Journal of Trauma and Injury

Original Article

Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea: Hongrye Kim, Mou Seop Lee, Su Young Yoon, Jonghee Han, Jin Young Lee, Junepill Seok; J Trauma Inj. 2024;37(2):114-123. Published online May 9, 2024; DOI: https://doi.org/10.20408/jti.2023.0087

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Abstract PDF Supplementary Material: Purpose
Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients.
Methods
Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma.
Results
In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5–15] vs. 15 [14–15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively)
Conclusions
Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.; Summary

Case Report

Conservative treatment of corpus callosum hemorrhage due to a falling coconut in Indonesia: a case report: Hanan Anwar Rusidi, Ferry Wijanarko; J Trauma Inj. 2024;37(1):79-82. Published online January 12, 2024; DOI: https://doi.org/10.20408/jti.2023.0052

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Abstract PDF: The potential for traumatic brain injury resulting from falling coconuts is frequently overlooked. These incidents can cause focal lesions in the form of brain hemorrhage. Corpus callosum hemorrhage due to blunt trauma from a falling object is rare and typically associated with poor prognosis. The purpose of this report is to detail a case of corpus callosum hemorrhage caused by a coconut fall and to discuss the conservative management approach employed. We report the case of a 54-year-old woman who was admitted to the hospital with symptoms of unconsciousness, headache, and expressive aphasia after being struck by a falling coconut. Notably, hemorrhage was detected within the body of the corpus callosum, as revealed by imaging findings. The patient received intensive monitoring and treatment in the intensive care unit, including oxygen therapy, saline infusion, an osmotic diuretic, analgesics, and medication to prevent stress ulcers. The patient demonstrated marked clinical improvement while undergoing conservative treatment. Despite the typically unfavorable prognosis of these rare injuries, our patient exhibited meaningful clinical improvement with conservative treatment. Timely diagnosis and appropriate interventions were crucial in managing the patient’s condition. This report emphasizes the importance of considering traumatic brain injury caused by falling coconuts and highlights the need for further research and awareness in this area.; Summary

Original Articles

Outcomes and physiologic responses associated with ketamine administration after traumatic brain injury in the United States and Canada: a retrospective analysis: Austin J. Peters, Saad A. Khan, Seiji Koike, Susan Rowell, Martin Schreiber; J Trauma Inj. 2023;36(4):354-361. Published online November 7, 2023; DOI: https://doi.org/10.20408/jti.2023.0034

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Abstract PDF Supplementary Material: Purpose
Ketamine has historically been contraindicated in traumatic brain injury (TBI) due to concern for raising intracranial pressure. However, it is increasingly being used in TBI due to the favorable respiratory and hemodynamic properties. To date, no studies have evaluated whether ketamine administered in subjects with TBI is associated with patient survival or disability.
Methods
We performed a retrospective analysis of data from the multicenter Prehospital Tranexamic Acid Use for Traumatic Brain Injury trial, comparing ketamine-exposed and ketamine-unexposed TBI subjects to determine whether an association exists between ketamine administration and mortality, as well as secondary outcome measures.
Results
We analyzed 841 eligible subjects from the original study, of which 131 (15.5%) received ketamine. Ketamine-exposed subjects were younger (37.3±16.9 years vs. 42.0±18.6 years, P=0.037), had a worse initial Glasgow Coma Scale score (7±3 vs. 8±4, P=0.003), and were more likely to be intubated than ketamine-unexposed subjects (88.5% vs. 44.2%, P<0.001). Overall, there was no difference in mortality (12.2% vs. 15.5%, P=0.391) or disability measures between groups. Ketamine-exposed subjects had significantly fewer instances of elevated intracranial pressure (ICP) compared to ketamine-unexposed subjects (56.3% vs. 82.3%, P=0.048). In the very rare outcomes of cardiac events and seizure activity, seizure activity was statistically more likely in ketamine-exposed subjects (3.1% vs. 1.0%, P=0.010). In the intracranial hemorrhage subgroup, cardiac events were more likely in ketamine-exposed subjects (2.3% vs. 0.2%, P=0.025). Ketamine exposure was associated with a smaller increase in TBI protein biomarker concentrations.
Conclusions
Ketamine administration was not associated with worse survival or disability despite being administered to more severely injured subjects. Ketamine exposure was associated with reduced elevations of ICP, more instances of seizure activity, and lower concentrations of TBI protein biomarkers.; Summary

Effect of use and type of helmet on occurrence of traumatic brain injuries in motorcycle riders in Korea: a retrospective cohort study: Sowon Seo, Seok Ran Yeom, Sung-Wook Park, Il Jae Wang, Suck Ju Cho, Wook Tae Yang, Youngmo Cho; J Trauma Inj. 2023;36(2):87-97. Published online December 9, 2022; DOI: https://doi.org/10.20408/jti.2022.0029

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Abstract PDF Supplementary Material: Purpose
The purpose of this study was to investigate (1) the association among helmet wearing, incidence rate of traumatic brain injury (TBI), and in-hospital mortality; TBI was diagnosed when the head Abbreviated Injury Scale (AIS) was ≥1, and as severe TBI when head AIS was ≥3; and (2) the association between helmet type and incidence rate of TBI, severe TBI, and in-hospital mortality of motorcycle accidents based on the newly revised Emergency Department-based Injury In-depth Surveillance (EDIIS) data.
Methods
Data collected from EDIIS between January 1, 2020 and December 31, 2020 were analyzed. The final study population comprised 1,910 patients, who were divided into two groups: helmet wearing group and unhelmeted group. In addition, the correlation between helmet type and motorcycle accident was determined in 596 patients who knew the exact type of helmet they wore. A total of 710 patients who wore helmet but did not know the type were excluded from this analysis. Multivariate logistic regression was performed in both the groups to investigate the factors affecting the primary (occurrence of TBIs) and secondary outcomes (severe TBI and in-hospital mortality).
Results
The prevalence of Injury Severity Scores, TBIs, and severe TBIs as well as in-hospital mortality were the highest in the unhelmeted group. Additionally, the results from the group that wore and knew the type of helmet worn indicated that wearing a full-face helmet decreased the incidence of TBIs in comparison to a half-face helmet.
Conclusions
The wearing of a helmet in motorcycle accidents is very important as it plays a role in reducing the occurrence of TBIs and severe TBIs and in-hospital mortality. The use of a full-face helmet lowered the incidence of TBIs.; Summary

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

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Abstract 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

Postoperative infection after cranioplasty in traumatic brain injury: a single center experience: Mahnjeong Ha, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim, Seunghan Yu; J Trauma Inj. 2022;35(4):255-260. Published online November 16, 2022; DOI: https://doi.org/10.20408/jti.2022.0043

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Abstract PDF: Purpose
To determine the incidence and risk factors of postoperative infection after cranioplasty in patients with traumatic brain injury (TBI).
Methods
Data of 289 adult patients who underwent cranioplasty after TBI at a single regional trauma center between year 2018 and 2021 were reviewed retrospectively. Patient characteristics and various procedural variables, such as interval between craniectomy and cranioplasty, estimated blood loss, laterality and materials of the bone flap, and duration and classification of perioperative antibiotics usage were analyzed.
Results
Postoperative infection occurred in 17 patients (5.9%). Onset time of infectious symptom ranged from 9 days to 174 days (median, 24 days) after cranioplasty. The most common cultured organism was Staphylococcus aureus (47.1%), followed by Klebsiella pneumoniae (17.6%) and Enterococcus faecalis (17.6%). Patients with postoperative infection were more likely to have diabetes (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.92–25.21; P=0.003), lower body mass index (OR, 0.81; 95% CI, 0.66–0.98; P=0.029), and shorter duration of perioperative antibiotics (OR, 0.83; 95% CI, 0.71–0.98; P=0.026).
Conclusions
For TBI patients with diabetes, poor nutritional status should be managed cautiously for increased risk of infection after cranioplasty. Further studies and discussions are needed to determine an appropriate antibiotics protocol in cranioplasty.; Summary

Usefulness of intraoperative transcranial sonography in patients with traumatic brain injuries: a comparison with postoperative computed tomography: Mahn Jeong Ha, Seung Han Yu, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim; J Trauma Inj. 2023;36(1):8-14. Published online June 20, 2022; DOI: https://doi.org/10.20408/jti.2021.0093

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Abstract PDF: Purpose
The aim of this study was to assess the agreement between intraoperative transcranial sonography (TCS) and postoperative computed tomog¬raphy (CT) in patients with traumatic brain injuries.
Methods
We performed a retrospective cross-sectional study of 35 patients who underwent TCS during surgery, among those who presented to a regional trauma center and underwent decompressive craniectomy between January 1, 2017 and April 30, 2020.
Results
The mean difference between TCS and CT in measuring the midline shift was –1.33 mm (95% confidence inter¬val, –2.00 to –0.65; intraclass correlation coefficient [ICC], 0.96; P<0.001). An excellent correlation was found between TCS and CT in assessing contralateral subdural hematomas (ICC, 0.96; P<0.001) and focal hematoma lesions (ICC, 0.99; P<0.001). A very good correlation between TCS and CT was found for measurements of ventricle width (ICC, 0.92; P<0.001).
Conclusions
TCS during surgery is considered an effective diagnostic tool for the detection of intraoperative parenchymal changes in patients with traumatic brain injuries.; Summary

Surgical Outcomes in Patients with Simultaneous Traumatic Brain and Torso Injuries in a Single Regional Trauma Center over a 5-Year Period: Jung-Ho Yun; J Trauma Inj. 2021;34(4):270-278. Published online December 31, 2021; DOI: https://doi.org/10.20408/jti.2021.0099

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Abstract PDF: Purpose
The purpose of the study is to analyze the results of surgical treatment of patients with brain and torso injury for 5 years in a single regional trauma center.
Methods
We analyzed multiple trauma patients who underwent brain surgery and torso surgery for chest or abdominal injury simultaneously or sequentially among all 14,175 trauma patients who visited Dankook University Hospital Regional Trauma Center from January 2015 to December 2019.
Results
A total of 25 patients underwent brain surgery and chest or abdominal surgery, with an average age of 55.4 years, 17 men and eight women. As a result of surgical treatment, there were 14 patients who underwent the surgery on the same day (resuscitative surgery), of which five patients underwent surgery simultaneously, four patients underwent brain surgery first, and one patient underwent chest surgery first, four patients underwent abdominal surgery first. Among the 25 treated patients, the 10 patients died, which the cause of death was five severe brain injuries and four hemorrhagic shocks.
Conclusions
In multiple damaged patients require both torso surgery and head surgery, poor prognosis was associated with low initial Glasgow Coma Scale and high Injury Severity Score. On the other hand, patients had good prognosis when blood pressure was maintained and operation for traumatic brain injury was performed first. At the same time, patients who had operation on head and torso simultaneously had extremely low survival rates. This may be associated with secondary brain injury due to low perfusion pressure or continuous hypotension and the traumatic coagulopathy caused by massive bleeding.; Summary

Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea: Maro Kim, Dongbum Suh, Jin Hee Lee, Hyuksool Kwon, Yujin Choi, Joo Jeong, Sola Kim, Soyun Hwang, Joong Wan Park, You Hwan Jo; J Trauma Inj. 2022;35(1):3-11. Published online October 28, 2021; DOI: https://doi.org/10.20408/jti.2021.0044

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5 Citations

Abstract PDF

Purpose
The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR=3.88; 95% confidence interval [CI] 1.33–11.36) and operating an ePMD while intoxicated (AOR=2.78; 95% CI 1.52–5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

Summary

Citations

Citations to this article as recorded by

Retrospective analysis of nonfatal skeletal injuries sustained in road incidents involving electric scooters
Maxim S. Siedin, Semyon S. Plis, Vladimir A. Klevno, Aleksandr V. Maksimov, Alexander A. Plashchinskiy
Russian Journal of Forensic Medicine.2024; 10(2): 160. CrossRef
The epidemiology and outcomes of severe road traffic injury by road user type in Korea: A nationwide retrospective observational study
Gyeongmin Lee, Jeong Ho Park, Seung Chul Lee, Sanghun Lee, Kyoung Jun Song, Sang Do Shin
Injury.2024; 55(10): 111732. CrossRef
Helmet wearing and related factors among electric personal mobility device users in Korea
Eunbi Kim, Taehun Kim, Sojeong Park, Sohyun Park, Juhwan Park, Junhyeok Lee, Junhyung Lee, Mi Ah Han
Health Promotion International.2024;[Epub] CrossRef
Exploring e-scooter riders’ risky behaviour: survey, observation, and interview study
Young Woo Kim, Seul Chan Lee, Sol Hee Yoon
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Types of injuries caused by isolated electric scooter accidents
Kyongwon Yoo, Hyung Il Kim
Journal of Trauma and Injury.2022; 35(4): 232. CrossRef

Case Report

Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report: Jung-Ho Yun; J Trauma Inj. 2021;34(3):212-217. Published online September 30, 2021; DOI: https://doi.org/10.20408/jti.2021.0073

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Abstract PDF: Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient’s consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient’s transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.; Summary

Original Articles

Cranioplasty Results after the Use of a Polyester Urethane Dural Substitute (Neuro-Patch^®) as an Adhesion Prevention Material in Traumatic Decompressive Craniectomy: Tae Seok Jeong, Woo Kyung Kim, Myung Jin Jang; J Trauma Inj. 2019;32(4):195-201. Published online December 30, 2019; DOI: https://doi.org/10.20408/jti.2019.030

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1 Citations

Abstract PDF

Purpose

This study was conducted to investigate the usefulness of a polyester urethane dural substitute (Neuro-Patch^®, B. Braun, Boulogne, France) as an anti-adhesion agent in subsequent cranioplasty by analyzing the use of Neuro-Patch^® during decompressive craniectomy in traumatic brain injury patients.

Methods

We retrospectively analyzed patients with traumatic brain injury who underwent decompressive craniectomy followed by cranioplasty from January 2015 to December 2018. Patients were analyzed according to whether they received treatment with Neuro-Patch^® or not (Neuro-Patch^® group, n=71; control group, n=55). Patients’ baseline characteristics were analyzed to identify factors that could affect cranioplasty results, including age, sex, hypertension, diabetes mellitus, use of antiplatelet agents or anticoagulant medication, the interval between craniectomy and cranioplasty, and the type of bone used in cranioplasty. The cranioplasty results were analyzed according to the following factors: operation time, blood loss, postoperative hospitalization period, surgical site infection, and revision surgery due to extra-axial hematoma.

Results

No significant difference was found between the two groups regarding patients’ baseline characteristics. For the cranioplasty procedures, the operation time (155 vs. 190 minutes, p=0.003), intraoperative blood loss (350 vs. 450 mL, p=0.012), and number of surgical site infections (4 vs. 11 cases, p=0.024) were significantly lower in the Neuro-Patch^® group than in the control group.

Conclusions

The use of Neuro-Patch^® was associated with a shorter operation time, less blood loss, and a lower number of surgical site infections in subsequent cranioplasties. These results may provide a rationale for prospective studies investigating the efficacy of Neuro-Patch^®.

Summary

Citations

Citations to this article as recorded by

Efficacy and safety of decompressive craniectomy with non-suture duraplasty in patients with traumatic brain injury
Tae Seok Jeong, Gi Taek Yee, Tae Gyu Lim, Woo Kyung Kim, Chan Jong Yoo, Giovanni Grasso
PLOS ONE.2020; 15(10): e0232561. CrossRef

The New Recreational Transportation on the Street: Personal Mobility, Is It Safe?: Young Woo Kim, Won Bin Park, Jin Seong Cho, Sung Youl Hyun, Geun Lee; J Trauma Inj. 2018;31(3):125-134. Published online December 31, 2018; DOI: https://doi.org/10.20408/jti.2018.040

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13 Citations

Abstract PDF

Purpose

The interest in the personal mobility started to grow and as the interest increases, there are growing concerns about the safety of it. The purpose of the study is to look at the types and dynamics of patients injured by the personal mobilities.

Methods

This was a retrospective 2-year observational study, from January 2016 to December 2017, on the patients who visited the emergency center and the trauma center, with an injury related to driving the personal mobility. Cases of the personal mobility-related accident were collected based on electronic medical records and hospital emergency department-based injury in-depth surveillance data.

Results

A total of 65 patients visited the emergency center and the trauma center, during this study period. Six patients of 50 adults admitted the alcohol consumption (12%) and two adult patients wore the helmet as the protection gear (3.1%). The number of the patients in 2017 rises three times more than the number of patients in 2016 (51 vs. 14). Injuries to the head and neck region (67.7%) was the most common, followed by the upper extremity (46.2%). Eleven patients (16.9%) were admitted to the hospital, of whom three were admitted to the intensive care unit due to intracranial hemorrhage. Nine patients underwent surgery.

Conclusions

The use of the personal mobility will continue to grow and the accidents, caused by the vehicle, will increase along with it. The study showed the damage is worse than expected. Personal mobility currently has a limited safety laws and the riders are not yet fully aware of its danger. The improvement of the regulation of the personal mobility, safety education is needed.

Summary

Citations

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Critical risk factors associated with fatal/severe crash outcomes in personal mobility device rider at-fault crashes: A two-step inter-cluster rule mining technique
Reuben Tamakloe, Kaihan Zhang, Ahmed Hossain, Inhi Kim, Shin Hyoung Park
Accident Analysis & Prevention.2024; 199: 107527. CrossRef
The epidemiology and outcomes of severe road traffic injury by road user type in Korea: A nationwide retrospective observational study
Gyeongmin Lee, Jeong Ho Park, Seung Chul Lee, Sanghun Lee, Kyoung Jun Song, Sang Do Shin
Injury.2024; 55(10): 111732. CrossRef
Typological index of alleyways: mapping the pattern of a forgotten urban form element
Khaled Alawadi, Asim Khanal, Rawan Sohdy Abdelfattah
Journal of Urban Design.2023; 28(2): 199. CrossRef
Electric personal mobility device driver behaviors, their antecedents and consequences: A narrative review
Clément Laverdet, Pascal Malola, Thierry Meyer, Patricia Delhomme
Journal of Safety Research.2023; 86: 274. CrossRef
Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea
Maro Kim, Dongbum Suh, Jin Hee Lee, Hyuksool Kwon, Yujin Choi, Joo Jeong, Sola Kim, Soyun Hwang, Joong Wan Park, You Hwan Jo
Journal of Trauma and Injury.2022; 35(1): 3. CrossRef
Types of injuries caused by isolated electric scooter accidents
Kyongwon Yoo, Hyung Il Kim
Journal of Trauma and Injury.2022; 35(4): 232. CrossRef
Revisiting transit-oriented development: Alleys as critical walking infrastructure
Khaled Alawadi, Asim Khanal, Azhar Doudin, Rahma Abdelghani
Transport Policy.2021; 100: 187. CrossRef
Epidemiological trends of personal mobility devices and power-assisted bicycles-related fires and injuries in Singapore
Jason Qi Wei Kwek, Qin Xiang Ng, Amelia Justina Lim, Li Feng Ang, Shalini Arulanandam
Burns.2021; 47(4): 983. CrossRef
Where to Ride? An Explorative Study to Investigate Potential Risk Factors of Personal Mobility Accidents
Jihun Oh, Jeongseob Kim
International Journal of Environmental Research an.2021; 18(3): 965. CrossRef
Contextual risk factors in the use of electric kick scooters: An episode sampling inquiry
Kyung-Jun Lee, Chan Hyeok Yun, Myung Hwan Yun
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Survey on e-Powered Micro Personal Mobility Vehicles: Exploring Current Issues towards Future Developments
Stefania Boglietti, Benedetto Barabino, Giulio Maternini
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Identifying the Risk Factors in the Context-of-Use of Electric Kick Scooters Based on a Latent Dirichlet Allocation
Kyung-Jun Lee, Chan Hyeok Yun, Ilsun Rhiu, Myung Hwan Yun
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Challenges Caused by Increased Use of E-Powered Personal Mobility Vehicles in European Cities
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Frequency of Post-Concussion Syndrome in Korean Patients with Minor Head Injury: Ji Young Lee, Young Hoon Yoon, Roger J Lewis, Juliana Tolles; J Trauma Inj. 2017;30(2):41-46. Published online June 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.2.41

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Abstract PDF: PURPOSE
To determine the incidence of post-concussion syndrome (PCS) in Korean patients after minor traumatic brain injury.
METHODS
We conducted an observational cohort study of a convenience sample of patients presenting to the emergency department of a major academic Korean hospital. Patients who visited the Emergency Department for head trauma were screened. A researcher questioned the subject regarding his or her symptoms. Subjects were contacted by phone approximately 2 weeks after their Emergency Department visit and questioned about subsequent symptoms and subsequent visits for medical care.
RESULTS
Only 8% of subjects reported any post-concussion symptoms. Only 0.4% had three or more symptoms which might have met criteria for PCS. The median peak onset of symptoms was 3 days after injury.
CONCLUSION
The incidence of PCS is Korean patients is much lower than that documented for patients in the United States or other western countries. On the other hand, this study results could give an idea that mild trauma could also cause the PCS. Further study is needed to replicate this finding and investigate possible explanations for this difference.; Summary

Characteristics of Head Injuries After Skiing and Snowboarding Accident: Sung Chan Kang, Kang Hyun Lee, Han Joo Choi, Kyung Hye Park, Sang Chul Kim, Hyun Kim, Sung Oh Hwang; J Korean Soc Traumatol. 2008;21(1):53-58.

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Abstract PDF: PURPOSE
Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries.
METHODS
One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders.
RESULTS
Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was 26.7+/-10.0, and that of the snowboarders was 26.7+/-6.2. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was 4.5+/-2.1 and that of the snowboarder group was 5.9+/-5.0 (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%).
CONCLUSION
The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.; Summary

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