Journal of Trauma and Injury

Volume 30(3); September 2017

Original Articles

Characteristics of Pediatric and Adolescent Trauma-Database Review of Single Level Trauma Center in Gangwon Province: Tae Han Lee, Pil Young Jung, Hye Youn Kwon, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Seongyup Kim; J Trauma Inj. 2017;30(3):75-79. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.75

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PURPOSE
Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims.
METHODS
The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record.
RESULTS
The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance (6.50±7.60 vs. 3.00±8.10; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury.
CONCLUSIONS
We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.

Summary

Citations

Citations to this article as recorded by

Age group characteristics of children who visited a regional trauma center and analysis of factors affecting the severe trauma
Hyung Won Lee, Jea Yeon Choi, Jae Ho Jang, Jin Seong Cho, Sung Youl Hyun, Woo Sung Choi, Jae-Hyug Woo
Pediatric Emergency Medicine Journal.2020; 7(2): 94. CrossRef

Analysis of Cultivator-related Trauma Cases in a Regional Trauma Center in the Rural Area of Gyeongbuk Province: Ui Kang Hwang, Seok Hwa Youn, Chan Yong Park; J Trauma Inj. 2017;30(3):80-86. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.80

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Abstract PDF: PURPOSE
To analyze the data of patients who suffered trauma in a cultivator accident and visited the trauma center in rural Gyeongbuk Province.
METHODS
We retrospectively reviewed the medical records and Korean Trauma Data Bank data of 120 patients who suffered cultivator-related traumas and visited the rural regional trauma center in Gyeongbuk Province from January to December 2015.
RESULTS
The age of the patients ranged from 35 to 96 years (mean, 70 years). Ninety-one (75.8%) patients were men, and twenty-nine (24.2%) were women. Most of the patients were in their 70s (46 men [50.5%] and 13 women [44.8%]). In total, 113 patients (94.1%) arrived at the regional trauma center by ground transport and 7 (5.9%) arrived by air transport. Ninety-eight patients (81.7%) were transported to the regional trauma center directly from the scene of the accident, and twenty-two (18.3%) were transferred from another medical institute. The mean time from the accident to arrival at the emergency department was 139 minutes, and only 46 patients (38.3%) arrived within 1 hour. Twelve (10.0%) patients died, including two deaths on arrival and two post- cardiopulmonary resuscitation deaths in the emergency department. All deaths were of male cultivator operators. The causes of death were shock (hypovolemic, traumatic, or septic), subdural hematoma (open), hemothorax, rhabdomyolysis, and pneumonia.
CONCLUSIONS
As the government - led regional trauma center project is on process, it would be clinically important to summarize the initial outcome of cultivator injuries, which are characteristically found more in regional trauma centers in the rural area, and have high mortality. Based on this study, in the future, it will be necessary to follow up and analyze more number of patients and to construct accurate database about trauma cases related to cultivator in Gyeongbuk region.; Summary

Experiences of Video-assisted Thoracic Surgery in Trauma: Dongsub Noh, Chan kyu Lee, Jung Joo Hwang, Hyun Min Cho; J Trauma Inj. 2017;30(3):87-90. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.87

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Abstract PDF: PURPOSE
Nowadays, Video-Assisted Thoracic Surgery (VATS) is widely used for its benefits, low post-operative pain, excellent anesthetic result and complete visualization of intrathoracic organs. Despite of these advantages, VATS has not yet been widely used in trauma patients. In this study, we aimed to investigate the usefulness of VATS in the chest trauma area.
METHODS
From January 2016 to December 2016, 203 patients underwent surgical treatment for chest trauma. Their medical records were analyzed retrospectively.
RESULTS
Eleven patients underwent thoracic surgery by VATS. Six patients were unstable vital sign in the emergency room. Two patients underwent emergency surgery and the rest patients underwent planned surgery. The common surgeries were VATS hematoma evacuation and wedge resection. There was no conversion to thoracotomy. The surgery proceeded without any problems for all patients.
CONCLUSIONS
VATS would be an effective diagnostic and therapeutic modality in chest trauma patients. It can be applied to retained hemothorax, persistent pneumothorax, suspicious diaphragm injury and even coagulation of bleeder.; Summary

Treatment Option for High Grade Spleen Injury and Predictive Factors for Non-operative Management: Joung Won Na, Jung Nam Lee, Byung Chul Yu, Min A Lee, Jae Jung Park, Gil Jae Lee; J Trauma Inj. 2017;30(3):91-97. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.91

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Abstract PDF: PURPOSE
The prognostic factors of non-operative management (NOM) in high-grade spleen injuries have been extensively studied, but factors that would help treatment decisions are lacking. We compared the characteristics of the patients to identify the factors affecting treatment choices.
METHODS
This is a review of 207 blunt spleen injury patients from January 2004 to December 2013. We compared clinical features and mortality between surgery and NOM, and used multivariate regression analysis to find the factor most strongly associated with prognosis.
RESULTS
Of the 207 patients, 107 had high-grade spleen injury patents (grade III or above). Of these, 42 patients underwent surgery and 65 patients underwent NOM. The mortality was 7% following surgery, 3% with NOM. The amount of packed red blood cells transfused in the first 24 hours and spleen injury grade were associated with management type, and mortality was highly associated with activated partial thromboplastin time (aPTT) and spleen injury grade.
CONCLUSIONS
The grade of spleen injury was associated with management and mortality, so correctly assessing the spleen injury grade is important.; Summary

Case Reports

A Successful Evacuation of Vertex Epidural Hematoma; A Case Report: Jang Hun Kim, Haewon Roh, Jong Hyun Kim, Taek Hyun Kwon; J Trauma Inj. 2017;30(3):98-102. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.98

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Abstract PDF: Vertex epidural hematoma (VEH) is an uncommon presentation of all epidural hematomas and presents with a wide range of symptom and signs. Diagnosis as well as treatment of VEH is also difficult because of its location adjacent to superior sagittal sinus (SSS). A 43-year-old male visited our hospital after fall down and was diagnosed with VEH. While evaluating its location and patency of SSS, he was deteriorated and urgently underwent evacuation of VEH. Bilateral craniotomies on each side, leaving a central bony island to avoid bleeding of midline structure and provide an anchor for dural tack-ups. After the operation, VEH was totally removed and the patient has restored.; Summary

A Case of Traumatic Cervical Braun-Sequard Syndrome: Dae Hyun Cho, Seung Hwan Lee, Jae Gil Lee, Myung Jae Jung; J Trauma Inj. 2017;30(3):103-106. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.103

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Abstract PDF: A traumatic Braun-Sequard syndrome of the cervical spine is reported in a 53-year-old male. The patient recovered spontaneously over several days with surgical intervention. The diagnosis was made on magnetic resonance imaging with physical examination, which also demonstrated subsequent resolution of bone marrow intensity. The etiological factors of spinal Braun-Sequard syndrome are reviewed.; Summary

Fat Embolism Syndrome - Three Case Reports and Review of the Literature: Leonidas Grigorakos, Ioannis Nikolopoulos, Stamatina Stratouli, Anastasia Alexopoulou, Eleftherios Nikolaidis, Eleftherios Fotiou, Daria Lazarescu, Ioannis Alamanos; J Trauma Inj. 2017;30(3):107-111. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.107

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Abstract PDF

The fat embolism syndrome (FES) represents a condition, usually with traumatic etiology, which may pose challenges to diagnosis while its treatment usually requires supportive measures in the intensive care units (ICUs). The clinical criteria, including respiratory and cerebral dysfunction and a petechial rash, along with imaging studies help in diagnosis. Here we present three case reports of young male who developed FES and were admitted to our ICUs after long bones fractures emerging after vehicle crashes and we briefly review FES literature. All patients' treatment was directed towards: 1) the restoration of circulating volume with fresh blood and/or plasma; 2) the correction of acidosis; and 3) immobilization of the affected part. All patients recovered and were released to the orthopedic wards. The incidence of cases of patients with FES admitted in our ICUs records a significant decrease. This may be explained in terms effective infrastructure reforms in Greece which brought about significant improvement in early prevention and management.

Summary

Citations

Citations to this article as recorded by

Late-onset isolated cerebral fat embolism syndrome after a simple tibial plateau fracture: a rare case report
Ta-Li Hsu, Tien-Chi Li, Fei-Pi Lai, Ming Ouhyoung, Chih-Hung Chang, Cheng-Tzu Wang
Journal of International Medical Research.2021; 49(7): 030006052110284. CrossRef

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