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- Could the Injury Severity Score be a new indicator for surgical treatment in patients with traumatic splenic injury?
- HyeJeong Jeong, SungWon Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Sung Min Jung, Heungman Jun, Yong Chan Shin, Eunhae Um
- J Trauma Inj. 2022;35(3):189-194. Published online May 30, 2022
- DOI: https://doi.org/10.20408/jti.2021.0065
- 1,949 View
- 67 Download
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Abstract
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Supplementary Material - Purpose
The purpose of this study was to determine whether a higher Injury Severity Score (ISS) could serve as an indicator of splenectomy in patients with traumatic splenic lacerations.
Methods
A total of 256 cases of splenic laceration were collected from January 1, 2005 to December 31, 2018. After the application of exclusion criteria, 105 were eligible for this study. Charts were reviewed for demographic characteristics, initial vital signs upon presentation to the emergency room, Glasgow Coma Scale, computed tomography findings, ISS, and treatment strategies. The cases were then divided into nonsplenectomy and splenectomy groups for analysis.
Results
When analyzed with the chi-square test and t-test, splenectomy was associated with a systolic blood pressure lower than 90 mmHg, a Glasgow Coma Scale score lower than 13, active bleeding found on computed tomography, a splenic laceration grade greater than or equal to 4, and an ISS greater than 15 at presentation. However, in multivariate logistic regression analysis, only active bleeding on computed tomography showed a statistically significant relationship (P=0.014).
Conclusions
Although ISS failed to show a statistically significant independent relationship with splenectomy, it may still play a supplementary role in traumatic splenic injury management. -
Summary
- The Prognosis of Traumatic Small Bowel Injury Accompanied by Liver Injury
- Yu Seong Noh, Sung Won Jung, Tae Gil Heo, Pyong Wha Choi, Jae Il Kim, Heung Man Jun, Yong Chan Shin, Sung Min Jung, Eun Hae Um
- J Trauma Inj. 2021;34(1):44-49. Published online December 7, 2020
- DOI: https://doi.org/10.20408/jti.2020.0052
- 8,424 View
- 99 Download
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Abstract
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Purpose The aim of this study was to elucidate the prognosis, and other clinical features, such as time to surgery and the amount of transfusion, of small bowel injury (SBI) accompanied by liver injury (LI).
Methods We investigated 221 patients with SBI who visited an emergency center from October 2000 to March 2019. We excluded patients with injuries that directly led to mortality, and the remaining 149 patients were divided into the SBI alone (SBI-A) group and the SBI accompanied by LI (SBI-LI) group. Data were collected for preoperative and surgical outcome variables, and the treatment results were compared between groups.
Results The SBI-LI group had a higher mortality rate than the SBI-A group (22.4% vs. 14.3%), but this difference was not statistically significant (
p =0.061). There were no significant differences between the SBI-A and SBI-LI groups, except for the amount of red blood cell (RBC) transfusion (SBI-A: 3.53±0.1 vs. SBI-LI: 8.38±0.7 packs,p =0.035) and the length of intensive care unit (ICU) stay (SBI-A: 6.7±0.2 vs. SBI-LI: 11.1±0.5 days,p =0.047).Conclusions The SBI-LI group required more RBC transfusions and longer ICU stays than the SBI-A group. SBI accompanied by LI may show higher mortality than SBI alone; however, since the difference was not statistically significant in the present study, larger-scale follow-up research is needed.
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Summary
- Optimal Insertion Angle between the Skin and Needle in Ultrasound-Guided Internal Jugular Vein Catheterization with Trauma Patients
- Hyun Min Jeon, Sung Min Jung, Ru Bi Jung, Jin Jeon, Chong Kun Hong, Tae Yong Shin, Young Rock Ha, Young Sik Kim
- J Trauma Inj. 2013;26(3):183-189.
- 1,393 View
- 2 Download
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Abstract
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- PURPOSE
The aim of this study was to identify the optimal insertion angle between the skin and the needle in ultrasound-guided internal jugular vein (IJV) catheterization with trauma patients.
METHODS
From March 2012 to December 2012, consecutive trauma patients who were planned to receive IJV catheterization were prospectively enrolled. We measured the distances from the skin to IJV's anterior-posterior (AP) vessel wall on the longitudinal scan's midline in supine-positioned patients. We calculated the AP diameter of IJV and the angle between skin and the imaginary line from the puncture site to the IJV's internal center on screen's midline (defined as optimal angle which is considered as the safest approach) on the longitudinal scan. We divided the patients into 3 groups based on the CVP (low CVP <5 cmH2O, 5< or = middle CVP < or =10 cmH2O, and high CVP>10 cmH2O) and compared their mean anterior posterior (AP) diameters and optimal angles.
RESULTS
A total of 56 patients were enrolled. Of these 21 were women(35.4%). The mean AP diameter of low CVP group was significantly lower than middle and high CVP groups(0.68+/-0.30, 1.06+/-0.31, and 1.23+/-0.49 cm respectively, p=0.003 vs. 0.002). There was no significant difference among 3 groups' mean optimal angles (28.1+/-6.1, 30.1+/-4.5, and 28.0+/-5.0 degree respectively).
CONCLUSION
The optimal angle between the skin and the needle in ultrasound-guided IJV catheterization with trauma patients is not changed as about 30 degrees regardless of CVP even though IJV's diameter is altered in proportion to the CVP. -
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