Journal of Trauma and Injury

Original Articles

Correlation of base deficit and age shock index with in-hospital mortality in geriatric major trauma patients: a 1-year retrospective study at a single level I trauma center in Indonesia: Miftahul Khairat Musmar Elbama, M. Iqbal Rivai, Irwan , Avit Suchitra, Aulia Rahman, Rose Dinda Martini; J Trauma Inj. 2025;38(3):204-210. Published online September 3, 2025; DOI: https://doi.org/10.20408/jti.2025.0021

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Abstract PDF: Purpose
Base deficit (BD) and age shock index have been utilized as an indicator of resuscitation adequacy and a predictor of poor outcomes in trauma cases, respectively. However, evidence regarding their correlation with in-hospital mortality among geriatric major trauma patients remains scarce in the literature.
Methods
This analytical observational study employed a retrospective cohort design involving 82 geriatric major trauma patients treated at our institution between November 2023 and November 2024. Data were collected from patients’ medical records at admission (age, trauma mechanism, vital signs, Glasgow Coma Scale [GCS], Injury Severity Score, hemoglobin, BD, and comorbidities) and at discharge (survival or death).
Results
The geriatric major trauma patients who experienced in-hospital mortality were predominantly male, with an average age of 69.6 years. Traffic accidents constituted the most common trauma mechanism. Most patients presented with a GCS score between 13 and 15, and hypertension was the most frequently recorded comorbidity. BD demonstrated a significant correlation with in-hospital mortality (P<0.05). Severe BD was associated with the highest odds of in-hospital mortality (adjusted odds ratio, 40.72; 95% confidence interval, 2.90–560.86). Although age shock index did not directly correlate with mortality, it played a confounding role. Additionally, a GCS score of <9 was significantly correlated with in-hospital mortality (P<0.05).
Conclusions
The findings of this study can inform initial clinical management strategies for geriatric major trauma patients at trauma centers. Prompt resuscitation and treatment should be prioritized for patients presenting with moderate or severe BD to reduce preventable mortality in this population.; Summary

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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2 Citations

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

Clinical implications of the newly defined concept of ventilator-associated events in trauma patients: Tae Yeon Lee, Jeong Woo Oh, Min Koo Lee, Joong Suck Kim, Jeong Eun Sohn, Jeong Hwan Wi; J Trauma Inj. 2022;35(2):76-83. Published online December 24, 2021; DOI: https://doi.org/10.20408/jti.2021.0064

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Abstract PDF: Purpose
Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator- associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support.
Methods
In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality.
Results
Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46–17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m2 had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32–14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30–14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013).
Conclusions
Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m2 on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.; Summary

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