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Youngeun Park 9 Articles
Epidemiology and outcomes of patients with penetrating trauma in Incheon Metropolitan City, Korea based on National Emergency Department Information System data: a retrsopective cohort study
Youngmin Kim, Byungchul Yu, Se-Beom Jeon, Seung Hwan Lee, Jayun Cho, Jihun Gwak, Youngeun Park, Kang Kook Choi, Min A Lee, Gil Jae Lee, Jungnam Lee
J Trauma Inj. 2023;36(3):224-230.   Published online December 21, 2022
DOI: https://doi.org/10.20408/jti.2022.0055
  • 1,404 View
  • 46 Download
AbstractAbstract PDF
Purpose
Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City.
Methods
Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded.
Results
Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals.
Conclusions
Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.
Summary
A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system
Byungchul Yu, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Youngeun Park, Yong-Cheol Yoon, Jayun Cho, Seung Hwan Lee, Jungnam Lee
J Trauma Inj. 2022;35(Suppl 1):S27-S30.   Published online June 15, 2022
DOI: https://doi.org/10.20408/jti.2022.0012
  • 2,102 View
  • 73 Download
AbstractAbstract PDF
In certain circumstances, invasive procedures such as creation of a surgical airway, insertion of a chest drain, intraosseous puncture, or amputation in the field are necessary. These invasive procedures can save lives. However, emergency medical service teams cannot perform such procedures according to the law in Korea. The upper arm of a 29-year-old male patient was stuck in a huge machine and the emergency medical service team could not rescue the patient. A doctor-car team was dispatched to the scene and the team performed the filed amputation to extricate the patient. He was brought to the trauma center immediately and underwent formal above-elbow amputation. Here we describe a case of field amputation to rescue a patient through a “doctor car” system, along with a literature review.
Summary
Major Causes of Preventable Death in Trauma Patients
Youngeun Park, Gil Jae Lee, Min A Lee, Kang Kook Choi, Jihun Gwak, Sung Youl Hyun, Yang Bin Jeon, Yong-Cheol Yoon, Jungnam Lee, Byungchul Yu
J Trauma Inj. 2021;34(4):225-232.   Published online July 29, 2021
DOI: https://doi.org/10.20408/jti.2020.0074
  • 7,827 View
  • 207 Download
  • 12 Citations
AbstractAbstract PDF
Purpose

Trauma is the top cause of death in people under 45 years of age. Deaths from severe trauma can have a negative economic impact due to the loss of people belonging to socio-economically active age groups. Therefore, efforts to reduce the mortality rate of trauma patients are essential. The purpose of this study was to investigate preventable mortality in trauma patients and to identify factors and healthcare-related challenges affecting mortality. Ultimately, these findings will help to improve the quality of trauma care.

Methods

We analyzed the deaths of 411 severe trauma patients who presented to Gachon University Gil Hospital regional trauma center in South Korea from January 2015 to December 2017, using an expert panel review.

Results

The preventable death rate of trauma patients treated at the Gachon University Gil Hospital regional trauma center was 8.0%. Of these, definitely preventable deaths comprised 0.5% and potentially preventable deaths 7.5%. The leading cause of death in trauma patients was traumatic brain injury. Treatment errors most commonly occurred in the intensive care unit (ICU). The most frequent management error was delayed treatment of bleeding.

Conclusions

Most errors in the treatment of trauma patients occurred in early stages of the treatment process and in the ICU. By identifying the main causes of preventable death and errors during the course of treatment, our research will help to reduce the preventable death rate. Appropriate trauma care systems and ongoing education are also needed to reduce preventable deaths from trauma.

Summary

Citations

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  • Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
    Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • TiME OUT: Time-specific machine-learning evaluation to optimize ultramassive transfusion
    Courtney H. Meyer, Jonathan Nguyen, Andrew ElHabr, Nethra Venkatayogi, Tyler Steed, Judy Gichoya, Jason D. Sciarretta, James Sikora, Christopher Dente, John Lyons, Craig M. Coopersmith, Crystal Nguyen, Randi N. Smith
    Journal of Trauma and Acute Care Surgery.2024; 96(3): 443.     CrossRef
  • Analysis of mortality over 7 years in a mature trauma center: evolution of preventable mortality in severe trauma patients
    Sarah Guigues, Jean Cotte, Jean-Baptiste Morvan, Henry de Lesquen, Bertrand Prunet, Mathieu Boutonnet, Nicolas Libert, Pierre Pasquier, Eric Meaudre, Julien Bordes, Michael Cardinale
    European Journal of Trauma and Emergency Surgery.2023; 49(3): 1425.     CrossRef
  • Incidence and predictors of mortality among adult trauma patients admitted to the intensive care units of comprehensive specialized hospitals in Northwest Ethiopia
    Mengistu Abebe Messelu, Ambaye Dejen Tilahun, Zerko Wako Beko, Hussien Endris, Asnake Gashaw Belayneh, Getayeneh Antehunegn Tesema
    European Journal of Medical Research.2023;[Epub]     CrossRef
  • Characteristics and Clinical Outcomes of Elderly Patients with Trauma Treated in a Local Trauma Center
    Kwanhoon Park, Geonjae Cho, Sungho Lee, Kang Yoon Lee, Ji Young Jang
    Journal of Acute Care Surgery.2023; 13(1): 13.     CrossRef
  • An Artificial Intelligence Model for Predicting Trauma Mortality Among Emergency Department Patients in South Korea: Retrospective Cohort Study
    Seungseok Lee, Wu Seong Kang, Do Wan Kim, Sang Hyun Seo, Joongsuck Kim, Soon Tak Jeong, Dong Keon Yon, Jinseok Lee
    Journal of Medical Internet Research.2023; 25: e49283.     CrossRef
  • Preventable Death Rate of Trauma Patients in a Non-Regional Trauma Center
    Kwanhoon Park, Wooram Choi, Sungho Lee, Kang Yoon Lee, Dongbeen Choi, Han-Gil Yoon, Ji Young Jang
    Journal of Acute Care Surgery.2023; 13(3): 118.     CrossRef
  • Nine year in-hospital mortality trends in a high-flow level one trauma center in Italy
    Elisa Reitano, Roberto Bini, Margherita Difino, Osvaldo Chiara, Stefania Cimbanassi
    Updates in Surgery.2022; 74(4): 1445.     CrossRef
  • Decision support by machine learning systems for acute management of severely injured patients: A systematic review
    David Baur, Tobias Gehlen, Julian Scherer, David Alexander Back, Serafeim Tsitsilonis, Koroush Kabir, Georg Osterhoff
    Frontiers in Surgery.2022;[Epub]     CrossRef
  • Flat Inferior Vena Cava on Computed Tomography for Predicting Shock and Mortality in Trauma: A Meta-Analysis
    Do Wan Kim, Hee Seon Yoo, Wu Seong Kang
    Diagnostics.2022; 12(12): 2972.     CrossRef
  • Model for Predicting In-Hospital Mortality of Physical Trauma Patients Using Artificial Intelligence Techniques: Nationwide Population-Based Study in Korea
    Seungseok Lee, Wu Seong Kang, Sanghyun Seo, Do Wan Kim, Hoon Ko, Joongsuck Kim, Seonghwa Lee, Jinseok Lee
    Journal of Medical Internet Research.2022; 24(12): e43757.     CrossRef
  • Thoracic injuries in trauma patients: epidemiology and its influence on mortality
    Andrea Lundin, Shahzad K. Akram, Lena Berg, Katarina E. Göransson, Anders Enocson
    Scandinavian Journal of Trauma, Resuscitation and .2022;[Epub]     CrossRef
Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Experience at a Single Regional Trauma Center
Min A Lee, Seung Hwan Lee, Kang Kook Choi, Youngeun Park, Gil Jae Lee, Byungchul Yu
J Trauma Inj. 2021;34(3):177-182.   Published online September 30, 2021
DOI: https://doi.org/10.20408/jti.2021.0070
  • 2,601 View
  • 86 Download
AbstractAbstract PDF
Purpose

Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries.

Methods

We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records.

Results

A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3).

Conclusions

For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

Summary
The Management of Open Pelvic Fractures: A Report of 2 Cases
Byungchul Yu, Giljae Lee, Min A Lee, Kangkook Choi, Jihun Gwak, Youngeun Park, Yong-Cheol Yoon, Jungnam Lee
J Trauma Inj. 2020;33(4):269-274.   Published online June 2, 2020
DOI: https://doi.org/10.20408/jti.2020.008
  • 16,479 View
  • 130 Download
  • 1 Citations
AbstractAbstract PDF

Open pelvic fractures are rare, but pose challenges for trauma surgeons due to their high morbidity and mortality. Generally, early death results from uncontrolled exsanguination and late death is related to pelvic sepsis. Therefore, management of these injuries should prioritize hemostasis and contamination control starting in the initial phase of treatment. We report two cases of unstable open pelvic fractures with perineal wounds that were managed successfully.

Summary

Citations

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  • Open Pelvic Fractures with a Faringer I Zone Injury: a Set of 3 Case Reports Treated in 2020
    J POMETLOVÁ, V JEČMÍNEK, R JEČMÍNKOVÁ
    Acta chirurgiae orthopaedicae et traumatologiae Ce.2022; 89(2): 164.     CrossRef
Case Series of Zone III Resuscitative Endovascular Balloon Occlusion of the Aorta in Traumatic Shock Patients
Byungchul Yu, Gil Jae Lee, Kang Kook Choi, Min A Lee, Jihun Gwak, Youngeun Park, Jung Nam Lee
J Trauma Inj. 2020;33(3):162-169.   Published online September 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0031
  • 3,546 View
  • 67 Download
AbstractAbstract PDF
Purpose

There is increasing evidence in the literature regarding resuscitative endovascular balloon occlusion of the aorta (REBOA) globally, but few cases have been reported in Korea. We aimed to describe our experience of successful Zone III REBOA and to discuss its algorithm, techniques, and related complications.

Methods

We reviewed consecutive cases who survived from hypovolemic shock after Zone III REBOA placement for 4 years. We reviewed patients’ baseline characteristics, physiological status, procedural data, and outcomes.

Results

REBOA was performed in 44 patients during the study period, including 10 patients (22.7%) who underwent Zone III REBOA, of whom seven (70%) survived. Only one patient was injured by a penetrating mechanism and survived after cardiopulmonary resuscitation. All patients underwent interventions to stop bleeding immediately after REBOA placement.

Conclusions

This case series suggests that Zone III REBOA is a safe and feasible procedure that could be applied to traumatic shock patients with normal FAST findings who receive a chest X-ray examination at the initial resuscitation.

Summary
The Suitability of the CdC field Triage for Korean Trauma Care
Kang Kook Choi, Myung Jin Jang, Min A Lee, Gil Jae Lee, Byungchul Yoo, Youngeun Park, Jung Nam Lee
J Trauma Inj. 2020;33(1):13-17.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.013
  • 5,059 View
  • 117 Download
  • 3 Citations
AbstractAbstract PDF
Purpose

Accurate and appropriate prehospital field triage is essential for a trauma system. The Korean trauma system (established in 2014) uses the trauma field triage algorithm of the United States Centers for Disease Control and Prevention (CDC). This study evaluated the suitability of the CDC field triage criteria for major trauma cases (injury severity score >15) in Korea.

Methods

This retrospective cohort study evaluated trauma patients who presented at the authors’ regional trauma center from January 1 to May 7, 2017. The undertriage and overtriage rates of each CDC field triage step were calculated. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was evaluated for each step.

Results

Among the 1,009 enrolled patients, 168 (16.7%) had major trauma. The undertriage/overtriage rates of each step (steps I, II, III, and IV) of CDC field triage were 9.2%/47.4%, 6.3%/50.8%, 4.5%/59.4%, and 5.3%/78.9%, respectively. The AUC values of each CDC triage step were 0.722, 0.783, 0.791, and 0.615, respectively. The AUC values of the separate components of each step (physiologic criteria, anatomic criteria, mechanism-of-injury criteria, and special considerations) were 0.722, 0.648, 0.647, and 0.456, respectively.

Conclusions

The CDC field triage system is acceptable, but not ideal, for Korean trauma care. If we follow the protocol, it would be preferable to omit step IV. The Korean Triage and Acuity Scale may be a good indicator for in-hospital triage. However, a new triage protocol that is simple to estimate on-scene while having good performance should be developed.

Summary

Citations

Citations to this article as recorded by  
  • Effects of Transport to Trauma Centers on Survival Outcomes Among Severe Trauma Patients in Korea: Nationwide Age-Stratified Analysis
    Hakrim Kim, Kyoung Jun Song, Ki Jeong Hong, Jeong Ho Park, Tae Han Kim, Stephen Gyung Won Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Prehospital triage in emergency medical services system: A scoping review
    Kisook Kim, Booyoung Oh
    International Emergency Nursing.2023; 69: 101293.     CrossRef
  • Assessment of the Suitability of Trauma Triage According to Physiological Criteria in Korea
    Gil Hwan Kim, Jae Hun Kim, Hohyun Kim, Seon Hee Kim, Sung Jin Park, Sang Bong Lee, Chan Ik Park, Dong Yeon Ryu, Kang Ho Lee, Sun Hyun Kim, Na Hyeon Lee, Il Jae Wang
    Journal of Acute Care Surgery.2022; 12(3): 120.     CrossRef
Immediate Post-laparotomy Hypotension in Patients with Severe Traumatic Hemoperitoneum
Gil Jae Lee, Min A Lee, Byungchul Yoo, Youngeun Park, Myung Jin Jang, Kang Kook Choi
J Trauma Inj. 2020;33(1):38-42.   Published online March 30, 2020
DOI: https://doi.org/10.20408/jti.2020.014
  • 6,712 View
  • 122 Download
AbstractAbstract PDF
Purpose

Immediate post-laparotomy hypotension (PLH) is a precipitous drop in blood pressure caused by a sudden release of abdominal tamponade after laparotomy in cases of severe hemoperitoneum. The effect of laparotomy on blood pressure in patients with significant hemoperitoneum is unknown.

Methods

In total, 163 patients underwent laparotomy for trauma from January 1, 2013 to December 31, 2015. Exclusion criteria included the following: negative laparotomy, only a hollow viscous injury, and hemoperitoneum <1,000 mL. After applying those criteria, 62 patients were enrolled in this retrospective review. PLH was defined as a decrease in the mean arterial pressure (MAP) ≥10 mmHg within 10 minutes after laparotomy.

Results

The mean estimated hemoperitoneum was 3,516 mL. The incidence of PLH was 23% (14 of 62 patients). The MAP did not show significant differences before and after laparotomy (5 minutes post-laparotomy, 67.5±16.5 vs. 68.3±18.8 mmHg; p=0.7; 10 minutes post-laparotomy, 67.5±16.5 vs. 70.4±18.8 mmHg; p=0.193). The overall in-hospital mortality was 24% (15 of 62 patients). Mortality was not significantly higher in the PLH group (two of 14 [14.3%] vs. 13 of 48 [27.1%]; p=0.33). No statistically significant between-group differences were observed in the intensive care unit and hospital stay.

Conclusions

PLH may be less frequent and less devastating than it is often considered. Surgical hemostasis during laparotomy is important. Laparotomy with adequate resuscitation may explain the equivalent outcomes in the two groups.

Summary
Type B Aortic Dissection with Visceral Artery Involvement Following Blunt Trauma: A Case Report
Ahram Han, Min A Lee, Youngeun Park, Jin Mo Kang, Jung Ho Kim, Jungnam Lee
J Trauma Inj. 2017;30(4):206-211.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.206
  • 3,944 View
  • 57 Download
AbstractAbstract PDF

Aortic dissection caused by blunt trauma is a rare injury that can be complicated by malperfusion syndrome resulting from obstruction of branch vessels of the aorta. Here, we present a case of traumatic type B aortic dissection with right renal and small bowel ischemia, successfully managed by endovascular fenestration.

Summary

J Trauma Inj : Journal of Trauma and Injury