Difference in Management Between Native Koreans and Foreigners with Penetrating Wounds In the Emergency Room

관통상으로 응급실을 내원한 내국인과 외국인 환자의 진료의 차이

  • Kim, Yong-Kwan (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul) ;
  • Jang, Yong-Soo (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul) ;
  • Kang, Gu-Hyun (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul) ;
  • Choi, Jung-Tae (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul) ;
  • Jeon, Hoo (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul) ;
  • Kim, Jin-Ho (Department of Emergency Medicine, Kangnam Sacred Heart Hospital, Hallym University Medical Center Seoul)
  • 김용관 (한림대학교 의과대학 강남성심병원 응급의학과) ;
  • 장용수 (한림대학교 의과대학 강남성심병원 응급의학과) ;
  • 강구현 (한림대학교 의과대학 강남성심병원 응급의학과) ;
  • 최정태 (한림대학교 의과대학 강남성심병원 응급의학과) ;
  • 전후 (한림대학교 의과대학 강남성심병원 응급의학과) ;
  • 김진호 (한림대학교 의과대학 강남성심병원 응급의학과)
  • Received : 2010.08.09
  • Accepted : 2010.10.13
  • Published : 2010.12.30

Abstract

Purpose: With the increasing numbers of foreign residents in Korea, the need for an emergency medical care system for foreign patients seems to be growing. Sometimes, a foreigner admitted to an emergency room is not treated sufficiently due to the absence of insurance, facility in the Korean language, and a guardian. The management of a foreigner with trauma in the ER is difficult due to various problems such as social and economic status. The purpose of this study was to investigate the current management status of foreigners with penetrating wounds in the emergency room. Methods: This study is an analysis of 580 patients that were diagnosed with penetrating wounds in one teaching Hospital from Jan. 1, 2008 to Dec. 31, 2008. We analyzed results according to nationality, alcohol ingestion, intentional or accidental trauma, trauma mechanism, injury severity, management time in the ER, and outcome in the ER. Results: Of the total 580 patients, 486 patients (83.8%) were native Koreans and 94 patients (16.2%) were foreigners. According to the Revised Trauma Score, the average score of native Korean patients was 7.808, and the average score of foreign patients was 7.638. Of native Korean patients, 22.6% had knife wounds while 38.3% of foreign patients did. Of native Korean patients, 17.3% experienced intentional trauma while 33.0% of the foreign patients did. Of native Korean patients, 22.5% had ingested alcohol while 49.4% of the foreigners had. Of native Korean patients, 10.5% were admitted while 7.6% of the foreign patients were. Of native Korean patients, 14.2% were discharged against medical advice (DAMA), while 18.5% of foreign patients were. Of native Korean patients, 1.2% ran away while 8.7% of the foreign patients did. Conclusion: Stabbing was the most common cause of penetrating wounds in foreigner patients in this study. Intentional trauma was more common in foreigners with penetrating wounds than in native Koreans. The severity was higher in foreigners with penetrating wounds than it was in native Koreans, and patients who ran away or were discharged against medical advice were more commonly foreigners with penetrating wounds. Social insurance or policy is needed for the management of foreigners with penetrating wounds.

Keywords

References

  1. Yun SY, Cheon YJ, Won TH. Clinical Patterns of Penetrating Torso Injury at Emergency Department, J Korean Trauma Soc 2005;18:47-52.
  2. Yang BJ, Yu JM, Kim CS, Lee KC, Ko JC. A Case of Thoraco-abdominal Penetrating Injury with an Scaffolding Pipe following a Falling, J Korean Trauma Soc 2006;19:183-187.
  3. Lee HH, Choi SH, Yun SS, Lee S, Park IY, Park SM, et al. Clinical Analysis of Patients With Stab Wounds, J Korean Soc Emerg Med 1997;8:111-120.
  4. Ko YG, Kim BJ, Baek KJ, Cho YU, Kim JS. A Clinical Analysis of Abdominal Stab Injuries for Five Years, J Korean Soc Emerg Med 2003;14:536-543.
  5. Jang YS, Shin CN. A Study of Characteristics of Patients at International Clinic of University Hospital, Korean Public Health Research 2005;31:46-54.
  6. Park YW, Lee H. Analysis of Clinical Contents of Outpatients in Foreign Clinic, J Korean Acad Fam Med 1997;18:192-201