- The Risk Factors for Developing Contrast-induced Nephropathy after the Evaluation of Trauma Patients at a Regional Trauma Center in Korea
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Yoo Mi An, Soon Chang Park, Hyung Bin Kim, Young Mo Cho, Dae Seop Lee, Yong In Kim, Sang Kyun Han
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J Trauma Inj. 2016;29(4):124-128. Published online December 31, 2016
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DOI: https://doi.org/10.20408/jti.2016.29.4.124
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 Abstract
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- PURPOSE
Computed tomography (CT) with intravenous (IV) contrast is an important step in the evaluation of trauma patients; however, the risk factors for contrast-induced nephropathy (CIN) in these patients remain unclear. This study determined the rate of CIN in trauma patients at a regional trauma center in Korea and identified the risk factors for developing CIN.
METHODS
We retrospectively reviewed the medical records of 138 patients for the patient demographics, creatinine levels, and vital signs. CIN was defined as an increase in creatinine by 0.5 mg/dL from admission after undergoing CT with IV contrast.
RESULTS
Of the patients, 7.2% developed CIN during their admission after receiving IV contrast for CT. In the multivariate analysis, only the creatinine level at presentation (Adjusted odds ratio [aOR], 5.944; 95% confidence interval [CI], 1.486-23.733; p=0.012) and an injury severity score (ISS) greater than 22 (aOR, 1.096; 95% CI, 1.021-1.176; p=0.011) were independently associated with the risk of CIN.
CONCLUSION
CIN is uncommon in trauma patients following CT with IV contrast. The creatinine level at presentation and ISS were independent risk factors for developing CIN in trauma patients.
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Summary
- The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion
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Ho Hyung Jung, Sang Kyoon Han, Sung Wha Lee, Sung Wook Park, Soon Chang Park, Seok Ran Yeom, Moon Gi Min, Yong In Kim, Ji Ho Ryu
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J Trauma Inj. 2014;27(4):108-114.
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Abstract
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- PURPOSE
Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion.
METHODS
This study was performed retrospectively with severe traumatic patients (Injury Severity Score> or =16) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013.
RESULTS
In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group (BAC< or =30 mg/dl) is 56 (57.10%)patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups.
CONCLUSION
In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.
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Summary
- Correlation Between Pulmonary Contusion and Myocardial Contusion in Patients with Multiple Injuries
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Ji Ho Ryu, Seok Ran Yeom, Jin Woo Jeong, Mun Ki Min, Maeng Real Park, Yong In Kim, Sang Kyun Han, Sung Wook Park
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J Korean Soc Traumatol. 2011;24(1):31-36.
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Abstract
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- PURPOSE
This study was conducted to evaluate the correlations among pulmonary contusion severity, trauma score and cardiac troponin I (cTnI) level.
METHODS
We prospectively evaluated patients with multiple injuries who had been admitted to the emergency department (ED) from July 2007 to July 2008. We first measured the total creatinine kinase (CK), the MB fraction of CK (CK-MB), TnI, and myoglobin within 2 hours after the injury. We then checked the electrocardiogram, x-ray, and computed tomography (CT) results. Finally, we assessed the injuries as variables and then compared the results for patients with elevated TnI levels (group A) and patients whose TnI levels fell within the normal range (group B).
RESULTS
Eighty-six of the 92 patients admitted to the ED were enrolled. The pulmonary contusion score (PCS) was well correlated with PaO2/FiO2. TnI levels were correlated with PCS. When TnI levels were above 0.86 ng/ml, the mortality was estimated with 100% sensitivity and 86.1% specificity.
CONCLUSION
Pulmonary contusion severity is correlated with TnI level. When the PCS is high and the cTnI level is elevated in multiple-injury patients, we recommend continuous cardiac monitoring and further evaluation.
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Summary
- Effect of the Emergency Trauma Team's Management on the Treatment of Patients with Multiple Severe Trauma
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Seong Hwa Lee, Suck Joo Cho, Seok Ran Yeom, Ji Ho Ryu, Jin Woo Jung, Sang Kyun Han, Yong In Kim, Maeng Real Park, Young Dae Kim
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J Korean Soc Traumatol. 2009;22(2):172-178.
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Abstract
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- PURPOSE
We performed this study to determine how the emergency trauma team affects the treatment of patients with multiple severe trauma and to discuss the effect and the direction of the emergency trauma team's management.
METHODS
We performed a retrospective analysis of 518 patients who visited our emergency department with severe trauma from August 2006 to July 2008. We divided the severe trauma patients into 2 groups : patients before and after trauma team management (Group 1 and Group 2). Then, we compared demographic characteristics, mechanisms of injury, and treatment outcomes (lengths of stay in the ED, admission ratio, and in-hospital mortality) between the 2 groups. In the same way, patients with multiple severe trauma were divided into 2 groups, that are patients before and after trauma team management (Group 3 and Group 4) and analyzed.
RESULTS
There was no significant difference, except mean age, between groups 1 and 2. In group 4 patients, compared to group 3 patients, the lengths of stay in the ED were lower (p value < 0.001), and the admission ratio were higher (p value = 0.017), but there was no significant difference in the in-hospital mortality between the groups 3 and 4.
CONCLUSION
When patients with multiple severe trauma visit the ED, the emergency trauma team's management can decrease the lengths of stay in the ED and increase the admission ratio, but does not produce a decrease in the in-hospital mortality rate. Further investigations of emergency trauma team management are needed to improve treatment outcomes for patients with multiple severe trauma.
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Summary
- Clinical Characteristics of Patients Treated in an Emergency Center for Vascular Trauma
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Yong Myeon Park, Seok Ran Yeom, Jin Woo Jeong, Sang Kyun Han, Suck Ju Cho, Ji Ho Ryu, Yong In Kim, Sung Woon Chung
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J Korean Soc Traumatol. 2009;22(1):5-11.
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Abstract
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- PURPOSE
The mortality and the amputation rates due to vascular trauma remain high despite advanced vascular surgical techniques and supportive management. The clinical features of patients with vascular trauma have not been well studied in the Korean population. The aim of this study was to analyze the clinical characteristics of patients with vascular trauma and to develop a database and guidelines for improving the outcomes of treatment.
METHODS
The medical records of 37 patients with traumatic vascular injuries who had visited in an emergency center between January 2002 and December 2006 were retrospectively reviewed and statistically analyzed.
RESULTS
The mean age was 37.8 years, and the male-to-female ratio was 5.2 : 1. The mechanism of vascular trauma was penetrating in 18 patients and blunt in 19 patients. Upper extremities were most frequently injured (39.4%). The treatment methods were primary repair in 21 patients, exploratory laparotomies in 7, radiological interventions in 3, resections and graft interpositions of the pseudoaneurysm in 3, observations in 3 and a bypass graft in 1. Four out of the 37 patients died, and three of these who died had injuried abdominal vessels. Twenty-five of the patients recovered completely, four expired, seven had neuropathy in the course of treatement, one had his limb amputated, and one experienced wound necrosis.
CONCLUSION
Peripheral vessel injuries are commonly accompanied by nerve, muscle, or tendon injuries. Patients without associated fractures or compartment syndrome had good prognosis. Although the time intervals from hospital arrival to definite treatment were the shortest among patients with blunt abdominal vascular injuries, three expired. Therefore, we offer a 'critical pathway' to improve the outcomes of patients with blunt abdominal vascular injury.
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