Journal of Trauma and Injury

Original Articles

Changes in the characteristics of civilian patients admitted to a military hospital before and during the healthcare system crisis: a retrospective cohort study: Changsin Lee, Sang Mok Lee, Kyungwon Lee; J Trauma Inj. 2026;39(1):14-24. Published online March 3, 2026; DOI: https://doi.org/10.20408/jti.2025.0096

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Abstract PDF: Purpose
In February 2024, a healthcare system crisis in Korea, triggered by the mass resignation of medical residents in protest of government medical policies, resulted in an increased influx of civilian trauma patients to a military trauma center. This study examines the scale, characteristics, and treatment outcomes of these patients before and during the crisis.
Methods
A retrospective review was conducted, comparing civilian trauma patients who visited the center from March 2023 to February 2024 (before crisis) and from March 2024 to February 2025 (during the crisis). The variables analyzed included patient demographics, injury types, methods of transportation, length of emergency room (ER) stay, hospitalization outcomes, and final treatment results. Only civilian trauma patients who required hospitalization were included; mild cases discharged from the ER were excluded.
Results
A total of 548 civilian patients visited the center during the study period, with a significant increase observed during the crisis (364 patients during the crisis vs. 81 patients before the crisis). Despite the surge, there were no significant differences in hospital arrival routes, methods of transportation, mechanisms of injury, or injury types. ER stay durations were shorter for both general and severe cases during the crisis (P=0.020 and P=0.033, respectively), although intensive care unit and overall hospital stay lengths remained unchanged. Civilian outpatient visits increased more than threefold in March 2024 compared to February 2024, and this elevated trend remained stable.
Conclusions
These findings highlight the military trauma center’s ability to maintain effective civilian trauma care despite significant healthcare system disruptions. The study underscores the resilience of the center and offers insights for optimizing trauma care operations in future crises.; Summary

Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients: Jeong Il Joo, Changsin Lee, Kyungwon Lee; J Trauma Inj. 2024;37(4):262-267. Published online December 4, 2024; DOI: https://doi.org/10.20408/jti.2024.0037

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Purpose
Blank cartridges are designed to produce the sound and gas flare of a gunshot without firing a bullet. However, blank cartridge shots (BCS) can still cause injuries ranging from minor to life-threatening. Within the South Korean military, most BCS-related injuries have occurred during suicide attempts. This study documents a case series of patients who sustained injuries from BCS during such attempts.
Methods
We examined the medical records of Korean soldiers at a military trauma center between April 2022 and April 2024 who had sustained injuries from BCS during suicide attempts. The analyzed data included general characteristics, injury site, surgical and psychiatric interventions, and length of hospitalization.
Results
The case series included five patients between 19 and 20 years old (mean age, 19.6±0.55 years). Four of these patients sustained self-inflicted gunshot wounds to the submandibular area, while one targeted the right temporal area. Although initial vital signs and laboratory findings were unremarkable, computed tomography scans revealed injuries from projectile gas and gunpowder, including burns, subcutaneous emphysema, and major structural damage. Cases 1 and 2 required emergency surgery for foreign body removal and debridement. The average length of hospitalization was 35.2±12.11 days. Patients were first admitted to the trauma surgery department for BCS injury management, and then transferred to the psychiatry department for emotional support. The average stay was 15.6±15.87 days in trauma surgery and 19.6±14.99 days in psychiatry.
Conclusions
This study highlights the consequences of BCS from suicide attempts in the South Korean military and provides valuable insights for medical personnel who may encounter patients with BCS injuries.

Summary

Citations

Citations to this article as recorded by

Penetrating chest injury caused by a rubber bullet in a Republic of Korea Army soldier: a case report
Chansin Lee, Kyungwon Lee
Journal of Acute Care Surgery.2025; 15(3): 164. CrossRef

One year of treating patients with open fractures of the lower extremity in a new military trauma center in Korea: a case series: Ji Wool Ko, Giho Moon, Jin Geun Kwon, Kyoung Eun Kim, Hankaram Jeon, Kyungwon Lee; J Trauma Inj. 2023;36(4):376-384. Published online December 19, 2023; DOI: https://doi.org/10.20408/jti.2023.0041

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3 Web of Science
3 Citations

Abstract PDF

Purpose
The Armed Forces Trauma Center of Korea was established in April 2022. This study was conducted to report our 1-year experience of treating soldiers with open fractures of the lower extremity.
Methods
In this case series, we reviewed the medical records of 51 Korean soldiers with open fractures of the lower extremity between April 2022 and March 2023 at a trauma center. We analyzed patients with Gustilo-Anderson type II and III fractures and reported the duration of transportation, injury mechanisms, injured sites, and associated injuries. We also presented laboratory findings, surgery types, intensive care unit stays, hospital stays, rehabilitation results, and reasons for psychiatric consultation. Additionally, we described patients’ mode of transport.
Results
This study enrolled nine male patients who were between 21 and 26 years old. Six patients had type II and three had type III fractures. Transport from the accident scene to the emergency room ranged from 75 to 455 minutes, and from the emergency room to the operating room ranged from 35 to 200 minutes. Injury mechanisms included gunshot wounds, landmine explosions, grenade explosions, and entrapment by ship mooring ropes. One case had serious associated injuries (inhalation burn, open facial bone fractures, and hemopneumothorax). No cases with serious blood loss or coagulopathies were found, but most cases had a significant elevation of creatinine kinase. Two patients underwent vascular reconstruction, whereas four patients received flap surgery. After rehabilitation, six patients could walk, one patient could move their joints actively, and two patients performed active assistive movement. Eight patients were referred to the psychiatry department due to suicidal attempts and posttraumatic stress disorder.
Conclusions
This study provides insights into how to improve treatment for patients with military trauma, as well as medical services such as the transport system, by revising treatment protocols and systematizing treatment.

Summary

Citations

Citations to this article as recorded by

The PTSD-Bone Axis: Evidence, Mechanisms, and Management
Olivia X. Jones, Kirsten D. Kelly, Stephanie K. Khoo, Ryan R. Kelly, Sara J. Sidles, Amanda C. LaRue
Current Osteoporosis Reports.2026;[Epub] CrossRef
Changes in the characteristics of civilian patients admitted to a military hospital before and during the healthcare system crisis: a retrospective cohort study
Changsin Lee, Sang Mok Lee, Kyungwon Lee
Journal of Trauma and Injury.2026; 39(1): 14. CrossRef
Injuries from blank cartridge shots in suicide attempts within the South Korean military: a case series of five patients
Jeong Il Joo, Changsin Lee, Kyungwon Lee
Journal of Trauma and Injury.2024; 37(4): 262. CrossRef

Management of Thoracic Aortic Injury after Blunt Trauma: Nine Cases at a Single Medical Center: Kyungwon Lee, Jae Gil Lee; J Trauma Inj. 2016;29(4):146-150. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.146

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Abstract PDF: PURPOSE
Traumatic aortic injuries are rare, but life threatening condition. They usually occur after high velocity impact on the chest or abdomen such as traffic accident or fall. We report the experiences of the traumatic aortic injuries at a single center.
METHODS
We retrospectively reviewed the medical records of nine patients with aortic injury resulting from the blunt trauma from Jan. 2010 to May. 2016.
RESULTS
The mean age was 51.1±20.8 years old, and ten (90.9%) were men. The mechanisms of injury were traffic accidents in seven patients (motorcycle accidents; 3, car accidents; 4), and four in fall injury. Most common injured sites were thoracic aorta (9, 81.8%). Aortic injuries were repaired by endovascular approach in four patients, and by open graft surgery in four. Two patients were managed conservatively. Nine patients survived without any complications.
CONCLUSION
We had experienced different approaches for management of aortic injuries after blunt trauma according to locations and severity of lesions.; Summary

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