- Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management
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Joung Won Na, Jung Nam Lee, Byung Chul Yu, Min A Lee, Jae Jung Park, Gil Jae Lee
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J Trauma Inj. 2017;30(3):91-97. Published online October 30, 2017
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DOI: https://doi.org/10.20408/jti.2017.30.3.91
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The prognostic factors of non-operative management (NOM) in high-grade spleen injuries have been extensively studied, but factors that would help treatment decisions are lacking. We compared the characteristics of the patients to identify the factors affecting treatment choices. METHODS This is a review of 207 blunt spleen injury patients from January 2004 to December 2013. We compared clinical features and mortality between surgery and NOM, and used multivariate regression analysis to find the factor most strongly associated with prognosis. RESULTS Of the 207 patients, 107 had high-grade spleen injury patents (grade III or above). Of these, 42 patients underwent surgery and 65 patients underwent NOM. The mortality was 7% following surgery, 3% with NOM. The amount of packed red blood cells transfused in the first 24 hours and spleen injury grade were associated with management type, and mortality was highly associated with activated partial thromboplastin time (aPTT) and spleen injury grade. CONCLUSIONS The grade of spleen injury was associated with management and mortality, so correctly assessing the spleen injury grade is important.
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- Characteristics of Korean Trauma Patients: A Single-center Analysis Using the Korea Trauma Database
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Youngeun Park, Min Chung, Gil Jae Lee, Min A Lee, Jae Jeong Park, Kang Kook Choi, Sung Youl Hyun, Yang Bin Jeon, Dae Sung Ma, Yong Cheol Yoon, Jungnam Lee, Byungchul Yoo
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J Trauma Inj. 2016;29(4):155-160. Published online December 31, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.4.155
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Two years have passed since a level I trauma center was officially opened in the Gacheon Gil Hospital, South Korea. We analyzed 2014 and 2015 registered patient data from the Korean Trauma Data Base (KTDB) to identify trends in trauma patient care and factors that influence the quality of trauma care at the Gacheon Gil trauma center. METHODS Data was extracted from the KTDB included patient age, sex, systolic blood pressure at emergency room arrival, revised trauma score, injury severity score, trauma injury severity score, transfusion amount, and the cause of death was analyzed. RESULTS A total of 3269 trauma patients were admitted to our trauma center in 2014 and 3225 in 2015. Demographics and mechanism of injury were not significantly different between years. The severity of trauma injury was decreased in 2015 although the mortality rate was slightly increased. This requires further analysis. CONCLUSION The aim of this study was to determine the general status and trends in trauma incidence and management outcomes for the Incheon area. We noted no significant changes in trauma status from 2014 to 2015. We need to collect and review trauma patient data over a long period in order to elucidate trauma incidence and management trends in the trauma field. Finally, studies using trauma patient data will indicate appropriate quality control factors for trauma care and help to improve the quality of trauma management.
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- Associated Injuries in Spine Trauma Patients: A Single-Center Experience
Seunghan Yu, Hyuk Jin Choi, Jung Hwan Lee, Byung Chul Kim, Mahnjeong Ha, In Ho Han Journal of Trauma and Injury.2020; 33(4): 242. CrossRef
- Right Diaphragmatic Injury Accompanied by Herniation of the Liver: A Case Report
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Min A Lee, Kang Kook Choi, Gil Jae Lee, Byung Chul Yu, Dae Sung Ma, Yang Bin Jeon, Jung Nam Lee, Min Chung
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J Trauma Inj. 2016;29(2):43-46. Published online June 30, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.2.43
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- Traumatic diaphragmatic injury (TDI) occurs in 1% of patients of blunt abdominal trauma. Most TDIs involve the left diaphragm, however the authors experienced TDI accompanied by a liver laceration of the right diaphragm. When detected early, TDI can be easily treated, however serious complications can occur if not. When diaphragmatic injury is suspected due to clinical manifestation, comprehensive analysis of the patient data including radiologic findings is important.
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- A Blunt Traumatic Vertebral Artery Injury: A Case Report
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Min A Lee, Kang Kook Choi, Gil Jae Lee, Byung Chul Yu, Dae Sung Ma, Yang Bin Jeon, Min Chung, Jung Nam Lee
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J Trauma Inj. 2016;29(1):28-32. Published online March 31, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.1.28
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- Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.
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- Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report
Rathna Paramaswamy Journal of Dental Anesthesia and Pain Medicine.2018; 18(3): 183. CrossRef
- Three-year Analysis of Patients and Treatment Experiences in the Regional Trauma Center of Gachon University Gil Hospital between 2011 and 2013
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Yong Cheol Yoon, Jung Nam Lee, Min Chung, Yang Bin Jeon, Jae Jeong Park, Byung Chul Yu, Gil Jae Lee, Hyun Jin Cho, Dae Sung Ma, Min A Lee, Jung Ju Choi, Seong Son
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J Trauma Inj. 2014;27(4):170-177.
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The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. METHODS The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. RESULTS The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of > or =16. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. CONCLUSION A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.
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- Traumatic Lumbar Hernia: Report of a Case
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Gil Jae Lee, Min Chung, Byung Chul Yu
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J Trauma Inj. 2013;26(3):222-225.
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- The occurrence of traumatic hernia is rare. However, traumatic lumbar hernias are the most frequently occurring traumatic hernias. Superior lumbar hernias occur more frequently than inferior lumbar hernias, but for anatomical reasons, among traumatic lumbar hernias, inferior lumbar hernias occur more frequently than superior lumbar hernias. Repair of a lumbar hernia is very difficult. Mesh fixation to the bony part and general weakness of surrounding tissue make repair of a lumbar hernia tricky. A traumatic lumbar hernia was repaired using transfascial fixation around the defect to secure the mesh. This technique is another choice for a lumbar hernia technique.
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- The Usefulness of the Admission Base Deficit as a Marker of Mortality in Severely Injured Patients with Blunt Trauma
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Byung Chul Yu, Min Chung, Gil Jae Lee, Jung Nam Lee
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J Trauma Inj. 2013;26(1):1-5.
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The base deficit (BD) at admission in severely injured patients has been shown to predict the adequacy of resuscitation and outcome, but this relationship is not well established in the Korean experience. The purpose of this study was to define the association between arterial blood gas (ABG) values and the mortality for patients with severe blunt trauma at a developing trauma center in Korea. METHODS A retrospective review of 415 adult patients with severe blunt trauma was conducted using electronic medical records from Jan. 2010 to Dec. 2011. RESULTS A total of 256 patients had ABG drawn within 1 hour of arrival. Patients who expired displayed a higher lactate level (4.86 vs. 3.31, p<0.0001), a worse BD (-7.99 vs. -5.37, p=0.001), and a lower pH (7.31 vs. 7.34, p=0.011) at arrival compared with those who survived. A statistically significant association was also observed between BD and blood product usage (p=0.001). CONCLUSION The base deficit at admission is a useful marker of mortality and outcome in severely injured patients with blunt trauma in Korea.
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