Journal of Trauma and Injury

Original Articles

The characteristics and clinical outcomes of trauma patients transferred by a physician-staffed helicopter emergency medical service in Korea: a retrospective study: Myung Jin Jang, Woo Sung Choi, Jung Nam Lee, Won Bin Park; Received October 9, 2023 Accepted November 30, 2023 Published online February 23, 2024; DOI: https://doi.org/10.20408/jti.2023.0074 [Epub ahead of print]

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Abstract PDF: Purpose
Helicopter transport with medical teams has been proven to be effective, with improvements in patient survival rates. This study compared and analyzed the clinical characteristics and treatment outcomes of trauma patients transported by doctor helicopters according to whether patients were transferred after a clinical evaluation or without a clinical evaluation.
Methods
This study retrospectively reviewed data from the Korean Trauma Data Bank of trauma patients who arrived at a regional trauma center through doctor helicopters from January 1, 2014, to December 31, 2022. The patients were divided into two groups: doctor helicopter transport before evaluation (DHTBE) and doctor helicopter transport after evaluation (DHTAE). These groups were compared.
Results
The study population included 351 cases. At the time of arrival at the trauma center, the systolic blood pressure was significantly lower in the DHTAE group than in the DHTBE group (P=0.018). The Injury Severity Score was significantly higher in the DHTAE group (P<0.001), and the accident to trauma center arrival time was significantly shorter in the DHTBE group (P<0.001). Mortality did not show a statistically significant between-group difference (P=0.094). Surgical cases in the DHTAE group had a longer time from the accident scene to trauma center arrival (P=0.002). The time from the accident to the operation room or from the accident to angioembolization showed no statistically significant differences.
Conclusions
DHTAE was associated with significantly longer transport times to the trauma center, as well as non-statistically significant trends for delays in receiving surgery and procedures, as well as higher mortality. If severe trauma is suspected, air transport to a trauma center should be requested immediately after a simple screening test (e.g., mechanism of injury, Glasgow Coma Scale, or Focused Assessment with Sonography in Trauma), which may help reduce the time to definitive treatment.; Summary

The New Recreational Transportation on the Street: Personal Mobility, Is It Safe?: Young Woo Kim, Won Bin Park, Jin Seong Cho, Sung Youl Hyun, Geun Lee; J Trauma Inj. 2018;31(3):125-134. Published online December 31, 2018; DOI: https://doi.org/10.20408/jti.2018.040

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Purpose

The interest in the personal mobility started to grow and as the interest increases, there are growing concerns about the safety of it. The purpose of the study is to look at the types and dynamics of patients injured by the personal mobilities.

Methods

This was a retrospective 2-year observational study, from January 2016 to December 2017, on the patients who visited the emergency center and the trauma center, with an injury related to driving the personal mobility. Cases of the personal mobility-related accident were collected based on electronic medical records and hospital emergency department-based injury in-depth surveillance data.

Results

A total of 65 patients visited the emergency center and the trauma center, during this study period. Six patients of 50 adults admitted the alcohol consumption (12%) and two adult patients wore the helmet as the protection gear (3.1%). The number of the patients in 2017 rises three times more than the number of patients in 2016 (51 vs. 14). Injuries to the head and neck region (67.7%) was the most common, followed by the upper extremity (46.2%). Eleven patients (16.9%) were admitted to the hospital, of whom three were admitted to the intensive care unit due to intracranial hemorrhage. Nine patients underwent surgery.

Conclusions

The use of the personal mobility will continue to grow and the accidents, caused by the vehicle, will increase along with it. The study showed the damage is worse than expected. Personal mobility currently has a limited safety laws and the riders are not yet fully aware of its danger. The improvement of the regulation of the personal mobility, safety education is needed.

Summary

Citations

Citations to this article as recorded by

Critical risk factors associated with fatal/severe crash outcomes in personal mobility device rider at-fault crashes: A two-step inter-cluster rule mining technique
Reuben Tamakloe, Kaihan Zhang, Ahmed Hossain, Inhi Kim, Shin Hyoung Park
Accident Analysis & Prevention.2024; 199: 107527. CrossRef
Typological index of alleyways: mapping the pattern of a forgotten urban form element
Khaled Alawadi, Asim Khanal, Rawan Sohdy Abdelfattah
Journal of Urban Design.2023; 28(2): 199. CrossRef
Electric personal mobility device driver behaviors, their antecedents and consequences: A narrative review
Clément Laverdet, Pascal Malola, Thierry Meyer, Patricia Delhomme
Journal of Safety Research.2023; 86: 274. 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
Journal of Trauma and Injury.2022; 35(1): 3. CrossRef
Types of injuries caused by isolated electric scooter accidents
Kyongwon Yoo, Hyung Il Kim
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Khaled Alawadi, Asim Khanal, Azhar Doudin, Rahma Abdelghani
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Jason Qi Wei Kwek, Qin Xiang Ng, Amelia Justina Lim, Li Feng Ang, Shalini Arulanandam
Burns.2021; 47(4): 983. CrossRef
Where to Ride? An Explorative Study to Investigate Potential Risk Factors of Personal Mobility Accidents
Jihun Oh, Jeongseob Kim
International Journal of Environmental Research an.2021; 18(3): 965. CrossRef
Contextual risk factors in the use of electric kick scooters: An episode sampling inquiry
Kyung-Jun Lee, Chan Hyeok Yun, Myung Hwan Yun
Safety Science.2021; 139: 105233. CrossRef
Survey on e-Powered Micro Personal Mobility Vehicles: Exploring Current Issues towards Future Developments
Stefania Boglietti, Benedetto Barabino, Giulio Maternini
Sustainability.2021; 13(7): 3692. CrossRef
Identifying the Risk Factors in the Context-of-Use of Electric Kick Scooters Based on a Latent Dirichlet Allocation
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Applied Sciences.2020; 10(23): 8447. CrossRef
Challenges Caused by Increased Use of E-Powered Personal Mobility Vehicles in European Cities
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Sustainability.2019; 12(1): 273. CrossRef

Association between Helicopter Versus Ground Emergency Medical Services in Inter-Hospital Transport of Trauma Patients: Kyeong Guk Kang, Jin Seong Cho, Jin Ju Kim, Yong Su Lim, Won Bin Park, Hyuk Jun Yang, Geun Lee; J Trauma Inj. 2015;28(3):108-114. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.108

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Abstract PDF

PURPOSE
To improve outcome of severe trauma patient, the shortening of transport time is needed. Although helicopter emergency medical services (HEMS) is still a subject of debate, it must also be considered for trauma system. The aim of this study is to assess whether transport method (HEMS versus ground EMS) is associated with outcome among inter-hospital transport.
METHODS
All trauma patients transported to regional emergency center by either HEMS or ground EMS from September 2011 to September 2014. We have classified patients according to two groups by transport method. Age younger than 15 years and self-discharged patients were excluded.
RESULTS
A total of 427 patients were available for analysis during this period. 60 patients were transported by HEMS and 367 patients were transported by ground EMS. HEMS group had higher mortality than ground EMS group (23.3% vs 3.5%; p<0.001), and included more patients with excess mortality ratio adjusted injury severity score (EMR-ISS)above 25 (91.7% vs 48.8%; p<0.001). In the multivariable regression analysis, HEMS was not associated with improved outcome compared with ground EMS, but only EMR-ISS was associated with a mortality of patients (odds ratio, 1.06; 95% confidence interval, 1.04-1.09).
CONCLUSION
In this study, helicopter emergency medical services transport was not associated with a decreased of mortality among the trauma patients who inter-hospital transported to the regional emergency center.

Summary

Citations

Citations to this article as recorded by

Reduced Mortality in Severely Injured Patients Using Hospital-based Helicopter Emergency Medical Services in Interhospital Transport
Oh Hyun Kim, Young-Il Roh, Hyung-Il Kim, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Sung Oh Hwang, Kang Hyun Lee
Journal of Korean Medical Science.2017; 32(7): 1187. CrossRef

Analysis of Delayed Diagnosis of Pediatric and Adolescent Patients Injured by Minor Trauma: Jee Ahn Choi, Won Bin Park, Jin Joo Kim, Jin Sung Jo, Jae Kwang Kim, Yong Su Lim, Sung Youl Hyun, Ho Seong Jeong, Hyuk Jun Yang, Gun Lee; J Korean Soc Traumatol. 2009;22(2):212-217.

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Abstract PDF: PURPOSE
To analyze delayed diagnosis, we collected date on pediatric and adolescent patients who had been admitted to the Emergency Department with injuries due to minor trauma METHODS: We retrospectively analyzed the age distribution, trauma mechanism, time interval for each affected body region at delayed diagnosis, hospital stay, and outcome for 161 pediatric and adolescent patients who had been admitted to the Emergent Department of Gachon University Gil Hospital from January 2006 to September 2008.
RESULTS
The incidence of delayed diagnosis in pediatric and adolescent trauma was 11.8% in our retrospective review of 161 pediatric and adolescent patients. Lengths of hospitalization were longer in patients with delayed diagnosis (p<0.05). Patients with delayed diagnosis were more often transferred to other hospitals than patients with non-delayed diagnosis (p<0.05). The time intervals for each different affected body regions at delayed diagnosis were significantly different, but the hospital stays were not. There were no statistical significance to age on affected body region.
CONCLUSION
From this study, we found that admission result and hospital stay were statistically significant differences between the delayed-diagnosis patient group and the non-delayed-diagnosis patient group. Finally, we must follow up pediatric and adolescent patients with minor trauma, closely considering missed injuries.; Summary

Predictive Indicators for the Severity of Pediatric Trauma and the Prevention of Injuries According to the General Characteristics and Pre-hospital Factors of Severe Pediatric Trauma Patients: Jae Hyug Woo, Hyuk Jun Yang, Yong Su Lim, Jin Seong Cho, Jin Joo Kim, Won Bin Park, Jae Ho Jang, Gun Lee; J Trauma Inj. 2014;27(3):43-49.

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Abstract PDF: PURPOSE
Trauma is one of the most common causes of death for children, and identifying severely injured children quickly in an overcrowded emergency room (ER) is difficult. Therefore, severe injury must be prevented, and the severity of injuries in children must be determined easily from their general characteristics and pre-hospital factors.
METHODS
Injured children younger than 15 years of age who visited the ER from June 2011 to May 2013 were enrolled. According to the revised trauma score (RTS) of the patients, the study population was divided in two groups, a severe group (RTS<7) and a mild group (RTS> or =7). The general characteristics and the pre-hospital factors were compared between the two groups.
RESULTS
Six hundred seventy-three children were enrolled, their mean age was 8.03 (+/-4.45) years, and 476 (70.73%) patients were male. Of these patients, 22 patients (3.27%) were in the severe group, and 651 patients (96.73%) were in the mild group. Fewer males were in the severe group than in the mild group (50.00% vs. 71.43%, p=0.030), and children in the severe group were younger than children in the mild group (3.50 vs. 8.00 years, p=0.049). In the severe group, toddlers (54.55%, p=0.036) were the most common age group. Severe injuries occurred more often in spring (32.81%) and summer (54.56%) than in autumn (9.09%) and winter (4.55%) (p=0.026). The most common places of injury in the severe group were roads (50.00%, p=0.009), and the most common mechanisms of injury in the severe group were traffic accidents (50.00%), followed by falls (31.82%) (p=0.011). Most severely injured children were transferred by ambulance (72.73%, p=0.000).
CONCLUSION
The results of this study may be helpful for identifying severely injured children quickly in the field and the ER. To prevent severe pediatric injuries, precautions and policies based on these results should be established.; Summary

Original article

Survival Rate and Neurologic Outcome for Patients after Traumatic Cardiac Arrest: Shin Woong Park, Sung Youl Hyun, Jin Joo Kim, Yong Su Lim, Jin Sung Cho, Hyuk Jun Yang, Won Bin Park, Jae Hyug Woo, Jae Ho Jang; J Trauma Inj. 2013;26(3):190-197.

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Abstract PDF: PURPOSE
Trauma is one of the major cause of death in Korea. This study focused on the survival rate and the neurologic outcome for patients with traumatic cardiac arrest (CA) at one emergency center.
METHODS
We retrospectively reviewed the medical records of patients with traumatic CA who were seen at a regional emergency medical center from January 2010 to December 2011. From among major trauma patients at that medical center, adults older than 18 years of age who had CA were included in this study. CA included out-of-hospital CA with arrival at the Emergency Department (ED) within three hours and in-hospital CA. We checked the survival rate and the neurologic outcome.
RESULTS
A total of 61 patients were analyzed: 32 patients had return of spontaneous circulation (ROSC), 6 patients survived to discharge (survival rate: 9.84%), and 4 were still alive 90 days after discharge. The Cerebral performance category (CPC) scores at 6 months after discharge showed 1 good and 5 poor in neurologic outcomes. Factors such as initial rhythm of CA, part with major injury, Revised Trauma Score (RTS) and pH, were significant for ROSC, survival, and neurologic outcome in patients with traumatic CA.
CONCLUSION
In this study, patients who had traumatic CA showed a 9.84% survival rate and a 1.64% good neurologic outcome. The results are poorer than those for CA caused by disease. Multi-center, prospective studies are needed.; Summary

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