- Injury Analysis of a 25-passenger Bus Left-quarter Turn Rollover Accident
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Sang Min Park, Sang Chul Kim, Kang Hyun Lee, Jae Wan Lee, Hyuk Jin Jeon, Ho Jung Kim, Jin Yong Kim, Young Soo Kwak, Woo Sung Lee
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J Trauma Inj. 2014;27(3):50-56.
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 Abstract
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- PURPOSE
Rollover motor vehicle crashes have a higher injury severity and fatality than other motor vehicle crash types. From a left-quarter turn rollover accident of 25-passenger bus, we intend to assess the injury of the occupant and the injury severities according to the occupants' position.
METHODS
We carried out the 3 steps investigation of occupants' interview, visiting the repair shop and using the police report. We analyzed injuries sustained by occupants, and compared injury severities considering column, row in occupant's position and passenger interaction.
RESULTS
The rollover involved 14 passengers in the bus who were all old women except a man driver. The most common injury was in the upper extremity, with six occurrences being a left clavicle fracture. Major injuries including hemothorax and pneumothorax were diagnosed at left side of the occupant. In the comparison of injury severity among driver's column (left side), mid column and passengercolumn, ISS of passenger column was the highest (9.9+/-7.4, 8.8+/-5.5, and 10.3+/-4.0, respectively, p>0.05). The injury severity of multiple occupants by row was higher than that of single occupant (10.8 vs. 3, p<0.05).
CONCLUSION
An occupant must fasten their seat belt to prevent an injury by passenger interaction in the left-quarter turn rollover accident of a bus.
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Summary
- Injury Characteristics of Self-injury Patients Who Visit the Emergency Department
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Young Soo Kwak, Kang Hyun Lee, Hyung Jin Shin, Kyung Hye Park, Han Joo Choi, Hyun Kim, Sung Oh Hwang
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J Korean Soc Traumatol. 2009;22(1):65-70.
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Abstract
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- PURPOSE
Many studies have addressed a psychiatric analysis of self-injury patients who have self-injurious behavior and who have attempted suicide. Few studies on the injury characteristics of self-injury related trauma patients have been conducted. We analyzed the injury characteristics of self-injury patients.
METHODS
A retrospective review of the medical records extracted from the injury surveillance system of Wonju Christian Hospital for the period from August 2006 to February 2008 was conducted. Of the 121 cases extracted, 103 were included in this study. We analyzed the sex ratio, age group, place of injury, injury mechanism, location of injury, management results, injury severity, and relation with drinking.
RESULTS
One hundred three cases were included (sex ratio: 1.06), and the mean age was 33.9+/-14.2 years old. Fifty-six patients (54.4%) were discharged from the emergency department (ED) on the day of injury after primary care, and 9 patients (8.7%) were discharged, because they refused treatment. Seven patients (6.8%) died. Of these, 4 patients (3.9%) died after attempted cardio-pulmonary resuscitation in the ED, 1 patient (1%) was dead on arrival, and 2 patients (1.9%) died after admission. Sixteen patients (15.5%) were admitted to the hospital, including 2 patients (1.9%) needing emergency surgery. Sixteen patients (15.5%) were transferred to other hospitals. Sixty-one cases (59.2%) involved drinking, and 31 (30.1%) did not; for 11 cases (10.7%), the involvement of drinking was unknown. The mean revised trauma score (RTS) was 11.26+/-2.52, and 88 cases (85.4%) hat a RTS of 12. The mean injury severity score (ISS) was 5.80+/-14.56, and 9 (8.7%) severely injured patients had scores of more than 15.
CONCLUSION
Most self-injuries were mild traumas related to drinking and occurred at a young age. Most cases were not so severe, and the patients were discharged from the ED, but some patients needed hospitalization. Other patients had injuries so severe that they died.
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Summary
- Prognosis for Blunt Abdominal Trauma Patients with Contrast Extravasation on the Abdominopelvic CT Scan
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Hyung Jin Shin, Kang Hyun Lee, Young Soo Kwak, Sun Hyu Kim, Hyun Kim, Sung Oh Hwang
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J Korean Soc Traumatol. 2009;22(1):57-64.
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Abstract
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Computed tomography (CT) is an accurate test for evaluating hemodynamically stable patients with blunt abdominal trauma. Until now, there have been few studies concentrating on the diagnostic and prognostic significance of the intravenous contrast extravasation (CE) site. We investigated the site of CE on abdominopelvic CT (APCT) and its effect on treating trauma patients and predicting the clinical outcome.
METHODS
The 50 patients admitted to our emergency department with blunt abdominal trauma showing CE on APCT from January 2004 to September 2006 were included in this study. Patients were prospectively collected, and medical records were reviewed and analyzed. The patients'clinical and lab findings, Focused Assessment with Sonography for Trauma (FAST) findings, CT findings were analyzed. CE sites were classified as intraperitoneal, retroperitoneal, and pelvic cavity and were correlated with post-treatment complications, mortality, and morbidity.
RESULTS
Of the 50 patients (mean age : 45+/-18years, 29 males, 21 females) included in our study, 33 patients died (66%). There was no correlation between CE site and ICU or total hospitalization duration (p=0.553, p=0.523). During the first 24 hours of resuscitation, the pelvic cavity group required a mean of 20 units more of packed red blood cell (pRBC) transfusion compared to other groups (p=0.003). In the intraperitoneal group, more patients received operative invasive intervention - either laparotomy or embolization (p=0.025). The intraperitoneal group had the highest mortality, with 13 deaths (11/33, 39%), and the highest early mortality rate (10/13, 76%) in the first 24 hours (p=0.001).
CONCLUSION
Intraperitoneal CE on the CT scan in cases of blunt abdominal trauma is regarded as an indication of a need for invasive intervention (either angiography or laparotomy) and of a higher mortality rate in the first 24 hours. A pelvic cavity CE rquires more aggressive transfusion with pRBC. However, the CT findings themselves showed no significant correlation with overall mortality, morbidity, or hospitalization.
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Summary
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