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Jun Ho Lee 4 Articles
Relationship of Mean Arterial Pressure with the Adverse Outcomes in Adult Blunt Trauma Patients: Cross-sectional Study
Seung Yong Cha, Yong Hwan Kim, Chong Kun Hong, Jun Ho Lee, Kwang Won Cho, Seong Youn Hwang, Kyoung Yul Lee, Younghwan Lee, Seong Hee Choi
J Trauma Inj. 2013;26(2):39-46.
  • 1,246 View
  • 11 Download
AbstractAbstract PDF
PURPOSE
Non-invasive blood pressure measurement is widely used as a pre-hospital triage tool for blunt trauma patients. However, scant data exits for using the mean arterial pressure (MAP), compared to the systolic blood pressure, as a guiding index. The aim of this study was to determine the association between adverse outcomes and mean arterial pressure (MAP) and to exhibit the therapeutic range of the MAP in adult blunt trauma patients.
METHODS
The electronic medical records for all trauma patients in a single hospital from January 2010 to September 2012 were retrospectively reviewed. Patients below 17 years of age, patients with penetrating injuries, and patients with serious head trauma (injuries containing any skull fractures or any intracranial hemorrhages) were excluded. Adverse outcomes were defined as one of the following: death in the Emergency Department (ED), admission via operating theater, admission to the intensive care unit, transfer to another hospital for emergency surgery, or discharge as hopeless.
RESULTS
There were 14,537 patients who met entry criteria. Adverse outcomes occurred for MAPs in range from 90 to 120 mmHg. Adverse outcomes were found, after adjusting for confounding variables, to occur increasingly as the MAP declined below 90 mmHg or rose above 120 mmHg.
CONCLUSION
Not only lower but also higher mean arterial pressure is associated with increased adverse outcomes in adult blunt trauma patients. Thus, patients with a MAP above 120 mmHg should be considered as a special group requiring higher medical attention, just as those with a MAP below 90 mmHg are.
Summary
FAST Reappraisal: Cross-sectional Study
Sang Hyun Ha, Chong Kun Hong, Jun Ho Lee, Seong Youn Hwang, Seong Hee Choi
J Korean Soc Traumatol. 2012;25(3):67-71.
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  • 8 Download
AbstractAbstract PDF
PURPOSE
Focused Assessment with Sonography for Trauma (FAST) provides an important initial screening examination in adult trauma patients. However, due to its low sensitivity, FAST is not a replacement for computed tomography (CT) in hemodynamically stable trauma patients. The aim of this study was to determine the test characteristics of FAST in adult, hemodynamically stable, blunt abdominal trauma patients by using a critical action as a reference standard.
METHODS
The medical records for FAST examination at a single hospital from January 2009 to February 2011 were retrospectively reviewed. The inclusion criterion was isolated, hemodynamically stable, blunt abdominal trauma. Hemodynamically unstable patients or patients with penetrating injuries were excluded. The reference standard was the presence of a critical action, which was defined as one of the following: 1) operative intervention for a finding discovered on CT, 2) interventional radiology for bleeding, 3) transfusion of 2 or more packed RBCs, or 4) death at the emergency department.
RESULTS
There were 230 patients who met the inclusion criterion. There were 20 true positive, 206 true negative, 0 false positive, and 4 false negative results. The sensitivity and the specificity were 83% and 100%, respectively.
CONCLUSION
Despite its low sensitivity for detecting any abnormal finding discovered on CT, negative FAST could aid to exclude critical action in hemodynamically stable, blunt abdominal trauma patients.
Summary
Predictive Factors for Cervical Spine Injury in Patients with Minor Head Injury
Chul Woo Park, Ae Jin Sung, Jun Ho Lee, Seong Youn Hwang
J Korean Soc Traumatol. 2009;22(2):154-160.
  • 1,050 View
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AbstractAbstract PDF
PURPOSE
This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury.
METHODS
We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test.
RESULTS
Among the 357 patients, 78 patients had cervical spine injuries. The average age was 43.9+/-15.2 yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively.
CONCLUSION
New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.
Summary
The Relationship between Blood Transfusion and Mortality in Trauma Patients
Se Young Choi, Jun Ho Lee, Young Cheol Choi
J Korean Soc Traumatol. 2008;21(2):108-114.
  • 1,166 View
  • 3 Download
AbstractAbstract PDF
PURPOSE
Using a propensity analysis, a recent study reported that blood transfusion might not be an independent predictor of mortality in critically ill patients, which contradicted the RESULTS of earlier studies. This study aims to reveal whether or not blood transfusion is an independent predictor of mortality in trauma patients.
METHODS
A total of three hundred fifty consecutive trauma patients who were admitted to our emergency center from January 2004 to October 2005 and who underwent an arterial blood gas analysis and a venous blood analysis were included in this study. Their medical records were collected prospectively and retrospectively. Using a multivariate logistic analysis, data on the total population and on the propensity-score -matched population were retrospectively analyzed for association with mortality.
RESULTS
Of the three hundred fifty patients, one hundred twenty-nine (36.9%) received a blood transfusion. These patients were older (mean age: 48 vs. 44 years; p=0.019) and had a higher mortality rate (27.9% vs.7.7%; p<0.001). In the total population, the multivariate analysis revealed that the Glasgow coma scale score, the systolic blood pressure, bicarbonate, the need for respiratory support, past medical history of heart disease, the amount of blood transfusion for 24 hours, and hemoglobin were associated with mortality. In thirty-seven pairs of patients matched with a propensity score, potassium, new injury severity score, amount of blood transfusion for 24 hours, and pulse rate were associated with mortality in the multivariate analysis. Therefore, blood transfusion was a significant independent predictor of mortality in trauma patients.
CONCLUSION
Blood transfusion was revealed to be a significant independent predictor of mortality in the total population of trauma patients and in the propensity-score-matched population.
Summary

J Trauma Inj : Journal of Trauma and Injury