Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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Prognostic Factor, for Major Trauma Patients in the Emergency Medical Service System

응급의료전달체계의 각 요인이 중증외상환자의 예후에 미치는 영향 분석

  • Lim, Du-Ko (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Chung, Tae-Nyoung (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Lee, Chang-Jae (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Jin, Su-Guun (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Kim, Eui-Chung (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Choi, Sung-Wook (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University) ;
  • Kim, Ok-Jun (Department of Emergency Medicine, CHA Bundang Medical Center, CHA University)
  • 임득호 (차의과학대학교 응급의학교실) ;
  • 정태녕 (차의과학대학교 응급의학교실) ;
  • 이창재 (차의과학대학교 응급의학교실) ;
  • 진수근 (차의과학대학교 응급의학교실) ;
  • 김의중 (차의과학대학교 응급의학교실) ;
  • 최성욱 (차의과학대학교 응급의학교실) ;
  • 김옥준 (차의과학대학교 응급의학교실)
  • Received : 2011.04.29
  • Accepted : 2011.06.23
  • Published : 2011.12.31
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Abstract

Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.

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