Journal of Trauma and Injury

Original Articles

Changes in severe injuries of child and adolescent pedestrians in child protection zones after the revision of the Road Traffic Act in Korea: a retrospective nationwide observational study: Eun Sook Ryu, Jae Ho Jang, Jae Yeon Choi, Woo Sung Choi, Sung Youl Hyun; J Trauma Inj. 2025;38(4):366-372. Published online December 31, 2025; DOI: https://doi.org/10.20408/jti.2025.0255

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Abstract PDF: Purpose
This study aimed to analyze changes in injury severity among child pedestrians following the implementation of the revised Road Traffic Act (the "Minsik Law") in Korea’s child protection zones on March 25, 2020.
Methods
We conducted a retrospective analysis using the nationwide Emergency Department-based Injury In-depth Surveillance (EDIIS) database. The pre-amendment period (January 2018 to February 2020; n=1,480) was compared with the post-amendment period (March 2021 to December 2023; n=1,085) for pedestrian accident patients under 13 years of age, applying a 1-year washout period to mitigate the effects of the COVID-19 pandemic. The primary outcome was severe injury, defined as an Injury Severity Score (ISS) of ≥15. Multivariate logistic regression was used for the assessment.
Results
A total of 2,565 patients were included. The proportion of severe injuries (ISS ≥15) decreased from 63.1% to 53.6% after the amendment, although this trend did not reach statistical significance (P=0.085). However, after adjustment for age, sex, and other variables, multivariate analysis showed that the post-amendment period was independently associated with a significant 38.4% reduction in the odds of severe injury (adjusted odds ratio, 0.616; P<0.001). A significant shift in the distribution of injury sites was also noted (P<0.005).
Conclusions
The revision of the Road Traffic Act was significantly associated with reduced injury severity among child pedestrians in Korea. These findings provide strong evidence supporting the policy’s effectiveness in improving clinical outcomes and strengthening child safety.; Summary

Use of the Obstetric Early Warning Score in emergency triage for pregnant trauma patients: a retrospective cross-sectional study on a tool for early hospitalization decision-making: Figen Topalak, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Kadir Nigiz, Mehmet Gorur, Ali İsa Aslan, Ihsan Dengiz; J Trauma Inj. 2026;39(1):25-33. Published online December 29, 2025; DOI: https://doi.org/10.20408/jti.2025.0104

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Abstract PDF: Purpose
Traumatic injuries during pregnancy present significant challenges for emergency providers, necessitating rapid assessment to ensure the safety of both mother and fetus. Scoring systems that can be applied immediately upon presentation may facilitate early triage and inform disposition decisions. This study evaluated the predictive performance of the Obstetric Early Warning Score (OEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) in determining hospitalization needs among pregnant trauma patients admitted to the emergency department (ED).
Methods
This retrospective cross-sectional study included pregnant trauma patients aged 18 years or older who were admitted to a tertiary care ED between January 2019 and December 2022. Demographic, clinical, laboratory, and trauma-related data were collected. OEWS, ISS, and RTS were calculated at admission. The primary outcome was the requirement for hospitalization. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess predictive performance.
Results
A total of 316 pregnant trauma patients were included. Hospitalization was required in 14.9% of cases. Higher OEWS (mean, 2.63 vs. 0.33; P=0.001) and ISS (mean, 18.02 vs. 5.04; P<0.001) were significantly associated with hospitalization. In multivariate analysis, OEWS (odds ratio [OR], 1.553; 95% confidence interval [CI], 1.087–2.219; P=0.016) and ISS (OR, 1.170; 95% CI, 1.083–1.264; P<0.001) were independent predictors of hospitalization. ROC analysis demonstrated that ISS had the highest predictive value (area under the curve, 0.783; 95% CI, 0.695–0.870; P<0.001).
Conclusions
Both ISS and OEWS are effective tools for predicting hospitalization needs in pregnant trauma patients. Incorporating these scoring systems into ED triage protocols may enhance early identification of high-risk patients and improve outcomes for both mothers and fetuses.; Summary

Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea: Hongrye Kim, Mou Seop Lee, Su Young Yoon, Jonghee Han, Jin Young Lee, Junepill Seok; J Trauma Inj. 2024;37(2):114-123. Published online May 9, 2024; DOI: https://doi.org/10.20408/jti.2023.0087

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Purpose
Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients.
Methods
Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma.
Results
In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively)
Conclusions
Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.

Summary

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Evaluation and Proposed Refinement of the Thoracic Trauma Severity Score: Improving Prognostic Accuracy in Blunt Chest Trauma Including Polytrauma Patients
Noha Mohamed Ashraf Fouda, Nour El-Din Noaman Gwely, Gehad Ibrahim Awad, Mohammed Abdelfattah Sanad
European Journal of Cardio-Thoracic Surgery.2026;[Epub] CrossRef
Accurate, fair, and generalisable scaling of injury severity score-based AI with demographics in terms of mortality in patients with trauma: multi-centre, multi-national retrospective cohort study
Yunjeong Choi, Junepill Seok, Thomas Young-Chul Oh, Jeremy Hsu, Do Wan Kim, Byungchul Yu, Jayun Cho, Woocheol Jang, Jina Kim, Na-eun Oh, Jehyeuk Ahn, Robert J. Femia, Paul A. Testa, Dong Keon Yon, Daniel K. Sodickson, Wu Seong Kang, Jinseok Lee
eBioMedicine.2026; 126: 106206. CrossRef
Development and validation of a prediction model for respiratory complications and in-hospital mortality in trauma patients
Do Wan Kim, Dongjin Yeo, Juyeong Kim, Yerin Hwang, Hyunjee Kim, Seung Ha Hwang, Jaeyu Park, Jinseok Lee, Jaehyeong Cho, Selin Woo, Junepill Seok, Byungchul Yu, Youngmin Kim, Sebeom Jeon, Dong Keon Yon, Wu Seong Kang
Scientific Reports.2026;[Epub] CrossRef
Clinical and instrumental diagnosis of combined fractures of the clavicle and ribs
O.A. Burianov, V.Р. Kvasha, M.V. Кrаvchuk, D.V. Miasnikov
EMERGENCY MEDICINE.2025; 21(8): 800. CrossRef
Clinical prediction models for the management of blunt chest trauma in the emergency department: a systematic review
Ceri Battle, Elaine Cole, Kym Carter, Edward Baker
BMC Emergency Medicine.2024;[Epub] CrossRef

The practicality of interleukin-6 in prognosis of blunt chest trauma in Korea: a retrospective study: Jeong Woo Oh, Tae Yeon Lee, Minjeong Chae; J Trauma Inj. 2023;36(2):114-120. Published online December 8, 2022; DOI: https://doi.org/10.20408/jti.2022.0050

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Abstract PDF

Purpose
There are many studies on the practicality of interleukin-6 (IL-6) as a prognostic predictor in patients with multiple severe traumas. However, few studies focus on the practicality of IL-6 in patients with chest trauma. So, this study investigated whether IL-6 is effective as a prognostic factor in patients with blunt chest trauma.
Methods
A total of 44 blunt chest trauma patients who visited the regional trauma center from July to December 2021 were included in this retrospective study. Blood IL-6 levels were measured immediately after emergency room admittance (IL-6 E) and 24 hours after trauma (IL-6 24). To determine whether IL-6 levels can predict the clinical course and prognosis of patients with blunt chest trauma, the correlation between IL-6 (IL-6 E and IL-6 24) and the trauma score system, Injury Severity Score, Thoracic Trauma Severity Score, and Pulmonary Contusion Score, intensive care unit (ICU) stay period, and total hospitalization period were analyzed.
Results
IL-6 E showed a good correlation with Injury Severity Score (P=0.505), Thoracic Trauma Severity Score (P=0.597), Pulmonary Contusion Score (P=0.493), ICU stay period (P=0.762), and total hospitalization period (P=0.662). However, IL-6 24 had a relatively low correlation compared to IL-6 E. Therefore, IL-6 E showed useful results for predicting the prognosis of patients with blunt chest trauma.
Conclusions
Early plasma IL-6 levels (IL-6 E) can predict the injury severity of blunt chest trauma, length of ICU stay, and total hospitalization period.

Summary

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Comprehensive analysis of cytokines as predictors of multi-organ dysfunction syndrome in patients with trauma: a prospective observational study
In Sik Shin, Myoung Jun Kim, Md Habibur Rahman, Cheol-Su Kim, Kwangmin Kim
Molecular & Cellular Toxicology.2026; 22(1): 47. CrossRef
Prognostic role of serum interleukin-6 levels in polytrauma patients: a comprehensive narrative review
Nicola Madani, Sereen Halayqeh, Hebah Almahariq, Ahmad Al-Badawi, Mohammad Alomari, Bassem Haddad
Journal of Trauma and Injury.2026; 39(1): 4. CrossRef

Changes in incidence and severity of commercial motorcycle accidents due to the use of delivery service platforms in Korea: a retrospective cohort study: Dam Moon, Jae Ho Jang, Jin Seong Cho, Jae Yeon Choi, Jae-hyug Woo, Woo Sung Choi, Sung Yeol Hyun, Seung Hwan Lee; J Trauma Inj. 2023;36(2):121-127. Published online September 19, 2022; DOI: https://doi.org/10.20408/jti.2022.0031

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Abstract PDF

Purpose
Recently, a sharp increase in the use of delivery services has led to an increase in motorcycle accidents. This study aimed to identify the characteristics of the commercial motorcycle injured patients and factors related to the severity during the past 10 years.
Methods
Patients (15–64 years old) who visited the emergency department with commercial motorcycle accidents injury registered in the Korean Emergency Department-based Injury In-depth Surveillance (2011–2020) database, were included. All included cases were categorized into two groups according to the period: group 1 (2011–2015) and group 2 (2016–2020). General characteristics and the factors associated with severity were investigated.
Results
Among 8,123 emergency department visits, patients in group 1 were 3,071, and patients in group 2 were 5,052. The odds for severity were affected by patients age (odds ratio [OR], 1.008; 95% confidence interval [CI], 1.004–1.013), and overnight/morning (00:00–12:00; OR, 1.243; 95% CI, 1.091–1.415). The odds for severity were higher in head and neck injury (OR, 8.357; 95% CI, 7.410–9.424) and torso injury (OR, 4.122; 95% CI, 3.610–4.708). The odds for the severity of accidents based on excess mortality ratio-adjusted Injury Severity Score (EMR-ISS) after 2015 were significant (OR, 1.491; 95% CI, 1.318–1.687). Hospitalization in the intensive care unit and death were associated with accidents after 2015 (OR, 2.593; 95% CI, 2.120–3.170).
Conclusions
Commercial motorcycle accidents have increased significantly over the past decade. There were statistical differences in severity based on EMR-ISS and the hospitalization in intensive care unit and death.

Summary

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Accident characteristics of professional versus regular two-wheeler riders in France and the UK: insights from national crash databases
Wei Wei, Zhengwei Ma, Jianhao Shen, Guoming Deng, Céline Vernet, Lionel Thollon
Accident Analysis & Prevention.2026; 230: 108476. CrossRef
The Epidemiology and Pattern of Orthopaedic Injuries Caused by Delivery Motorbike Accidents (DMBA) at a South African Tertiary Hospital
Sibusiso M.D. Nzimande, Falethu M. Sukati
The Open Public Health Journal.2025;[Epub] CrossRef

An analysis of missed injuries in patients with severe trauma: EunGyu Ju, Sun Young Baek, Sung Soo Hong, Younghwan Kim, Seok Hwa Youn; J Trauma Inj. 2022;35(4):248-254. Published online September 14, 2022; DOI: https://doi.org/10.20408/jti.2022.0017

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Abstract PDF

Purpose
To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys.
Methods
We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1, 2019 to June 30, 2021.
Results
In trauma patients with an Injury Severity Score ≥16 accounted for 38.0% in the non-missed injury group (non-MIG), but this rate was considerably higher at 71.2% in MIG. The mean hospitalization longer in MIG (50.90±39.56) than in non-MIG (24.74±26.11). The proportion of patients with missed injuries detected through tertiary trauma survey (TTS) was 28 patients (23.5%) within 24 hours, 90 patients (75.6%) after 24 hours to before discharge. The majority of missed injuries were fractures (82.4%) and ligament tears (8.4%), which required consultation with the orthopedic department. The final diagnoses of missed injuries were confirmed by computed tomography (44.5%), magnetic resonance imaging (19.3%), X-ray (19.3%), bone scan (11.8%), and physical examination (5.0%).
Conclusions
TTS is considered a useful process for detecting missed injuries that were not identified at the time of initial resuscitation in the primary and secondary surveys. In the future, to detect missed injuries quickly, it is necessary to develop a suitable TTS program for each trauma center. In addition, further research is needed to verify the effectiveness of the protocolized TTS and survey chart to improve the effectiveness of TTS.

Summary

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Factors contributing to missed injuries in patients with trauma: Polytrauma and night-time presentation at the trauma resuscitation unit
Uido Yeo, Younghwan Kim, Mina Kim, Youngwoong Kim, Jinho Jheong, Gaesung Ha, Lina Ryu, Eun Gyu Ju, Seok Hwa Youn
Injury.2026; 57(1): 112814. CrossRef
Delayed Diagnosis of an Ipsilateral Patellar Fracture in an Open Segmental Tibial Fracture Managed With Ilizarov External Fixation: A Case Report
Md Sulaiman
Cureus.2026;[Epub] CrossRef
More than meets the eye: the continuing importance of tertiary trauma survey even in moderate (ISS 9–15) trauma
Chris Knight, Joshua Richard Burke, Simon Hind, Stella Ruth Smith
Injury.2026; : 113370. CrossRef
Clinical outcomes of trauma tertiary surveys conducted by allied health and non-medical healthcare professionals: A scoping review
Khang Duy Ricky Le, Annie Jiao Wang, Jovy Carpio
Injury.2025; 56(7): 112402. CrossRef
Missed injuries in trauma care: An analysis of mechanisms and prevention of one of the surgeon's worst nightmares
Lucas Fontenelle Vieira, Aarnav Grover, Jose Gustavo Parreira, Thomas Scalea, Marcelo A.F. Ribeiro
Injury.2025; 56(8): 112600. CrossRef
Elbow Trauma in the Polytraumatized Patient
Alexandra M. Arguello, Jonathan D. Barlow
Hand Clinics.2025; 41(4): 387. CrossRef
Tertiary Trauma Survey on Emergency Department Observational Units: A Systematic Literature Review
Tamkeen Pervez, Mehreen Malik
Cureus.2024;[Epub] CrossRef

Initial assessment of hemorrhagic shock by trauma computed tomography measurement of the inferior vena cava in blunt trauma patients: Gun Ho Lee, Jeong Woo Choi; J Trauma Inj. 2022;35(3):181-188. Published online June 10, 2022; DOI: https://doi.org/10.20408/jti.2021.0066

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Abstract PDF: Purpose
Inferior vena cava (IVC) collapse is related to hypovolemia. Sonography has been used to measure the IVC diameter, but there is variation depending on the skill of the operator and it is difficult to obtain accurate measurements in patients who have a large amount of intestinal gas or are obese. As a modality to obtain accurate measurements, we measured the diameters of the IVC and aorta on trauma computed tomography scans and investigated the correlation between the IVC to aorta ratio and the shock index in blunt trauma patients.
Methods
We retrospectively analyzed the medical records of 588 trauma patients who were transferred to the regional trauma center (level 1) of Wonkang University hospital from March 2020 to February 2021. We included trauma patients 18 years or older who met the trauma activation criteria and underwent trauma computed tomography scans with intravenous contrast within 40 minutes of admission. The shock index was calculated from vital signs before trauma computed tomography scan, and measurements of the anteroposterior diameter of the IVC (AP), the transverse diameter of the IVC (T), and aorta were made 10 mm above the right renal vein in the venous phase.
Results
Overall, 271 patients were included in this study, of whom 150 had a shock index ≤0.7 and 121 had a shock index >0.7. The T to AP ratio and AP to aorta ratio were significantly different between groups. Cutoffs were identified for the T to AP ratio and AP to aorta ratio (2.37 and 0.62, respectively) that produced clinically useful sensitivity and specificity for predicting a shock index >0.7, demonstrating moderate accuracy (T to AP ratio: area under the curve, 0.71; sensitivity, 59%; specificity, 87% and AP to aorta ratio: area under the curve, 0.70; sensitivity, 55%; specificity, 91%).
Conclusions
The T to AP ratio and AP to aorta ratio are useful for predicting hemorrhagic shock in trauma patients.; Summary

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

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Abstract PDF 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

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The Effect of Osteopathic Visceral Manipulation on Quality of Life and Postural Stability in Women with Endometriosis and Women with Pelvic Organ Prolapse: A Non-Controlled Before–After Clinical Study
Małgorzata Wójcik, Małgorzata Kampioni, Zuzana Hudáková, Idzi Siatkowski, Witold Kędzia, Grażyna Jarząbek-Bielecka
Journal of Clinical Medicine.2025; 14(3): 767. CrossRef

Impact of obesity on the severity of trauma in patients injured in pedestrian traffic accidents: Pillsung Oh, Jin-Seong Cho, Jae Ho Jang, Jae Yeon Choi, Woo Sung Choi, Byungchul Yu; J Trauma Inj. 2022;35(4):240-247. Published online December 8, 2021; DOI: https://doi.org/10.20408/jti.2021.0050

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Abstract PDF

Purpose
Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents.
Methods
This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m². An Injury Severity Score of 25 or greater was considered to indicate a critical injury.
Results
In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01–2.48) compared with nonobese patients.
Conclusions
Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

Summary

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Early identification of high-risk older two-wheeler riders: A dual-sample approach for 30-day mortality prediction
Ming-Chuan Hsu, Ya-Hui Chang, Chung-Yi Li, I-Lin Hsu, Chung-Shun Wong, Ping-Ling Chen, Hon-Ping Ma
Accident Analysis & Prevention.2026; 224: 108298. CrossRef
Development and validation of a prediction model for respiratory complications and in-hospital mortality in trauma patients
Do Wan Kim, Dongjin Yeo, Juyeong Kim, Yerin Hwang, Hyunjee Kim, Seung Ha Hwang, Jaeyu Park, Jinseok Lee, Jaehyeong Cho, Selin Woo, Junepill Seok, Byungchul Yu, Youngmin Kim, Sebeom Jeon, Dong Keon Yon, Wu Seong Kang
Scientific Reports.2026;[Epub] CrossRef
Pregnancy is associated with more severe injuries from motor vehicle crashes
Ya-Hui Chang, Yu-Wen Chien, Chiung-Hsin Chang, Ping-Ling Chen, Tsung-Hsueh Lu, Chung-Yi Li
Journal of the Formosan Medical Association.2024; 123(8): 849. CrossRef
Obesity as a Risk Factor for Adverse Outcomes After Pedestrian Trauma Accidents in the Pediatric Population
Hannah Mulvihill, Katie Roster, Nisha Lakhi
Pediatric Emergency Care.2024; 40(7): 498. CrossRef
Changes in incidence and severity of commercial motorcycle accidents due to the use of delivery service platforms in Korea: a retrospective cohort study
Dam Moon, Jae Ho Jang, Jin Seong Cho, Jae Yeon Choi, Jae-hyug Woo, Woo Sung Choi, Sung Yeol Hyun, Seung Hwan Lee
Journal of Trauma and Injury.2023; 36(2): 121. CrossRef

Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea: Maro Kim, Dongbum Suh, Jin Hee Lee, Hyuksool Kwon, Yujin Choi, Joo Jeong, Sola Kim, Soyun Hwang, Joong Wan Park, You Hwan Jo; J Trauma Inj. 2022;35(1):3-11. Published online October 28, 2021; DOI: https://doi.org/10.20408/jti.2021.0044

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Purpose
The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR=3.88; 95% confidence interval [CI] 1.33–11.36) and operating an ePMD while intoxicated (AOR=2.78; 95% CI 1.52–5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

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A Hybrid Brake System for e-Scooters: Design, Optimization, and Performance-Validation Study of Axial Flux Eddy-Current Brake With Halbach Array
Gilsu Choi, Gwan-Hui Jang
IEEE Access.2026; 14: 16233. CrossRef
Exploring e-scooter riders’ risky behaviour: survey, observation, and interview study
Young Woo Kim, Seul Chan Lee, Sol Hee Yoon
Ergonomics.2025; 68(9): 1371. CrossRef
Assessing bicycle helmet protection for head and neck in E-scooter falls
Nicolas Bailly, Andreas Schäuble, Marianne Guesneau, Wei Wei, Yvan Petit
Traffic Injury Prevention.2025; 26(7): 866. CrossRef
Retrospective analysis of nonfatal skeletal injuries sustained in road incidents involving electric scooters
Maxim S. Siedin, Semyon S. Plis, Vladimir A. Klevno, Aleksandr V. Maksimov, Alexander A. Plashchinskiy
Russian Journal of Forensic Medicine.2024; 10(2): 160. CrossRef
The epidemiology and outcomes of severe road traffic injury by road user type in Korea: A nationwide retrospective observational study
Gyeongmin Lee, Jeong Ho Park, Seung Chul Lee, Sanghun Lee, Kyoung Jun Song, Sang Do Shin
Injury.2024; 55(10): 111732. CrossRef
Helmet wearing and related factors among electric personal mobility device users in Korea
Eunbi Kim, Taehun Kim, Sojeong Park, Sohyun Park, Juhwan Park, Junhyeok Lee, Junhyung Lee, Mi Ah Han
Health Promotion International.2024;[Epub] CrossRef
Types of injuries caused by isolated electric scooter accidents
Kyongwon Yoo, Hyung Il Kim
Journal of Trauma and Injury.2022; 35(4): 232. CrossRef

Characteristics and Outcomes of Patients with Bicycle-Related Injuries at a Regional Trauma Center in Korea: Yoonhyun Lee, Min Ho Lee, Dae Sang Lee, Maru Kim, Dae Hyun Jo, Hyosun Park, Hangjoo Cho; J Trauma Inj. 2021;34(3):147-154. Published online June 4, 2021; DOI: https://doi.org/10.20408/jti.2020.0066

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Abstract PDF

Purpose

We analyzed the characteristics and outcomes of patients with bicycle-related injuries at a regional trauma center in northern Gyeonggi Province as a first step toward the development of improved prevention measures and treatments.

Methods

The records of 239 patients who were injured in different types of bicycle-related accidents and transported to a single regional trauma center between January 2017 and December 2018 were examined. This retrospective single-center study used data from the Korea Trauma Database.

Results

In total, 239 patients experienced bicycle-related accidents, most of whom were males (204, 85.4%), and 46.9% of the accidents were on roads for automobiles. Forty patients (16.7%) had an Injury Severity Score (ISS) of 16 or more. There were 125 patients (52.3%) with head/neck/face injuries, 97 patients (40.6%) with injuries to the extremities, 59 patients (24.7%) with chest injuries, and 21 patients (8.8%) with abdominal injuries. Patients who had head/neck/face injuries and an Abbreviated Injury Score (AIS) ≥3 were more likely to experience severe trauma (ISS ≥16). In addition, only 13 of 125 patients (10.4%) with head/neck/face injuries were wearing helmets, and patients with injuries in this region who were not wearing helmets had a 3.9-fold increased odds ratio of severe injury (AIS ≥2).

Conclusions

We suggest that comprehensive accident prevention measures, including safety training and expansion of safety facilities, should be implemented at the governmental level, and that helmet wearing should be more strictly enforced to prevent injuries to the head, neck, and face.

Summary

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Characteristics of Bicycle-Related Maxillofacial Injuries Between 2019–2023—Retrospective Study from Poznan, Poland
Kacper Nijakowski, Szymon Rzepczyk, Maria Szczepaniak, Jakub Majewski, Jakub Jankowski, Czesław Żaba, Maciej Okła
Journal of Clinical Medicine.2025; 14(17): 6075. CrossRef

Characteristics of Traffic Accidents on Highways: An Analysis Based on Patients Treated at a Regional Trauma Center: Sung Yong Lee, Kyung Hoon Sun, Chan Yong Park, Tae Hoon Kim; J Trauma Inj. 2021;34(4):263-269. Published online June 4, 2021; DOI: https://doi.org/10.20408/jti.2020.0063

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Abstract PDF

Purpose

There have been increasing concerns about serious traffic accidents on highways. The purpose of this study was to analyze factors affecting traffic accidents on highways and the severity of the resulting injuries.

Methods

This retrospective study was conducted at a regional trauma center. We reviewed 594 patients who had been in 114 traffic accidents on highways from January 2018 to June 2020. We collected demographic data, clinical data, accident-related factors, and meteorological data (weather and temperature).

Results

Environmental risk factors were found to be significantly associated with the incidence of traffic accidents on highways. Injury severity and the death rate were higher in sedans than in any other type of vehicle. Tunnels were the most common location of accidents, accounting for 47 accidents (41.2%) and 269 injured patients (45.3%). The injury severity of individuals riding in the driver’s seat (front seat) was high, regardless of vehicle type. Three meteorological risk factors were found to be significantly associated with traffic accidents: rainy roads (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.84–3.29; p=0.01), icy or snowy roads (OR 5.12; 95% CI 2.88–7.33; p<0.01), and foggy conditions (OR 2.94; 95% CI 2.15–4.03; p<0.05).

Conclusions

The injury severity of patients was affected by seat position and type of vehicle, and the frequency of accident was affected by the location. The incidence of traffic accidents was strongly influenced by meteorological conditions (rain, snow/ice, and fog).

Summary

Citations

Citations to this article as recorded by

Spatial variability of fog formation thresholds influenced by terrain and land cover using road CCTV-derived observations
Chaeyeon Yi, Taeseok Kim, Byungdo Heo, SeongIn Kang
Journal of Climate Change Research.2026; 17(1): 35. CrossRef
What are the individual and joint impacts of key meteorological factors on the risk of unintentional injuries? A case-crossover study of over 147,800 cases from a sentinel-based surveillance system
Xiao Lin, Tian Tian, Congxing Shi, Pengyu Wang, Shimin Chen, Tong Guo, Zhiqiang Li, Boheng Liang, Wangjian Zhang, Pengzhe Qin, Yuantao Hao
Sustainable Cities and Society.2023; 91: 104413. CrossRef

The Suitability of the CdC field Triage for Korean Trauma Care: Kang Kook Choi, Myung Jin Jang, Min A Lee, Gil Jae Lee, Byungchul Yoo, Youngeun Park, Jung Nam Lee; J Trauma Inj. 2020;33(1):13-17. Published online March 30, 2020; DOI: https://doi.org/10.20408/jti.2020.013

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Abstract PDF

Purpose

Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea.

Methods

This retrospective cohort study evaluated trauma patients who presented at the authors’ regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step.

Results

Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively.

Conclusions

The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Summary

Citations

Citations to this article as recorded by

Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
Journal of Korean Medical Science.2024;[Epub] CrossRef
Prehospital triage in emergency medical services system: A scoping review
Kisook Kim, Booyoung Oh
International Emergency Nursing.2023; 69: 101293. CrossRef
Assessment of the Suitability of Trauma Triage According to Physiological Criteria in Korea
Gil Hwan Kim, Jae Hun Kim, Hohyun Kim, Seon Hee Kim, Sung Jin Park, Sang Bong Lee, Chan Ik Park, Dong Yeon Ryu, Kang Ho Lee, Sun Hyun Kim, Na Hyeon Lee, Il Jae Wang
Journal of Acute Care Surgery.2022; 12(3): 120. CrossRef

Factors and Their Correlation with Injury Severity of Elderly Pedestrian Traffic Accidents: Tae gyu Hyun, Seok-Ran Yeom, Sung-Wook Park, Deasup Lee, Hyung bin Kim, Il Jae Wang, Byung Gwan Bae, Min keun Song, Youngmo Cho; J Trauma Inj. 2019;32(3):143-149. Published online September 30, 2019; DOI: https://doi.org/10.20408/jti.2019.022

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Abstract PDF

Purpose

No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions.

Methods

This study used data from the Emergency Department-based Injury In-depth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ≥65 years were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity.

Results

Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034?1.313, p=0.012). Older age of patients and the use of ambulances were associated with greater injury severity. The accident time affected the degree of injury severity; i.e., compared to dawn, injury severity increased in the morning (OR: 1.246, p=0.047) and decreased at night (OR: 0.678, p<0.001). A significant difference was noted in the correlation between the type of vehicle causing the accident and the accident severity; i.e., motorcycle accidents had lower severity than bicycle accidents (OR: 0.582, p=0.047).

Conclusions

Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.

Summary

Citations

Citations to this article as recorded by

Unveiling the Severity of Pedestrian Traffic Crashes in South Australia: Age-based Insights and Safety Implications
Ali Soltani, Ahmed Jaber, Hamed Najafi Kashkooli, Madiha Bencekri
Injury.2025; 56(11): 112716. CrossRef

Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital: Kyoung Hwan Kim, Sung Ho Han, Soon-Ho Chon, Joongsuck Kim, Oh Sang Kwon, Min Koo Lee, Hohyoung Lee; J Trauma Inj. 2019;32(1):1-7. Published online March 31, 2019; DOI: https://doi.org/10.20408/jti.2018.054

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Abstract PDF: Purpose
The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region.
Methods
We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups.
Results
No significant differences were found in the annual patients’ average age (54.1±20.0 vs. 52.8±18.2, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: ?0.358, ?0.271 vs. post-trauma group: 1.071, 0.958).
Conclusions
There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.; Summary

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