Journal of Trauma and Injury

Original Articles

Effect of use and type of helmet on occurrence of traumatic brain injuries in motorcycle riders in Korea: a retrospective cohort study: Sowon Seo, Seok Ran Yeom, Sung-Wook Park, Il Jae Wang, Suck Ju Cho, Wook Tae Yang, Youngmo Cho; J Trauma Inj. 2023;36(2):87-97. Published online December 9, 2022; DOI: https://doi.org/10.20408/jti.2022.0029

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Purpose
The purpose of this study was to investigate (1) the association among helmet wearing, incidence rate of traumatic brain injury (TBI), and in-hospital mortality; TBI was diagnosed when the head Abbreviated Injury Scale (AIS) was ≥1, and as severe TBI when head AIS was ≥3; and (2) the association between helmet type and incidence rate of TBI, severe TBI, and in-hospital mortality of motorcycle accidents based on the newly revised Emergency Department-based Injury In-depth Surveillance (EDIIS) data.
Methods
Data collected from EDIIS between January 1, 2020 and December 31, 2020 were analyzed. The final study population comprised 1,910 patients, who were divided into two groups: helmet wearing group and unhelmeted group. In addition, the correlation between helmet type and motorcycle accident was determined in 596 patients who knew the exact type of helmet they wore. A total of 710 patients who wore helmet but did not know the type were excluded from this analysis. Multivariate logistic regression was performed in both the groups to investigate the factors affecting the primary (occurrence of TBIs) and secondary outcomes (severe TBI and in-hospital mortality).
Results
The prevalence of Injury Severity Scores, TBIs, and severe TBIs as well as in-hospital mortality were the highest in the unhelmeted group. Additionally, the results from the group that wore and knew the type of helmet worn indicated that wearing a full-face helmet decreased the incidence of TBIs in comparison to a half-face helmet.
Conclusions
The wearing of a helmet in motorcycle accidents is very important as it plays a role in reducing the occurrence of TBIs and severe TBIs and in-hospital mortality. The use of a full-face helmet lowered the incidence of TBIs.

Summary

Citations

Citations to this article as recorded by

Helmet use in patients with severe traumatic brain injury: associations with Rotterdam CT score components, skull fractures, and cervical fractures
Christopher Ryalino, Joukje van der Naalt, Sebastiaan M. Bossers, Frank W. Bloemers, Dennis Den Hartog, Esther M.M. Van Lieshout, Nico Hoogerwerf, Stephan A. Loer, Lothar A. Schwarte, Patrick Schober, Anthony R. Absalom
Brain Injury.2026; 40(2): 107. CrossRef
Systematic review and meta-analysis of efficacy of helmet use and helmet laws to reduce mortality and cervical spine injury in adult motorcycle riders: A practice management guideline from the Eastern Association for the Surgery of Trauma
Asanthi M. Ratnasekera, Sirivan S. Seng, Stuart K. Gardiner, Caroline Butler, Anna Goldenberg-Sandau, Ning Lu, Hiba Abdel Aziz, Rachel D. Appelbaum, Hassan Mashbari, Shabnam Hafiz, Sharfuddin Chowdhury, Hahn Soe-Lin, John M. Reynolds, Amanda L. Teichman,
Journal of Trauma and Acute Care Surgery.2025; 99(4): 650. CrossRef

Needle Decompression for Trauma Patients: Chest Wall Thickness and Size of the Needle: Jeewan Kim, Jinwoo Jeong, Suck Ju Cho, Seokran Yeom, Sang Kyoon Han, Sungwook Park; J Korean Soc Traumatol. 2010;23(2):63-67.

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Abstract PDF: PURPOSE
A tension pneumothorax is a fatal condition that requires immediate intervention. Although a definitive treatment for a tension pneumothorax is a tube thoracostomy, needle decompression can provide temporary relief, that is lifesaving. The traditional procedure for needle decompression involves inserting a needle or catheter at the second intercostal space, the midclavicular line. Recent evidence suggests that the commonly used catheters do not have sufficiently penetrate the chest wall. There are also claims that a lateral approach to needle decompression is easier and safer than the traditional anterior approach. The purpose of this study is to evaluate the optimal approach for needle decompression for the Korean population by measuring chest wall thicknesses at the points used for both the anterior and the lateral approaches.
METHODS
The chest wall thickness (CWT) of trauma victims who visited the Emergency Center of Pusan National University Hospital was measured by computed tomography (CT) images. The CWT was measured at the points used for the anterior and the lateral methods and was compared with the length of commonly used catheters, which is 45 mm.
RESULTS
The mean CWT at the second intercostal space, the midclavicular line, was shorter than the CWT at the 5th intercostal space, the anterior axillary line. However, the percentage of patients whose CWT was greater than 45 mm was larger when measured anteriorly (8.2%) that when measure laterally (5.7%). Female patients and those older than 60 were more likely to have an anterior CWT greater than 45 mm (28.2% for females and 15.5% for those older than 60).
CONCLUSION
The percentage of trauma victims in Korea whose CWT is greater than 45 mm is lower than the values previously reported by other countries. However, females and older patients tend to have thicker chest walls, so the lateral approach would be suggested when performing needle decompression for such patients with suspected tension pneumothoraces.; Summary

Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma: Yong Myeon Park, Seok Ran Yeom, Jin Woo Jeong, Sang Kyun Han, Suck Ju Cho, Ji Ho Ryu, Yong In Kim, Sung Woon Chung; J Korean Soc Traumatol. 2009;22(1):5-11.

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Abstract PDF: PURPOSE
The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment.
METHODS
The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed.
RESULTS
The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis.
CONCLUSION
Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'critical pathway' to improve the outcomes of patients with blunt abdominal vascular injury.; Summary

Field Triage of Severely Injured Patients and Transportation by the EMS Rescue Group of Busan and Kyungnam, Korea: Is It Appropriate?: Jong Eon Lim, Seok Ran Yeom, Suck Ju Cho, Sang Kyun Han, Sung Wook Park, Sung Hwa Lee; J Trauma Inj. 2012;25(4):145-151.

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Abstract PDF: PURPOSE
The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea.
METHODS
The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol.
RESULTS
In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3.
CONCLUSION
We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.; Summary

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