We report a case of delayed chest wall reconstruction after thoracotomy. A 53-year-old female, a victim of a motor vehicle accident, presented with bilateral multiple rib fractures with flail motion and multiple extrathoracic injuries. Whole-body computed tomography revealed multiple fractures of the bilateral ribs, clavicle, and scapula, and bilateral hemopneumothorax with severe lung contusions. Active hemorrhage was also found in the anterior pelvis, which was treated by angioembolization. The patient was transferred to the surgical intensive care unit for follow-up. We planned to perform surgical stabilization of rib fractures (SSRF) because her lung condition did not seem favorable for general anesthesia. Within a few hours, however, massive hemorrhage (presumably due to coagulopathy) drained through the thoracic drainage catheter. We performed an exploratory thoracotomy in the operating room. We initially planned to perform exploratory thoracotomy and “on the way out” SSRF. In the operating room, the hemorrhage was controlled; however, her condition deteriorated and SSRF could not be completed. SSRF was completed after about a month owing to other medical conditions, and the patient was weaned successfully.
Trauma incidence and hospitalizations of trauma patients are generally believed to be affected by season and weather. The objective of this study was to explore possible associations of the hospitalization rate of trauma patients with weather and time variables at a single regional trauma center in South Korea.
Trauma hospitalization data were obtained from a regional trauma center in South Korea from January 1, 2017 to December 31, 2019. In total, from 6,788 patients with trauma, data of 3,667 patients were analyzed, excluding those from outside the city where the trauma center was located. Hourly weather service data were obtained from the Korea Meteorological Administration.
The hospitalization rate showed positive correlations with temperature (
Weather and time affected the number of hospitalizations at a trauma center. The findings of this study could be used to determine care delivery, staffing, and resource allocation plans at trauma centers and emergency departments.
Citations
No previous study has assessed elderly pedestrian traffic accidents based on a nationwide database. This study aimed to help primary physicians who examine patients in emergency departments to determine and make prompt and accurate treatment decisions.
This study used data from the Emergency Department-based Injury In-depth Surveillance from 2013 to 2017, managed by the Korea Centers for Disease Control and Prevention. Pedestrians aged ≥65 years were included, and using multivariate logistic regression multiple factors were analyzed to determine their relationship with injury severity.
Of 227,695 subjects, 6,498 were included, of whom 2,065 (31.8%) were severely injured. There were more female than male patients in all severity groups. Most accidents occurred in the afternoon and on general roads. In the multivariate analysis, the odds ratio (OR) of injury severity for male pedestrians was 1.165 (95% confidence interval: 1.034?1.313,
Injury severity was correlated with sex, age, transportation to the ED, TA onset time, and type of vehicle. The study results suggest that injury severity may be positively reflected in initial assessments and overall integrated treatments by physicians and in the related policies.