Journal of Trauma and Injury

Byungchul Yu

4 Articles

Rectal Injury Associated with Pelvic Fracture: Jihun Gwak, Min A Lee, Byungchul Yu, Kang Kook Choi; J Trauma Inj. 2016;29(4):201-203. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.201

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Rectal injury is seen in 1-2% of all pelvic fractures, and lower urinary tract injury occurs in up to 7%. These injuries are rare, but if missed, can lead to a severe septic response. Rectal injury may be suspected by the presence of gross blood on digital rectal examination. However, this classic sign is not always present on physical examination. If an Antero-Posterior Compression type pelvic fracture is seen, we should consider the possibility of rectal and lower urinary tract injury. It is important to define the anatomic location of the rectal injury as it relates to the peritoneal reflection. Trauma to the intraperitoneal rectum should be managed as a colonic injury. Extraperitoneal rectal injury should be managed with fecal diversion regardless of primary repair. We present the case of a 46-year-old man who was referred to our hospital following a major trauma to the pelvis in a pedestrian accident.

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Rectal Perforation Associated with a Pelvic Fracture Managed with Lateral Caudal Axial Pattern Flap Surgery Using the Tail to Skin Defect in a Mixed-Breed Dog
Jongjin Lee, Jinsu Kang, Namsoo Kim, Suyoung Heo
Journal of Veterinary Clinics.2021; 38(5): 240. CrossRef

Blush on Computed Tomography and Transcatheter Arterial Embolization in Pelvic Fracture: Jihun Gwak, Yong Cheol Yoon, Min A Lee, Byungchul Yu, Myung Jin Jang, Kang Kook Choi; J Trauma Inj. 2016;29(4):161-166. Published online December 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.4.161

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Abstract PDF: PURPOSE
Bleeding is the primary cause of death after severe pelvic fracture. Transcatheter arterial embolization (TAE) is the mainstay of treatment for arterial bleeding. This study aimed to determine the frequency of bleeding by angiography of blush-positive pelvic fractures on computed tomography (CT) images. The bleeding arteries that were involved were investigated by pelvic angiography.
METHODS
This retrospective cohort study evaluated 83 pelvic fracture patients who were treated in the intensive care unit of the author's trauma center between January 01, 2013 and April 30, 2015.
RESULTS
Overall mortality was 9 of 83 patients (10.8%). Blush was observed in 37 patients; blush-positive patients had significantly higher mortality (24.3%) than blush-negative patients (0%). Twenty-four of the 83 patients (28.9%) underwent pelvic angiography. Bleeding was showed in 22 of 24 patients in pelvic angiography. TAE was successfully performed in 21 (95.5%) of the bleeding 22 patients. Angiography was performed in 23 of 37 blush-positive patients, and arterial bleeding was identified in 21 (91.3%). A total 33 bleeding arteries were identified in 22 angiography-positive patients. The most frequent origin of bleeding was internal iliac artery (69.7%) followed by the external iliac artery (18.2%) and lumbar arteries (12.1%).
CONCLUSION
The vascular blush observed in CT scans indicates sites of ongoing bleeding in pelvic angiography. TAE is an excellent therapeutic option for arterial bleeding and has a high success rate with few complications.; Summary

Analysis of KTDB Registered Trauma Patients from a Single Trauma Center in Korea: Byungchul Yu, Min Chung, Giljae Lee, Mina Lee, Jaejeong Park, Kangkook Choi, Sungyeol Hyun, Yangbin Jeon, Daesung Ma, Young Cheol Yoon, Jungnam Lee; J Trauma Inj. 2015;28(3):123-128. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.123

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PURPOSE
Establishment of the trauma system changed quality of trauma care in many countries. As one of the first designated level 1 trauma center in Korea, we analyzed trauma registration data in 2014.
METHODS
Data was extracted from Korean Trauma Data Base (KTDB) that was started from august 2013. Variables related to demographics and trauma was collected through the year 2014.
RESULTS
There were 3269 trauma patients who admitted to our hospital and registered to KTDB in 2014. Median age was 49 years, 64.4% were men, and 90% of patients were blunt in mechanism. Median injury severity score (ISS) was 5, mean revised trauma score (RTS) was 7.65. There were 138 (4.2%) deaths and 87 (2.7%) patients of them was death after admission.
CONCLUSION
This is the first report using KTDB registration from our institution. Trauma volume is appropriate but it should be compared with other trauma centers in Korea. In future national analysis of KTDB is mandatory.

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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
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
Journal of Trauma and Injury.2022; 35(4): 240. CrossRef
An analysis of missed injuries in patients with severe trauma
EunGyu Ju, Sun Young Baek, Sung Soo Hong, Younghwan Kim, Seok Hwa Youn
Journal of Trauma and Injury.2022; 35(4): 248. CrossRef

PARK Index for Preventable Major Trauma Death Rate: Chan Yong Park, Byungchul Yu, Ho Hyun Kim, Jung Joo Hwang, Jungnam Lee, Hyun Min Cho, Han Na Park; J Trauma Inj. 2015;28(3):115-122. Published online September 30, 2015; DOI: https://doi.org/10.20408/jti.2015.28.3.115

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Abstract PDF

PURPOSE
To calculate Preventable Trauma Death Rate (PTDR), Trauma and Injury Severity Score (TRISS) is the most utilized evaluation index of the trauma centers in South Korea. However, this method may have greater variation due to the small number of the denominator in each trauma center. Therefore, we would like to develop new indicators that can be used easily on quality improvement activities by increasing the denominator.
METHODS
The medical records of 1005 major trauma (ISS >15) patients who visited 2 regional trauma center (A center and B center) in 2014 were analyzed retrospectively. PTDR and PARK Index (Preventable Major Trauma Death Rate, PMTDR) were calculated in 731 patients with inclusion criteria. We invented PARK Index to minimize the variation of preventability of trauma death. In PTDR the denominator is all number of deaths, and in PARK Index the denominator is number of all patients who have survival probability (Ps) larger than 0.25. Numerator is the number of deaths from patients who have Ps larger than 0.25.
RESULTS
The size of denominator was 40 in A center, 49 in B center, and overall 89 in PTDR. The size of denominator was significantly increased, and 287 (7.2-fold) in A center, 422 (8.6-fold) in B center, and overall 709 (8.0-fold) in PARK Index. PARK Index was 12.9% in A center, 8.3% in B center, and overall 10.2%.
CONCLUSION
PARK Index is calculated as a rate of mortality from all major trauma patients who have Ps larger than 0.25. PARK Index obtain an effect that denominator is increased 8.0-fold than PTDR. Therefore PARK Index is able to compensate for greater disadvantage of PTDR. PARK Index is expected to be helpful in implementing evaluation of mortality outcome and to be a new index that can be applied to a trauma center quality improvement activity.

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Comparison of Outcomes at Trauma Centers versus Non-Trauma Centers for Severe Traumatic Brain Injury
Tae Seok Jeong, Dae Han Choi, Woo Kyung Kim
Journal of Korean Neurosurgical Society.2023; 66(1): 63. CrossRef
Comparison of Preventable Trauma Death Rates in Patients With Traumatic Brain Injury Before and After the Establishment of Regional Trauma Center: A Single Center Experience
Dae Han Choi, Tae Seok Jeong, Myung Jin Jang
Korean Journal of Neurotrauma.2023; 19(2): 227. CrossRef
PARK Index and S-score Can Be Good Quality Indicators for the Preventable Mortality in a Single Trauma Center
Chan Yong Park, Kyung Hag Lee, Na Yun Lee, Su Ji Kim, Hyun Min Cho, Chan Kyu Lee
Journal of Trauma and Injury.2017; 30(4): 126. CrossRef

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