Journal of Trauma and Injury

Original Article

Patterns of penetrating trauma in New York City before, during, and after the COVID-19 pandemic: Elias Youssef, Bonny J. Baron, Andrew Sweeny, Hossein Kalantari, Roshanak Benabbas, Valery Roudnitsky, Donald Doukas, Hope A. Taitt, Nathanaens O. Estervil, Shahriar Zehtabchi; J Trauma Inj. 2026;39(1):52-59. Published online March 31, 2026; DOI: https://doi.org/10.20408/jti.2025.0196

2,074 View
18 Download

Abstract PDF: Purpose
The COVID-19 pandemic profoundly impacted multiple sectors of society, including healthcare. Major cities such as New York City (NYC) saw shifts in injury numbers and patterns during this period, underscoring the need to track these fluctuations to optimize resource allocation, improve trauma protocols, and inform public health policy. We examined trends in penetrating trauma in NYC before, during, and after the COVID-19 pandemic.
Methods
This retrospective cohort study used data from the NYC Health + Hospitals, which includes 11 acute care hospitals and trauma centers citywide. We analyzed electronic medical records from five level I trauma centers and one level II trauma center (pediatric level I) from August 1, 2019, to November 30, 2024. The study included patients with penetrating injuries and excluded minor-mechanism penetrating injuries or those incompatible with stab or gunshot mechanisms. Patients presenting for follow-up of prior injuries were excluded. The study timeframe was divided into three periods: pre–COVID-19 (August 1, 2019–February 29, 2020), COVID-19 (March 1, 2020–December 31, 2021), and post–COVID-19 (January 1, 2022–November 30, 2024). Descriptive statistics were used to summarize demographic and injury characteristics. Proportions are reported as percentages and continuous variables as medians with interquartile ranges (IQRs).
Results
Data for 9,118 patients were analyzed. Most were male (87.5%), with a median age of 30 years (IQR, 23–39 years). The incidence of penetrating trauma increased significantly during the COVID-19 period (164 cases per month) compared with pre–COVID-19 (110 cases per month) and post–COVID-19 (136 cases per month). Stab wounds were the most common injury type across all periods (53.7%).
Conclusions
Penetrating trauma cases increased notably during the COVID-19 pandemic in NYC, consistent with nationwide trends. Although not directly measured, socioeconomic stressors such as economic instability, social isolation, and substance abuse are plausible contributors to this increase.; Summary

Case Report

Delayed diagnosis of proximal ureter injury after a blunt abdominal trauma in Korea: a case report: Soon Ki Min, Byungchul Yu, Gil Jae Lee, Min A Lee, Yang Bin Jeon, Youngeun Park, Kang Kook Choi, Hyuk Jun Yang; J Trauma Inj. 2024;37(3):243-246. Published online September 3, 2024; DOI: https://doi.org/10.20408/jti.2024.0016

3,741 View
49 Download

Abstract PDF: Traumatic ureteral injuries account for fewer than 1% of traumatic urologic injuries, and those caused by blunt trauma are even rarer than those caused by penetrating trauma. The symptoms associated with ureteral injury may be subtle, with or without hematuria, making it difficult to diagnose. We report the case of a 31-year-old man with a delayed diagnosis of proximal ureter injury after abdominal blunt trauma sustained in a motorcycle traffic accident. The patient underwent emergency laparotomy on admission for liver injury, mesenteric injury, and resultant hemoperitoneum. On postoperative day 6, he underwent angioembolization for suspected remnant intra-abdominal bleeding. Persistent symptoms of flank pain and leukocytosis led to follow-up imaging studies that revealed proximal ureter injury, and the patient underwent unilateral nephrectomy. This case stresses the importance of clinical suspicion for genitourinary injuries in the presence of abdominal trauma.; Summary

Original Article

Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study: Youngmin Kim, Byungchul Yu, Se-Beom Jeon, Seung Hwan Lee, Jayun Cho, Jihun Gwak, Youngeun Park, Kang Kook Choi, Min A Lee, Gil Jae Lee, Jungnam Lee; J Trauma Inj. 2023;36(3):224-230. Published online December 21, 2022; DOI: https://doi.org/10.20408/jti.2022.0055

5,961 View
98 Download

Abstract PDF: Purpose
Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.
Methods
Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.
Results
Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.
Conclusions
Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.; Summary

Case Reports

Nonoperative management of colon and mesocolon injuries caused by blunt trauma: three case reports: Naa Lee, Euisung Jeong, Hyunseok Jang, Yunchul Park, Younggoun Jo, Jungchul Kim; J Trauma Inj. 2022;35(4):291-296. Published online September 19, 2022; DOI: https://doi.org/10.20408/jti.2022.0009

8,944 View
104 Download
1 Citations

Abstract PDF

The therapeutic approach for colon injury has changed continuously with the evolution of management strategies for trauma patients. In general, immediate laparotomy can be considered in hemodynamically unstable patients with positive findings on extended focused assessment with sonography for trauma. However, in the case of hemodynamically stable patients, an additional evaluation like computed tomography (CT) is required. Surgical treatment is often required if prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation are observed. However, immediate intervention in hemodynamically stable patients without indications for surgical treatment remains questionable. Three patients with colon and mesocolon injuries caused by blunt trauma were treated by nonoperative management. At the time of admission, they were alert and their vital signs were stable. Colon and mesocolon injuries, large hematoma, colon wall edema, and/or ischemia were revealed on CT. However, no prominent mesenteric extravasation, free fluid, bowel infarction, and/or colon wall perforation were observed. In two cases, conservative treatment was performed without worsening abdominal pain or laboratory tests. Follow-up CT showed improvement without additional treatment. In the third case, follow-up CT and percutaneous drainage were performed in considering the persistent left abdominal discomfort, fever, and elevated inflammatory markers of the patient. After that, outpatient CT showed improvement of the hematoma. In conclusion, nonoperative management can be considered as a therapeutic option for mesocolon and colon injuries caused by blunt trauma of selected cases, despite the presence of large hematoma and ischemia, if there are no clear indications for immediate intervention.

Summary

Citations

Citations to this article as recorded by

Isolated mesocolon injury and sigmoid colon necrosis secondary to abdominal blunt trauma
Imen Ben Ismail, Mohamed Karim Tounsi, Marwen Sghaier, Mohamed Boujemaa, Hakim Zenaidi, Ayoub Zoghlami
Trauma Case Reports.2025; 58: 101208. CrossRef

Successful management of a common carotid artery injury using a Pruitt-F3 Carotid Shunt: a case report: Kang Kook Choi, Jayun Cho, Min A Lee, Soo Min Eun, Yang Bin Jeon; J Trauma Inj. 2022;35(Suppl 1):S3-S7. Published online May 25, 2022; DOI: https://doi.org/10.20408/jti.2021.0032

7,658 View
126 Download
1 Web of Science
2 Citations

Abstract PDF

Penetrating neck injuries are a surgical challenge. In particular, penetrating neck injuries associated with carotid artery injuries have a high mortality rate. Overt external hemorrhage is unanimously considered as an indication for surgical exploration. The authors present a case of successful surgical management for a penetrating common carotid artery injury using a Pruitt-F3 Carotid Shunt (LeMaitre Vascular Inc., Burlington, MA, USA) in a 60-year-old male patient who was transferred to the level 1 trauma center due to a metal fragment piercing his neck while working. Active pulsatile bleeding was observed from the 3-cm-long external wound on the anterior neck in zone II. Emergent neck exploration showed near-total transection of the left common carotid artery just below the carotid bifurcation. After a Pruitt-F3 Carotid Shunt was applied to the injured carotid artery as a temporary vascular shunt, artificial graft interposition was performed for the injured common carotid artery. The patient experienced cerebral infarction as a complication caused by ischemia-reperfusion of the common carotid artery but was discharged in a suitable state for rehabilitation therapy.

Summary

Citations

Citations to this article as recorded by

Damage Control Surgery for Wartime Carotid Artery Injuries: Interaction Between Role 2 and Role 3 Facilities in Ukraine and a Clinical Case Series Analysis
Ihor Rusanov, Dmytro Mialkovskyi, Iurii Mikheiev, Roman Kuziv, Kostiantyn Gumeniuk, Serhii Machuskyi, Alex Valadka, Rocco A. Armonda
EJVES Vascular Forum.2026; 65: 107. CrossRef
One-Stage Endovascular-to-Open Repair for Traumatic Common Carotid Artery (CCA) Pseudoaneurysm: Expanding the Hybrid Treatment Landscape
Alexander T Daskalov, Boris Ilchev
Cureus.2025;[Epub] CrossRef

Penetrating sacral injury with a metallic pipe: a case report and literature review: Mahnjeong Ha, Kyoung Hyup Nam, Jae Hun Kim, In Ho Han; J Trauma Inj. 2022;35(2):131-138. Published online May 11, 2022; DOI: https://doi.org/10.20408/jti.2021.0063

11,161 View
108 Download
1 Web of Science
1 Citations

Abstract PDF

Other than gunshot injuries, sacral penetrating injuries with a foreign body exiting to the other side are extremely rare. We encountered a case of sacral injury in which a long metallic pipe penetrated from the anus into the lower back of a patient. Since the pelvis contains various organs, management of a penetrating injury requires multidisciplinary treatment involving several medical specialties. Due to the infrequency of this type of injury, there are no definitive guidelines for effective management. We described our experience surgically treating a sacral penetrating injury and conducted a literature review. On this basis, we suggest a surgical strategy for treating this type of injury.

Summary

Citations

Citations to this article as recorded by

Delayed Diagnosis of Pyogenic Spondylitis After Impalement by Steel Rods: Case Report
Myoung Soo Kim, Seok Hwa Youn, Seonpyo Jang
Korean Journal of Neurotrauma.2026; 22(3): 285. CrossRef

Traumatic abdominal wall hernia with hemoperitoneum caused by blunt injury: laparoscopic exploration with mini-laparotomy repair. A case report: Euisung Jeong, Hyunseok Jang, Younggoun Jo, Yunchul Park, Naa Lee, Jungchul Kim; J Trauma Inj. 2022;35(1):61-65. Published online December 23, 2021; DOI: https://doi.org/10.20408/jti.2021.0062

10,600 View
99 Download
3 Citations

Abstract PDF

Traumatic abdominal wall hernia is a very rare clinical entity. Herein, we report the case of a patient who was transferred from a local clinic to the emergency department because of left lower abdominal pain. Initially, an intra-abdominal hematoma was observed on computed tomography and no extravasation was noted. Conservative treatment was initiated, and the patient’s symptoms were slightly relieved. However, though abdominal pain was relieved during the hospital stay, bowel herniation was suspected in the left periumbilical area. Follow-up computed tomography showed traumatic abdominal wall hernia with hemoperitoneum in the abdomen. We performed a laparoscopic exploration of the injury site and hernia lesion. The anterior abdominal wall hernia was successfully closed.

Summary

Citations

Citations to this article as recorded by

Traumatic abdominal wall hernia associated with a cow horn in Korea: a case report
Hwajin Shin, Chan Yong Park
Journal of Acute Care Surgery.2025; 15(2): 82. CrossRef
Traumatic hernia associated with Morel-Lavallé lesion in closed abdominal trauma: case report
Leonel L. Lugo, César I. G. Ramírez, Laura A. De la M. Marrufo
International Surgery Journal.2025; 12(11): 1987. CrossRef
Unique laparoscopic emergency management of traumatic obstructed abdominal wall hernia: A case report and review of literature
Arwa M. Aljuhani, Ghaith A. Al Saied, Arjmand Reyaz, Mohammed A. Alkahlan, Ibrahim M. Aljohani, Muhammed M. Abukhater
International Journal of Abdominal Wall and Hernia.2024; 7(3): 139. CrossRef

Emergency Repair Using Cervico-median Sternotomy for Cervicothoracic Penetrating Injury: Hyun Joo Lee, Hyun Koo Kim, Young Ho Choi; J Korean Soc Traumatol. 2008;21(2):136-139.

2,112 View
6 Download

Abstract PDF: A great variety of penetrating injuries is happening due to the increasing population and violence today. An optimal surgical approach is the key factor for successful repair of a complicated penetrating injury. A 23-yearold woman fell down the stairs from the second floor and received cervico-thoracic penetration injury due to a metalic bar. The metalic bar ruptured the right jugular vein and penetrated the left upper and lower lung. Under cervico-median sternotomy, neck vessels were repaired and the left thorax was successfully entered to repair the damaged lung through the mediastinal pleura. With this approach, the patient's position did not need to be changed during operation, while reduced the operation time compared to the conventional approach (cervical incision and standard thoracotomy).; Summary

Original Article

Difference in Management Between Native Koreans and Foreigners with Penetrating Wounds In the Emergency Room: Yong Kwan Kim, Yong Soo Jang, Gu Hyun Kang, Jung Tae Choi, Hoo Jeon, Jin Ho Kim; J Korean Soc Traumatol. 2010;23(2):102-106.

1,900 View
6 Download

Abstract PDF: PURPOSE
With the increasing numbers of foreign residents in Korea, the need for an emergency medical care system for foreign patients seems to be growing. Sometimes, a foreigner admitted to an emergency room is not treated sufficiently due to the absence of insurance, facility in the Korean language, and a guardian. The management of a foreigner with trauma in the ER is difficult due to various problems such as social and economic status. The purpose of this study was to investigate the current management status of foreigners with penetrating wounds in the emergency room.
METHODS
This study is an analysis of 580 patients that were diagnosed with penetrating wounds in one teaching Hospital from Jan. 1, 2008 to Dec. 31, 2008. We analyzed results according to nationality, alcohol ingestion, intentional or accidental trauma, trauma mechanism, injury severity, management time in the ER, and outcome in the ER.
RESULTS
Of the total 580 patients, 486 patients (83.8%) were native Koreans and 94 patients (16.2%) were foreigners. According to the Revised Trauma Score, the average score of native Korean patients was 7.808, and the average score of foreign patients was 7.638. Of native Korean patients, 22.6% had knife wounds while 38.3% of foreign patients did. Of native Korean patients, 17.3% experienced intentional trauma while 33.0% of the foreign patients did. Of native Korean patients, 22.5% had ingested alcohol while 49.4% of the foreigners had. Of native Korean patients, 10.5% were admitted while 7.6% of the foreign patients were. Of native Korean patients, 14.2% were discharged against medical advice (DAMA), while 18.5% of foreign patients were. Of native Korean patients, 1.2% ran away while 8.7% of the foreign patients did.
CONCLUSION
Stabbing was the most common cause of penetrating wounds in foreigner patients in this study. Intentional trauma was more common in foreigners with penetrating wounds than in native Koreans. The severity was higher in foreigners with penetrating wounds than it was in native Koreans, and patients who ran away or were discharged against medical advice were more commonly foreigners with penetrating wounds. Social insurance or policy is needed for the management of foreigners with penetrating wounds.; Summary

First
Prev
Page of 1
Next
Last

Search