- Clinical implications of the newly defined concept of ventilator-associated events in trauma patients
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Tae Yeon Lee, Jeong Woo Oh, Min Koo Lee, Joong Suck Kim, Jeong Eun Sohn, Jeong Hwan Wi
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J Trauma Inj. 2022;35(2):76-83. Published online December 24, 2021
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DOI: https://doi.org/10.20408/jti.2021.0064
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 Abstract
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- Purpose
Ventilator-associated pneumonia is the most common nosocomial infection in patients with mechanical ventilation. In 2013, the new concept of ventilator- associated events (VAEs) replaced the traditional concept of ventilator-associated pneumonia. We analyzed risk factors for VAE occurrence and in-hospital mortality in trauma patients who received mechanical ventilatory support.
Methods
In this retrospective review, the study population comprised patients admitted to the Jeju Regional Trauma Center from January 2020 to January 2021. Data on demographics, injury characteristics, and clinical findings were collected from medical records. The subjects were categorized into VAE and no-VAE groups according to the Centers for Disease Control and Prevention/National Healthcare Safety Network VAE criteria. We identified risk factors for VAE occurrence and in-hospital mortality.
Results
Among 491 trauma patients admitted to the trauma center, 73 patients who received ventilator care were analyzed. Patients with a chest Abbreviated Injury Scale (AIS) score ≥3 had a 4.7-fold higher VAE rate (odds ratio [OR], 4.73; 95% confidence interval [CI], 1.46–17.9), and those with a glomerular filtration rate (GFR) <75 mL/min/1.73 m2 had 4.1-fold higher odds of VAE occurrence (OR, 4.15; 95% CI, 1.32–14.1) and a nearly 4.2-fold higher risk for in-hospital mortality (OR, 4.19; 95% CI, 1.30–14.3). The median VAE-free duration of patients with chest AIS ≥3 was significantly shorter than that of patients with chest AIS <3 (P=0.013).
Conclusions
Trauma patients with chest AIS ≥3 or GFR <75 mL/min/1.73 m2 on admission should be intensively monitored to detect at-risk patients for VAEs and modify the care plan accordingly. VAEs should be closely monitored to identify infections early and to achieve desirable results. We should also actively consider modalities to shorten mechanical ventilation in patients with chest AIS ≥3 to reduce VAE occurrence.
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Summary
- The Influence of Seasons and Weather on the Volume of Trauma Patients: 4 Years of Experience at a Single Regional Trauma Center
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Se Heon Kim, Young Hoon Sul, Jin Young Lee, Joong Suck Kim
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J Trauma Inj. 2021;34(1):21-30. Published online March 23, 2021
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DOI: https://doi.org/10.20408/jti.2020.0027
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Abstract
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- Purpose
The purpose of this study was to determine the influence of seasons and weather on the volume of trauma patients in central Korea.
Methods
The records of 4,665 patients treated at Chungbuk National Hospital Regional Trauma Center from January 2016 to December 2019 were retrospectively reviewed. Meteorological data including hourly temperature (°C), precipitation (mm), humidity (%), and wind speed (m/s) for each district were collected retrospectively. Statistical analysis was done using the independent <i>t</i>-test, one-way analysis of variance (ANOVA), and linear regression analysis.
Results
Patients’ average age was 53.66 years, with a significant difference between men (49.92 years) and women (60.48 years) (p<0.001). Rolling/slipping down was a prominent cause of injury in winter (28.4%, n=283), with statistical significance (p<0.001). Trauma occurred least frequently in winter (p=0.005). Linear regression analysis revealed an increasing number of patients as the temperature increased (p<0.05), the humidity increased (p<0.001), and the wind speed decreased (p<0.001). Precipitation did not affect patient volume (p=0.562). One-way ANOVA revealed a decreased incidence of trauma when the temperature exceeded 30°C (p<0.001), and when the humidity was more than 75%, compared to 25–50% and 50–75%.
Conclusions
At the regional trauma center of Chungbuk National University Hospital, in central Korea, the number of trauma patients was lowest in winter, and patient volume was affected by temperature, humidity, and wind speed.
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Summary
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Citations
Citations to this article as recorded by  - Climate change and mental health in Korea: A scoping review
Jiyoung Shin, Juha Baek, Sumi Chae
Journal of Climate Change Research.2023; 14(6-2): 989. CrossRef - The impact of COVID-19 on trauma patients and orthopedic trauma operations at a single focused training center for trauma in Korea
Wonseok Choi, Hanju Kim, Whee Sung Son, Seungyeob Sakong, Jun-Min Cho, Nak-Jun Choi, Tae-Wook Noh, Namryeol Kim, Jae-Woo Cho, Jong-Keon Oh
Journal of Trauma and Injury.2022; 35(3): 195. CrossRef
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