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Journal of Trauma and Injury 2012;25(4):152-158.
A Nationwide Study on the Epidemiology of Head Trauma and the Utilization of Computed Tomography in Korea
So Young Park, Jae Yun Jung, Young Ho Kwak, Do Kyun Kim, Dong Bum Suh
Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea. dongbumes@naver.com
건강보험심사평가원 환자표본자료를 이용한
국내 두부손상의 역학 및 뇌 CT 시행 분석
박소영∙정재윤∙곽영호∙김도균∙서동범
서울대학교 의과대학 응급의학교실
Received: 24 August 2012   • Revised: 28 August 2012   • Accepted: 23 October 2012
Abstract
PURPOSE
To understand the epidemiology of head trauma and the utilization of brain CT in Korea, we analyzed a national sampling data set, the National Patient Sample obtained from the Health Insurance Review and Assessment Service.
METHODS
We retrospectively collected and analyzed demographic and clinical data on enrolled patients from the National Patient Sample based on medical claims data for 2009. The data included patient's age, sex, treatment date, diagnosis codes, procedure codes related with CT, holiday or night consultation fee, and fee for emergency management services.
RESULTS
In 2009, the estimated population with head trauma was 819,059(1.8%), and the rate of brain CT utilization was 22.4%. Children ages 5 to 15 were the most commonly injured group(22.8%), but had the lowest brain CT utilization(16.5%). The mean age of the estimated population with head trauma was 34.9+/-0.5 years old, and male patients accounted for 60.5% of that population. Intracranial injury was found in 8.6% of all head traumas, and the rate of intracranial injury in children was lower than it was in adults(4.1% vs. 10.9%, p<0.001). Twenty-three percent of patients with head trauma visited the emergency department (ED). More patients with head trauma visited medical facilities in the daytime on weekdays(66.5% vs. 33.5%, p<0.001), but head CT was performed more frequently at night or on weekends/holidays(16.1% vs. 34.7%, p<0.001). There is low incidence of head trauma in the winter in children (p<0.001). In the multivariate logistic regression analysis, patients who were adults, female, or ED visitors were more likely to undergo brain CT (odds ratio (OR): 1.65, 95% confidence interval (CI): 1.47-1.84; OR: 1.40, 95% CI: 1.27-1.54; OR: 7.80, 95% CI: 6.91-8.80, respectively).
CONCLUSION
In this study, we analyzed the national epidemiologic trend for head trauma, and the pattern of utilization of brain CT.
Key Words: Head trauma; Brain CT; the National Patient Sample; Nationwide
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