef
Traumatic Separation of Bipartite Patella Underlying Gout
Eun Seok Choi, Jae Ang Sim, Jae Yun Go, Young Gon Na
J Trauma Inj. 2018;31(3):189-193.   Published online December 31, 2018
DOI: https://doi.org/10.20408/jti.2018.028
  • 4,399 View
  • 51 Download
  • 1 Citations
AbstractAbstract PDF

Gouty arthritis is a common crystal arthropathy, but gout tophus in the bipartite patella is a rare condition. This report presented a traumatic separation of bipartite patellar fragment caused by mild trauma in a patient with comorbid gout. When a patient with bipartite patella and underlying gouty arthritis complains of pain after trauma, clinical suspicion is needed about fragment separation of the bipartite patella.

Summary

Citations

Citations to this article as recorded by  
  • Beyond Medical Treatment: Surgical Treatment of Gout
    Jonathan Carcione, Shari Bodofsky, Brian LaMoreaux, Naomi Schlesinger
    Current Rheumatology Reports.2021;[Epub]     CrossRef

J Trauma Inj : Journal of Trauma and Injury