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Jae Gil Lee 5 Articles
The Effectiveness of Simulation Training in an Advanced Trauma Life Support Program for General Surgery Residents: A Pilot Study
Myoung Jun Kim, Jae Gil Lee, Seung Hwan Lee
J Trauma Inj. 2020;33(4):219-226.   Published online October 27, 2020
DOI: https://doi.org/10.20408/jti.2020.0015
  • 6,946 View
  • 141 Download
AbstractAbstract PDFSupplementary Material
Purpose

Although the Advanced Trauma Life Support (ATLS) course is now taught internationally, it has not been implemented in Korea. In recent years, interest has increased in simulation as a teaching tool in the ATLS course. We therefore hypothesized that simulation training would be a useful adjunct to the ATLS course.

Methods

We designed a 1-day curriculum that included skill development workstations, expert lectures, trauma patient simulations, and group discussion for general surgery residents. We conducted a survey to evaluate participants’ level of understanding of the initial evaluation and treatment of trauma patients, their degree of knowledge and technical improvement, their satisfaction with the learning goals, and their overall satisfaction with the curriculum. We then analyzed the effects before and after the training.

Results

Nine residents attended this course. None of the residents initially reported that they could perform a primary survey of trauma patients. The analysis revealed significant improvements after training in the questionnaire areas of “assembly of the team and preparation for resuscitation of a trauma patient” (p=0.008), “performance of a primary survey for trauma patients” (p=0.007), “resuscitative procedures for trauma patients” (p=0.008), “importance of re-evaluation” (p=0.007), “identifying the pitfalls associated with the initial assessment and management” (p=0.007), and “importance of teamwork” (p=0.007).

Conclusions

After the ATLS simulation training, all participants showed significant improvements in their understanding of how to manage multiple trauma patients. Therefore, ATLS simulation training for residents will help in the management of trauma patients.

Summary
Early Predictive Values for Severe Rhabdomyolysis in Blunt Trauma
Jung Yun Park, Myoung Jun Kim, Jae Gil Lee
J Trauma Inj. 2019;32(1):26-31.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.029
  • 4,568 View
  • 126 Download
  • 2 Citations
AbstractAbstract PDF
Purpose

Rhabdomyolysis (RB) is a syndrome characterized by the decomposition of striated muscles and leakage of their contents into the bloodstream. Acute kidney injury (AKI) is the most significant and serious complication of RB and is a major cause of mortality in patients with RB. Severe RB (creatine kinase [CK] ≥5,000) has been associated with AKI. However, early prediction is difficult because CK can reach peak levels 1?3 days after the trauma. Hence, the aim of our study was to identify predictors of severe RB using initial patient information and parameters.

Methods

We retrospectively analyzed 1,023 blunt trauma patients admitted to a single tertiary hospital between August 2011 and March 2018. Patients with previously diagnosed chronic kidney disease were excluded from the study. RB and severe RB were defined as a CK level ≥1,000 U/L and ≥5,000 U/L, respectively. The diagnosis of AKI was based on RIFLE criteria.

Results

The overall incidence of RB and severe RB was 31.3% (n=320) and 6.2% (n=63), respectively. On multivariable analysis, male sex (odds ratio [OR] 3.78, 95% confidence interval [CI] 1.43 to 10.00), initial base excess (OR 0.85, 95% CI 0.80 to 0.90), initial CK (OR 2.07, 95% CI 1.67 to 2.57), and extremity abbreviated injury scale score (OR 1.78, 95% CI 1.39 to 2.29) were found to predict severe RB. The results of receiver operating characteristic analysis showed that the best cutoff value for the initial serum CK level predictive of severe RB was 1,494 U/L.

Conclusions

Male patients with severe extremity injuries, low base excess, and initial CK level >1,500 U/L should receive vigorous fluid resuscitation.

Summary

Citations

Citations to this article as recorded by  
  • Factors Associated with Acute Kidney Injury Occurrence and Prognosis in Rhabdomyolysis at the Emergency Department
    Jun Seok Seo, Inhwan Yeo, Changho Kim, Daeun Kim, Jeong-Hoon Lim, Kyoungtae Park, Jiwoo Jeong, Hojin Kwon, Yuna Cho, Sungyeon Park
    Medicina.2024; 60(1): 105.     CrossRef
  • Role of the Neutrophil-to-Lymphocyte Ratio at the Time of Arrival at the Emergency Room as a Predictor of Rhabdomyolysis in Severe Trauma Patients
    Jin Chul Bae, Kyung Hoon Sun, Yong Jin Park
    Journal of Trauma and Injury.2020; 33(2): 96.     CrossRef
Usefulness of Shock Index to Predict Outcomes of Trauma Patient: A Retrospective Cohort Study
Myoung Jun Kim, Jung Yun Park, Mi Kyoung Kim, Jae Gil Lee
J Trauma Inj. 2019;32(1):17-25.   Published online March 31, 2019
DOI: https://doi.org/10.20408/jti.2018.034
  • 5,135 View
  • 167 Download
  • 6 Citations
AbstractAbstract PDF
Purpose

We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma.

Methods

We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers.

Results

Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals “age” (p<0.001; OR, 1.068), “pre-hospital SI >0.9” (p<0.001; OR, 11.629), and “delta SI ≥0.3” (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression.

Conclusions

SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

Summary

Citations

Citations to this article as recorded by  
  • Shock Index for the Prediction of Interventions and Mortality in Patients With Blunt Thoracic Trauma
    Mohammad Asim, Ayman El-Menyar, Talat Chughtai, Ammar Al-Hassani, Husham Abdelrahman, Sandro Rizoli, Hassan Al-Thani
    Journal of Surgical Research.2023; 283: 438.     CrossRef
  • Emergency Department Shock Index Outperforms Prehospital and Delta Shock Indices in Predicting Outcomes of Trauma Patients
    Hamidreza Hosseinpour, Tanya Anand, Sai Krishna Bhogadi, Christina Colosimo, Khaled El-Qawaqzeh, Audrey L. Spencer, Lourdes Castanon, Michael Ditillo, Louis J. Magnotti, Bellal Joseph
    Journal of Surgical Research.2023; 291: 204.     CrossRef
  • Shock index as a predictor for mortality in trauma patients: a systematic review and meta-analysis
    Malene Vang, Maria Østberg, Jacob Steinmetz, Lars S. Rasmussen
    European Journal of Trauma and Emergency Surgery.2022; 48(4): 2559.     CrossRef
  • Delta Shock Index Predicts Outcomes in Pediatric Trauma Patients Regardless of Age
    Samer Asmar, Muhammad Zeeshan, Muhammad Khurrum, Jorge Con, Mohamad Chehab, Letitia Bible, Rifat Latifi, Bellal Joseph
    Journal of Surgical Research.2021; 259: 182.     CrossRef
  • Shock index as a predictor for short‐term mortality in helicopter emergency medical services: A registry study
    Johannes Björkman, Lasse Raatiniemi, Piritta Setälä, Jouni Nurmi
    Acta Anaesthesiologica Scandinavica.2021; 65(6): 816.     CrossRef
  • Association between prehospital field to emergency department delta shock index and in-hospital mortality in patients with torso and extremity trauma: A multinational, observational study
    Dae Kon Kim, Joo Jeong, Sang Do Shin, Kyoung Jun Song, Ki Jeong Hong, Young Sun Ro, Tae Han Kim, Sabariah Faizah Jamaluddin, Zsolt J. Balogh
    PLOS ONE.2021; 16(10): e0258811.     CrossRef
External Iliac Artery Transection Managed by Iliofemoral Bypass Grafting Using Temporary Balloon Occlusion
Young Un Choi, Jae Gil Lee, Kwangmin Kim, Seongyup Kim, Keumseok Bae, Ji Young Jang, Pil Young Jung, Hongjin Shim, Young Jin Youn, Il Hwan Park
J Trauma Inj. 2017;30(4):242-246.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.242
  • 3,766 View
  • 39 Download
AbstractAbstract PDF

Traumatic abdominal vessel injury is rare, but difficult to manage. Approaching the injured vessel and controlling the bleeding is very hard. We experienced the right iliac artery transection managed by iliofemoral bypass grafting using temporary balloon occlusion. Proximal occlusion of an iliac artery with a temporary balloon cab be an option or bridge technique for a definite operation in case of iliac artery rupture. So, we present our case.

Summary
Characteristics and Outcomes of Trauma Patients via Emergency Medical Services
Dae Hyun Cho, Jae Gil Lee
J Trauma Inj. 2017;30(4):120-125.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.120
  • 3,383 View
  • 30 Download
AbstractAbstract PDF
Purpose

The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS).

Methods

Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis.

Results

Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05).

Conclusions

The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.

Summary

J Trauma Inj : Journal of Trauma and Injury