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J Trauma Inj : Journal of Trauma and Injury

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4 "Hyung Min Kim"
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Original Articles
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
  • 2,808 View
  • 55 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
Analysis of Factors Related to Length of Stay Time in Patients with Back Pain at Emergency Department
Kwang Yong Choi, Byung Hak So, Hyung Min Kim, Kyung Man Cha, Won Jung Jeong
J Trauma Inj. 2017;30(4):173-178.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.173
  • 2,754 View
  • 21 Download
AbstractAbstract PDF
Purpose

Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER.

Methods

We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups.

Results

A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034).

Conclusions

In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

Summary
Evaluation the Usefulness of Individual factors for Determining the Severity and Predicting Prognosis of Trauma Victims
Sung Yoon Kim, Byung Hak So, Hyung Min Kim, Won Jung Jeong, Kyung Man Cha, Seung Pill Choi
J Trauma Inj. 2015;28(3):134-143.   Published online September 30, 2015
DOI: https://doi.org/10.20408/jti.2015.28.3.134
  • 1,759 View
  • 5 Download
  • 1 Citations
AbstractAbstract PDF
PURPOSE
Many patients are injured by trauma. And some of them expire due to severity of trauma. Various scoring systems have been introduced in grading severity and predicting mortality of trauma patients. This study is to evaluation the usefulness of factors for determining the severity and predicting the prognosis of the trauma victims.
METHODS
Data on the patients who visited our Emergency departments from January 2010 to December 2011 were retrospectively reviewed using electronic medical records. The patients were activated severe trauma team calling system. The patients were categorized as survivors and non-survivors. Univariated associations were calculated, and a multiple logistic regression analysis was used to determine variables associated with hospital mortality.
RESULTS
Two hundred sixty two(262) patients were enrolled, and the mortality rate was 25.6%. By multivariate analysis, lower respiration rate, lower Glasgow Coma Score, higher International Normalized Ratio and emergency transfusion within 6 hours were expected as severity and prognosis predict factors (each of odds ratio were 24.907, 14.282, 2.667 and 16.144).
CONCLUSION
As predict factors, respiration rate, Glasgow Coma Score, International Normalized Ratio and emergency transfusion, are useful determining the severity and predicting prognosis of trauma victims.
Summary

Citations

Citations to this article as recorded by  
  • Prognostic Accuracy of the Quick Sequential Organ Failure Assessment for Outcomes Among Patients with Trauma in the Emergency Department: A Comparison with the Modified Early Warning Score, Revised Trauma Score, and Injury Severity Score
    Min Woo Kang, Seo Young Ko, Sung Wook Song, Woo Jeong Kim, Young Joon Kang, Kyeong Won Kang, Hyun Soo Park, Chang Bae Park, Jeong Ho Kang, Ji Hwan Bu, Sung Kgun Lee
    Journal of Trauma and Injury.2021; 34(1): 3.     CrossRef
Predictive Factors of Blood Transfusion Requirement in Blunt Trauma Patients Admitted to the Emergency Room
Ji Sun Oh, Hyung Min Kim, Se Min Choi, Kyoung Ho Choi, Tai Yong Hong, Kyu Nam Park, Byung Hak So
J Korean Soc Traumatol. 2009;22(2):218-226.
  • 1,128 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
In multiple blunt trauma patients, transfusion may be a significant therapeutic adjunct to non-operative management. The blood products must be expedited and efficiently to patients in impending shock caused by hemorrhage or traumatic coagulopathy, but the decision to perform blood transfusion has been made empirically, based on the clinician's and has not been guided by objective parameters, but own opinion, that may result in an underestimate of or a failure to detect bleeding, in delayed transfusion, and in a reduced outcome. This article presents quickly assessable predictive factors for determining if a blood transfusion is required to improve outcomes in multiple blunt trauma patients admitted to the emergency room.
METHODS
In a retrospective review of 282 multiple blunt trauma patients who visited our emergency center by emergency rescuer during a 1-year period, possible factors predictive of the need for a blood transfusion were subjected to univariate and multivariate logistic regression analysis.
RESULTS
Of blunt trauma patients ,9.2% (26/282), received red blood cells in the first 24 hours of care. Univariate analysis revealed significant associations between blood transfused and heart rate (HR) > 100 beats/min, respiratory rate (RR) > 20 breaths/min, Glasgow Coma Scale (GCS) < 14, Revised Trauma Score (RTS) < 11, white blood cell count (WBC) < 4000 or > 10000, and initial abnormal portable trauma series (Cspine lateral, chest AP, pelvis AP). A multiple regression analysis, with a correction for diagnosis, identified HR > 100 beats/min (EXP 3.2), GCS < 14 (EXP 4.1), and abnormal trauma series (EXP 2.9), as independent predictors.
CONCLUSION
In our study, systolic blood pressure (SBP) < 90 mmHg, old age > 65 years, hemoglobin < 13g/dL, mechanism of injury were poor predictors of early blood transfusion. Initial abnormal portable trauma series, HR > 100 beats/min, and GCS < 14 were quickly assessable useful factors for predicting a need for early blood transfusion in blunt trauma patients visiting the emergency room.
Summary

J Trauma Inj : Journal of Trauma and Injury