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J Trauma Inj : Journal of Trauma and Injury



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HOME > J Korean Soc Traumatol > Volume 23(1); 2010 > Article
Current State and Problem of the Transfer of Severely Injured Patients in One Regional Emergency Medical Center
Won Chul Lee, Choong Hyun Jo, Kyoung Won Jung, Young Gi Min, Sang Cheon Choi, Gi Woon Kim, Jung Hwan Ahn, Yong Sik Jung, Sun Ae Hwang, Ji Yong Kim, Kug Jong Lee, Yoon Seok Jung
Journal of Trauma and Injury 2010;23(1):6-15
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1Department of Emergency Medicine, Ajou University School of Medicine, Suwon, Korea.
2Department of Surgery, Ajou University School of Medicine, Suwon, Korea.

Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center.
Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggi-do. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer.
Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%).
Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

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