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J Trauma Inj : Journal of Trauma and Injury



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Radiologic assessment of the optimal point for tube thoracostomy using the sternum as a landmark: a computed tomography‐based analysis
Jaeik Jang, Jae-Hyug Woo, Mina Lee, Woo Sung Choi, Yong Su Lim, Jin Seong Cho, Jae Ho Jang, Jea Yeon Choi, Sung Youl Hyun
J Trauma Inj. 2024;37(1):37-47.   Published online February 23, 2024
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AbstractAbstract PDFSupplementary Material
This study aimed at developing a novel tube thoracostomy technique using the sternum, a fixed anatomical structure, as an indicator to reduce the possibility of incorrect chest tube positioning and complications in patients with chest trauma.
This retrospective study analyzed the data of 184 patients with chest trauma who were aged ≥18 years, visited a single regional trauma center in Korea between April and June 2022, and underwent chest computed tomography (CT) with their arms down. The conventional gold standard, 5th intercostal space (ICS) method, was compared to the lower 1/2, 1/3, and 1/4 of the sternum method by analyzing CT images.
When virtual tube thoracostomy routes were drawn at the mid-axillary line at the 5th ICS level, 150 patients (81.5%) on the right side and 179 patients (97.3%) on the left did not pass the diaphragm. However, at the lower 1/2 of the sternum level, 171 patients (92.9%, P<0.001) on the right and 182 patients (98.9%, P= 0.250) on the left did not pass the diaphragm. At the 5th ICS level, 129 patients (70.1%) on the right and 156 patients (84.8%) on the left were located in the safety zone and did not pass the diaphragm. Alternatively, at the lower 1/2, 1/3, and 1/4 of the sternum level, 139 (75.5%, P=0.185), 49 (26.6%, P<0.001), and 10 (5.4%, P<0.001), respectively, on the right, and 146 (79.3%, P=0.041), 69 (37.5%, P<0.001), and 16 (8.7%, P<0.001) on the left were located in the safety zone and did not pass the diaphragm. Compared to the conventional 5th ICS method, the sternum 1/2 method had a safety zone prediction sensitivity of 90.0% to 90.7%, and 97.3% to 100% sensitivity for not passing the diaphragm.
Using the sternum length as a tube thoracostomy indicator might be feasible.
Analysis of KTDB Registered Trauma Patients from a Single Trauma Center in Korea
Byungchul Yu, Min Chung, Giljae Lee, Mina Lee, Jaejeong Park, Kangkook Choi, Sungyeol Hyun, Yangbin Jeon, Daesung Ma, Young Cheol Yoon, Jungnam Lee
J Trauma Inj. 2015;28(3):123-128.   Published online September 30, 2015
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  • 3 Citations
AbstractAbstract PDF
Establishment of the trauma system changed quality of trauma care in many countries. As one of the first designated level 1 trauma center in Korea, we analyzed trauma registration data in 2014.
Data was extracted from Korean Trauma Data Base (KTDB) that was started from august 2013. Variables related to demographics and trauma was collected through the year 2014.
There were 3269 trauma patients who admitted to our hospital and registered to KTDB in 2014. Median age was 49 years, 64.4% were men, and 90% of patients were blunt in mechanism. Median injury severity score (ISS) was 5, mean revised trauma score (RTS) was 7.65. There were 138 (4.2%) deaths and 87 (2.7%) patients of them was death after admission.
This is the first report using KTDB registration from our institution. Trauma volume is appropriate but it should be compared with other trauma centers in Korea. In future national analysis of KTDB is mandatory.


Citations to this article as recorded by  
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    Journal of Acute Care Surgery.2022; 12(3): 120.     CrossRef
  • Impact of obesity on the severity of trauma in patients injured in pedestrian traffic accidents
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    Journal of Trauma and Injury.2022; 35(4): 240.     CrossRef
  • An analysis of missed injuries in patients with severe trauma
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    Journal of Trauma and Injury.2022; 35(4): 248.     CrossRef

J Trauma Inj : Journal of Trauma and Injury