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The impact of COVID-19 on trauma patients and orthopedic trauma operations at a single focused training center for trauma in Korea
Wonseok Choi, Hanju Kim, Whee Sung Son, Seungyeob Sakong, Jun-Min Cho, Nak-Jun Choi, Tae-Wook Noh, Namryeol Kim, Jae-Woo Cho, Jong-Keon Oh
J Trauma Inj. 2022;35(3):195-201.   Published online December 1, 2021
DOI: https://doi.org/10.20408/jti.2021.0078
  • 2,879 View
  • 67 Download
AbstractAbstract PDF
Purpose

The objective of this study was to determine the effects of coronavirus disease 2019 (COVID-19) on the volume of trauma patients, the number of orthopedic trauma operations, and the severity of injuries. We also investigated the correlations between social distancing and these variables.

Methods

This was a retrospective review of trauma patient cases at a single focused training center for trauma in Korea from January 2017 to April 2021. The COVID-19 group included patients treated from January 1 to April 30 in 2020 and 2021, and the control group included patients treated during the same months from 2017 to 2019. The volume of trauma patients according to the level of social distancing was evaluated among patients treated from August 2, 2020 to November 23, 2020.

Results

The study included 3,032 patients who presented to the emergency department with traumatic injuries from January to April 2017 to 2021. The average number of patients was 646.7 and 546.0 in the control and COVID-19 groups, respectively. The percentage of patients injured in traffic accidents (TAs) decreased from 25.0% to 18.2% (p<0.0001). The proportions of in-car TAs and pedestrian TAs also decreased from 6.7% and 10.8% to 3.5% and 6.0%, respectively (p=0.0002 and p<0.0001). The percentage of bicycle TAs increased from 2.4% to 4.0% (p=0.0128). The proportion of patients with an Injury Severity Score above 15 and the mortality rate did not change significantly. As the level of social distancing increased, the number of trauma patients and the number of trauma injuries from TAs decreased. The number of orthopedic trauma operations also depended on the social distancing level.

Conclusions

The number of trauma patients presenting to the emergency department decreased during the COVID-19 period. The volume of trauma patients and orthopedic trauma operations decreased as the social distance level increased.

Summary
Effects of the Coronavirus Disease 2019 (COVID-19) Pandemic on Outcomes among Patients with Polytrauma at a Single Regional Trauma Center in South Korea
Sun Hyun Kim, Dongyeon Ryu, Hohyun Kim, Kangho Lee, Chang Ho Jeon, Hyuk Jin Choi, Jae Hoon Jang, Jae Hun Kim, Seok Ran Yeom
J Trauma Inj. 2021;34(3):155-161.   Published online June 4, 2021
DOI: https://doi.org/10.20408/jti.2020.0064
  • 3,848 View
  • 120 Download
  • 9 Citations
AbstractAbstract PDF
Purpose

The coronavirus disease 2019 (COVID-19) pandemic has necessitated a redistribution of resources to meet hospitals’ service needs. This study investigated the impact of COVID-19 on a regional trauma center in South Korea.

Methods

We retrospectively reviewed cases of polytrauma at a single regional trauma center in South Korea between January 20 and September 30, 2020 (the COVID-19 period) and compared them to cases reported during the same time frame (January 20 to September 30) between 2016 and 2019 (the pre-COVID-19 period). The primary outcome was in-hospital mortality, and secondary outcomes included the number of daily admissions, hospital length of stay (LOS), and intensive care unit (ICU) LOS.

Results

The mean number of daily admissions decreased by 15% during the COVID-19 period (4.0±2.0 vs. 4.7±2.2, p=0.010). There was no difference in mechanisms of injury between the two periods. For patients admitted during the COVID-19 period, the hospital LOS was significantly shorter (10 days [interquartile range (IQR) 4–19 days] vs. 16 days [IQR 8–28 days], p<0.001); however, no significant differences in ICU LOS and mortality were found.

Conclusions

The observations at Regional Trauma Center, Pusan National University Hospital corroborate anecdotal reports that there has been a decline in the number of patients admitted to hospitals during the COVID-19 period. In addition, patients admitted during the COVID-19 pandemic had a significantly shorter hospital LOS than those admitted before the COVID-19 pandemic. These preliminary data warrant validation in larger, multi-center studies.

Summary

Citations

Citations to this article as recorded by  
  • Patientensicherheit bei differenzierter (innerklinischer) Schockraumaktivierung für Schwerverletzte
    S. Hagel, K. R. Liedtke, S. Bax, S. Wailke, T. Klüter, P. Behrendt, G. M. Franke, A. Seekamp, P. Langguth, A. Balandin, M. Grünewald, D. Schunk
    Die Unfallchirurgie.2023; 126(6): 441.     CrossRef
  • Characteristics of Patients With Traumatic Brain Injury in a Regional Trauma Center: A Single-Center Study
    Mahnjeong Ha, Seunghan Yu, Byung Chul Kim, Jung Hwan Lee, Hyuk Jin Choi, Won Ho Cho
    Korean Journal of Neurotrauma.2023; 19(1): 6.     CrossRef
  • Changes in Injury Pattern and Outcomes of Trauma Patients after COVID-19 Pandemic: A Retrospective Cohort Study
    Myungjin Jang, Mina Lee, Giljae Lee, Jungnam Lee, Kangkook Choi, Byungchul Yu
    Healthcare.2023; 11(8): 1074.     CrossRef
  • Análise do atendimento primário de pacientes vítimas de violência interpessoal e autodirigida durante a pandemia da COVID-19
    HELOÍSA MORO TEIXEIRA, ANGEL ADRIANY DA-SILVA, ANNE KAROLINE CARDOZO DA-ROCHA, MARIANA ROTHERMEL VALDERRAMA, RAFAELLA STRADIOTTO BERNARDELLI, VITÓRIA WISNIEVSKI MARUCCO SILVA, LUIZ CARLOS VON BAHTEN
    Revista do Colégio Brasileiro de Cirurgiões.2023;[Epub]     CrossRef
  • Analysis of primary care of victims of interpersonal and self inflicted violence during the COVID-19 pandemic
    HELOÍSA MORO TEIXEIRA, ANGEL ADRIANY DA-SILVA, ANNE KAROLINE CARDOZO DA-ROCHA, MARIANA ROTHERMEL VALDERRAMA, RAFAELLA STRADIOTTO BERNARDELLI, VITÓRIA WISNIEVSKI MARUCCO SILVA, LUIZ CARLOS VON BAHTEN
    Revista do Colégio Brasileiro de Cirurgiões.2023;[Epub]     CrossRef
  • Comparison of Clinical Characteristics of Traumatic Brain Injury Patients According to the Mechanism Before and After COVID-19
    Jonghyun Sung, Jongwook Choi, Kum Whang, Sung Min Cho, Jongyeon Kim, Seung Jin Lee, Yeon gyu Jang
    Korean Journal of Neurotrauma.2023; 19(3): 307.     CrossRef
  • Outcomes improvement despite continuous visits of severely injured patients during the COVID-19 outbreak: experience at a regional trauma centre in South Korea
    Sooyeon Kang, Ji Eun Park, Ji Wool Ko, Myoung Jun Kim, Young Un Choi, Hongjin Shim, Keum Seok Bae, Kwangmin Kim
    BMC Emergency Medicine.2022;[Epub]     CrossRef
  • Impact of the COVID-19 pandemic on the epidemiology of traffic accidents: a cross-sectional study
    ANGEL ADRIANY DA SILVA, GABRIELA REDIVO STRÖHER, HELOÍSA MORO TEIXEIRA, MARIA VICTÓRIA GUTIERREZ CORDEIRO, MARCIA OLANDOSKI, LUIZ CARLOS VON-BAHTEN
    Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub]     CrossRef
  • Impacto da pandemia da COVID-19 na epidemiologia dos acidentes de trânsito: um estudo transversal
    ANGEL ADRIANY DA SILVA, GABRIELA REDIVO STRÖHER, HELOÍSA MORO TEIXEIRA, MARIA VICTÓRIA GUTIERREZ CORDEIRO, MARCIA OLANDOSKI, LUIZ CARLOS VON-BAHTEN
    Revista do Colégio Brasileiro de Cirurgiões.2022;[Epub]     CrossRef
Incidence and Clinical Features of Urethral Injuries with Pelvic Fractures in Males: A 6-Year Retrospective Cohort Study at a Single Institution in South Korea
Hyun Woo Sun, Hohyun Kim, Chang Ho Jeon, Jae Hoon Jang, Gil Hwan Kim, Chan Ik Park, Sung Jin Park, Jae Hun Kim, Seok Ran Yeom
J Trauma Inj. 2021;34(2):98-104.   Published online April 2, 2021
DOI: https://doi.org/10.20408/jti.2020.0034
  • 3,262 View
  • 137 Download
AbstractAbstract PDF
Purpose

Severe pelvic fractures are associated with genitourinary injuries, but the relationship between pelvic trauma and concomitant urethral injuries has yet to be elucidated. This study evaluated the incidence, mechanism, site, and extent of urethral injuries in male patients with pelvic fractures.

Methods

A retrospective cohort study was performed involving patients with urethral injuries accompanying pelvic fractures who visited Pusan National University Hospital from January 1, 2014 to December 31, 2019. Demographics, mechanisms of injury, clinical features of the urethral injuries, concomitant bladder injuries, methods of management, and the configuration of the pelvic fractures were analyzed.

Results

The final study population included 24 patients. The overall incidence of urethral injury with pelvic fracture was 2.6%, with the most common mechanism of urethral injury being traffic accidents (62.5%). Complete urethral disruption (16/24, 66.7%) was more common than partial urethral injuries (8/24, 33.3%), and unstable pelvic fractures were the most common type of pelvic fracture observed (70.8%). There was no definitive relationship between the extent of urethral injury and pelvic ring stability.

Conclusions

The present study provides a 6-year retrospective review characterizing the incidence, mechanism, and clinical features of urethral injury-associated pelvic fractures. This study suggests that the possibility of urethral injury must be considered, especially in unstable pelvic fracture patients, and that treatment should be chosen based on the clinical findings.

Summary
Epidemiology and Incidence of Orthopedic Fractures in the Military of the Republic of Korea
Sung Jin An, Sang Hyun Lee, Gi-Ho Moon
J Trauma Inj. 2021;34(1):50-56.   Published online November 30, 2020
DOI: https://doi.org/10.20408/jti.2020.0046
  • 3,214 View
  • 82 Download
  • 1 Citations
AbstractAbstract PDF
Purpose

Fractures are common in the military population, but limited studies have investigated the incidence of fractures among Korean military personnel. Hence, this study aimed to clarify this issue.

Methods

Eligible subjects were patients who had sustained a fracture and were registered in the N-DEMIS (the medical records system of participating hospitals) from June 2017 to May 2019. Fractures were categorized according to the fracture site, patients’ age, sex, and type of duty.

Results

In total, 23,687 patients with 23,981 fractures were included. There were 216 patients with multiple fractures, of whom 156 had fractures at two sites, 42 had fractures at three sites, and 18 had fractures at four sites. Of the 23,687 patients, 23,340 were men and 347 were women. The incidence of fractures in men and women was 12.96 per 1,000 person-years and 0.19 per 1,000 person-years, respectively. In terms of the broad location of fractures, the percentage of fractures was the highest in the hand, followed by the foot and lower leg. When the location of fractures was analyzed more specifically, the percentage of fractures was the highest in the phalanx (thumb and fingers), followed by the ankle and metacarpal bones.

Conclusions

Hand, foot, ankle, and wrist fractures were the most commonly encountered fractures in the Korean military population. To prevent the loss of combat power due to non-battle-related injuries, thorough preparation is necessary, including protective equipment and preliminary training for areas with a high frequency of fracture occurrence.

Summary

Citations

Citations to this article as recorded by  
  • Systematic Review and Meta-analysis of Exercise for the Prevention of Musculoskeletal Injuries in Soldiers
    Hoyong Sung, Geon Hui Kim, On Lee, Jaewoo Kim, Kyoung Bae Kim, Hyo Youl Moon, Yeon Soo Kim
    The Korean Journal of Sports Medicine.2024; 42(1): 1.     CrossRef
Incidences of Lower Extremity Injuries in Korea
Chang Sun Kim, Hyuk Joong Choi, Jai Yong Kim, Sang Do Shin, Sang Baek Koh, Kug Jong Lee, Tai Ho Im
J Korean Soc Traumatol. 2008;21(1):36-45.
  • 19,614 View
  • 6 Download
AbstractAbstract PDF
PURPOSE
We conducted this retrospective epidemiological study to assess the incidence and severity of lower extremity injuries in Korea METHODS: For this study, we retrospectively reviewed nationwide lower-extremity injury data compiled from 2001 to 2003 based on the National Injury Database, what included National Health Insurance Corporation (NHIC), Car Insurance, and Industry Insurance data. Data were standardized in terms of demographic characteristics, region, and socioeconomic status by using NHIC data. To assess the degree of the injuries, we used the Modified Abbreviated Injury Scale (MoAIS), what has been changed from the International Classification of Disease-10 (ICD-10) code. By using the Excess Mortality Ratio-adjusted Injury Severity Score (EMR-ISS), we classified the degree of severity into four categories: mild, moderate, severe and critical.
RESULTS
From 2001 to 2003, lower extremity injuries increased slightly, with a yearly average of 2,437,335. Insurance data should that lower-extremity injuries were the most common, followed by upper-extremity injuries. Significant difference were seen in the numbers of lower extremity injuries based on gender and age. As for provinces, Seoul and Gyeongi provinces had the highest numbers of cases. Junlabukdo had the highest rate of 55,282 cases per 1 million people for standardized gender and population. The annual incidence of the insured patients with lower extrimity injuries was higher than the employer's medical insurance contributions to the medical insurance program. Daily cases occur most often in May and June, with the lowest occurrences being in January and February.
CONCLUSION
The result of this study shows that lower extremity injuries comprised common cause of all injuries. In addition, differences associated with gender, location and socioeconomic status were observed. Further studies are needed to find reasons and then this knowledge will allow strategies to prevent the lower extremity injuries.
Summary

J Trauma Inj : Journal of Trauma and Injury