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Original Articles
Effect of trauma center operation on emergency care and clinical outcomes in patients with traumatic brain injury
Han Kyeol Kim, Yoon Suk Lee, Woo Jin Jung, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Oh Hyun Kim
J Trauma Inj. 2023;36(1):22-31.   Published online December 6, 2022
DOI: https://doi.org/10.20408/jti.2022.0049
  • 1,483 View
  • 45 Download
AbstractAbstract PDF
Purpose
Traumatic brain injury (TBI) directly affects the survival of patients and can cause long-term sequelae. The purpose of our study was to investigate whether the operation of a trauma center in a single tertiary general hospital has improved emergency care and clinical outcomes for patients with TBI.
Methods
The participants of this study were all TBI patients, patients with isolated TBI, and patients with TBI who underwent surgery within 24 hours, who visited our level 1 trauma center from March 1, 2012 to February 28, 2020. Patients were divided into two groups: patients who visited before and after the operation of the trauma center. A comparative analysis was conducted. Differences in detailed emergency care time, hospital stay, and clinical outcomes were investigated in this study.
Results
On comparing the entire TBI patient population via dividing them into the aforementioned two groups, the following results were found in the group of patients who visited the hospital after the operation of the trauma center: an increased number of patients with a good functional prognosis (P<0.001 and P=0.002, respectively), an increased number of surviving discharges (P<0.001 and P<0.001, respectively), and a reduction in overall emergency care time (P<0.05, for all item values). However, no significant differences existed in the length of intensive care unit stay, ventilator days, and total length of stay for TBI patients who visited the hospital before and after the operation of the trauma center.
Conclusions
The findings confirmed that overall TBI patients and patients with isolated brain injury had improved treatment results and emergency care through the operation of a trauma center in a tertiary general hospital.
Summary
Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience
Young Il Roh, Hyung Il Kim, Yong Sung Cha, Kyoung-Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Oh Hyun Kim
J Trauma Inj. 2017;30(4):131-139.   Published online December 30, 2017
DOI: https://doi.org/10.20408/jti.2017.30.4.131
  • 3,905 View
  • 63 Download
  • 4 Citations
AbstractAbstract PDFSupplementary Material
Purpose

Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center.

Methods

During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015).

Results

Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. ?0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group.

Conclusions

The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

Summary

Citations

Citations to this article as recorded by  
  • Mortality Trends in Chest-Abdominal Trauma Patients Before and After the Establishment of Trauma Centers in South Korea
    Dae Ryong Kang, Hye Sim Kim, Ji Young Jang, Ou-Hyen Kim, Kiyoung Kim, Un Young Choi, Jiwool Ko, Keum Seok Bae, Hongjin Shim
    Journal of Acute Care Surgery.2024; 14(1): 1.     CrossRef
  • The Feedback Form and Its Role in Improving the Quality of Trauma Care
    Hany Bahouth, Roi Abramov, Moran Bodas, Michael Halberthal, Shaul Lin
    International Journal of Environmental Research an.2022; 19(3): 1866.     CrossRef
  • Survival benefit of direct transport to trauma centers among patients with unintentional injuries in Korea: a propensity score-matched analysis
    Dong Jun Lee, Seok Hoon Ko, Jongkyeong Kang, Myung Chun Kim, Han Zo Choi
    Clinical and Experimental Emergency Medicine.2022; 10(1): 37.     CrossRef
  • Machine Learning Model to Predict Ventilator Associated Pneumonia in patients with Traumatic Brain Injury: The C.5 Decision Tree Approach
    Ahmad Abujaber, Adam Fadlalla, Diala Gammoh, Hassan Al-Thani, Ayman El-Menyar
    Brain Injury.2021; 35(9): 1095.     CrossRef
The Characteristics of Spinal Injury in Skiing and Snowboarding Injuries
Yong Sung Cha, Kang Hyun Lee, Sun Hyu Kim, Yong Su Jang, Hyun Kim, Tae Yong Shin, Sung Oh Hwang
J Korean Soc Traumatol. 2007;20(1):33-39.
  • 1,111 View
  • 4 Download
AbstractAbstract PDF
PURPOSE
Few studies have been done for spinal injuries after skiing and snowboarding accidents. Assuming that the riding patterns of skiing and snowboarding were different, we analyzed the differences between the mechanisms, diagnoses and levels of spinal injuries caused by them. The purpose of this study was to gain a better understanding of spinal hazards associated with skiing and snowboarding in order to educate skiers and snowboarders.
METHODS
We conducted a prospective study of 96 patients who had sustained spinal injuries as a result of skiing and snowboarding accidents from January 2003 to March 2006. We used a questionnaire, radiological studies, history taking, and physical examinations. We analyzed the mechanism of injury, the level of spinal injury, the severity of spinal injury, and the Abbreviated Injury Scale scores (AIS score). We used the t-test and the chi-square test.
RESULTS
The skiing and the snowboarding injury group included in 96 patients. The skiing injury group included 30 patients (31.2%), and the snowboarding injury group included the remaining 66 patients (69.8%). The primary mechanism of injury in skiing was collisions and in snowboarding was slip downs (p=0.508). The primary level of spinal injury in skiing and snowboarding was at the L-spine level (p=0.547). The most common athlete ability of the injured person was at the intermediate level (p=0.954). The injured were most commonly at the beginner or the intermediate level (p=0.302). The primary diagnosis of spinal injury in skiing and snowboarding was back spain (p=0.686). The AIS scores did not differed between the two groups (p=0.986).
CONCLUSION
The most common spinal injury after skiing and snowboarding accidents was back sprain. There was no difference in the severity of spinal injury between skiing and snowboarding accidents.
Summary
Clinical Characteristics and Prognostic Factors of Geriatric Patients Involved in Traffic Accidents
Tae Su Kim, Kang Hyun Lee, Tae Hoon Kim, O Hyun Kim, Yong Sung Cha, Kyung Chul Cha, Sung Oh Hwang
J Trauma Inj. 2014;27(4):101-107.
  • 1,324 View
  • 9 Download
AbstractAbstract PDF
PURPOSE
Recently, the population of elderly people has been increasing rapidly all over the world. The social activities of the aging population have increased, which has also increased the number of elderly patients injured in traffic accidents. Thus, we analyzed the characteristics of elderly patients involved in traffic accidents.
METHODS
This study was conducted retrospectively from July 2008 to March 2009 among trauma patients involved in traffic accidents who visited Wonju Severance Christian Hospital. Patients under 18 years of age and pregnant patients were excluded. We divided the patients in two groups, a geriatrics group and an adult group on the basis of an age of 65. We compared the types of traffic accidents, the locations of the accidents, the behaviors of the patients at the times of the accidents, the use of seat-belts, and alcohol consumption between the two groups. We calculated the Revised Trauma Score (RTS), Injury Severity Score (ISS), and Trauma and Injury Severity Score (TRISS) for each group.
RESULTS
Total number of the included patients was 903, and the number of elderly patients was 181 (mean age: 71.7+/-4.9 years old). There were no significant differences in the initial vital signs, GCS (Glasgow Coma Scale), and RTS between the two groups. There were differences in the types and the locations of the crashes, the behaviors of the patients at the times of the accidents, the use of seat belts, and alcohol consumption between the two groups (p<0.05). The average ISS of the geriatric group was higher than that of the adult group (9.66+/-10.11 vs. 6.59+/-8.99, p=0.004). The mortality was higher in the geriatric group (n=17,9%) than in the adult group (n=23,2%) (p=0.004).
CONCLUSION
The numbers of mortalities and surgical procedures were greater within the elderly group than the adult group. The average ISS was higher in the geriatric group than in the adult group. The severity of injuries due to traffic accidents was higher in the geriatric group than it was in the adult group.
Summary

J Trauma Inj : Journal of Trauma and Injury