Browse > Article
http://dx.doi.org/10.14408/KJEMS.2021.25.3.037

Comparative study of geographic differences of severe trauma mortality in Korea  

Jeong, Tae-Wook (Department of Emergency Medical Service, National Medical Center)
Jo, Ji-Yeon (Division of Chronic Diseases Control & Research, Korea Centers for Diseases Control and Prevention)
Kim, Seong-Ho (Department of Emergency Medical Service, Seoul National University Bundang Hospital)
Publication Information
The Korean Journal of Emergency Medical Services / v.25, no.3, 2021 , pp. 37-48 More about this Journal
Abstract
Purpose: Mortality due to trauma is relevant to both low-income and high-income countries. A diversity of causes leads to mortality such as, socioeconomic status and geographic factors. This study sought to differentiate between cases of mortality in a metropolitan city and a rural area, with data from critical trauma patients. Methods: Community-based severe trauma surveillance data from 2018 was used in this study. Logistic regression was conducted to compare the odds ratios between deaths that occurred in a metropolitan city and a rural area. Multiple logistic regression by controlling variables such as type of medical institution and injury severity score was conducted to estimate the effect on the trauma patients. Results: In total, 28,217 participants were selected as total population. We observed that the odds of death decreased as the level of the trauma center increased. Compared to the metropolitan city, the odds ratio of rural areas was 1.44. The odds ratio increased as the injury severity score increased. Conclusion: This study suggests that the mortality of critical trauma patients is higher in rural areas than in metropolitan cities. More studies are needed to expand on this.
Keywords
Injuries; Geography; Mortality; Trauma;
Citations & Related Records
Times Cited By KSCI : 3  (Citation Analysis)
연도 인용수 순위
1 Lee EJ, Lee JS, Kim Y, Park KH, Eun SJ, Suh SK et al. Patterns of unintentional domestic injuries in Korea. J Prev Med Public Health 2010;43(1):84-92. https://doi.org/10.3961/jpmph.2010.43.1.84   DOI
2 World Health Organization. The injury chart book : a graphical overview of the global burden of injuries. Available at: https://apps.ho.int/iris/handle/10665/42566
3 Hong TH, Lee SH, Kim HW, Jung MJ, Lee JG. Patterns of In-hospital Mortality and Causes of Death in Blunt Poly-trauma Patients. J Acute Care Surg 2014;4(2):67-72. https://doi.org/10.17479/jacs.2014.4.2.67   DOI
4 Korea National Statistical Office. Annual report on the causes of death statistics in 2019. Available at: https://kostat.go.kr/portal/eng/index.action
5 National Emergency Medical Center. 2019 Emergency medical statistics yearbook. Available at: https://www.e-gen.or.kr/nemc/statistics_annual_report.do
6 Jung KY, Kim JS, Kim Y. Problems in trauma care and preventable deaths. J Korean Soc Emerg Med 2001;12(1):45-56.
7 Brown JB, Rosengart MR, Billiar TR, Peitzman AB, Sperry JL. Geographic distribution of trauma centers and injury related mortality in the United States. J Trauma Acute Care Surg 2016;80(1):42. https://doi.org/10.1097/TA.0000000000000902   DOI
8 Kim IM. Clinical experience of head-injured patients in the rural area. J Korean Neurosurg Soc 2000;29(8):1050-4.
9 Lee KH. Current status and future perspective of regional trauma center in Korea. J Korean Med Assoc 2016;59(12):917-8. https://doi.org/10.5124/jkma.2016.59.12.917   DOI
10 Bartolomeo SD, Sanson G, Michelutto V, Nardi G, Burba L, Francescutti C et al. Epidemiology of major injury in the population of Friuli Venezia Giulia-Italy. Injury 2004;35(4):391-400. https://doi.org/10.1016/S0020-1383(03)00246-8   DOI
11 Van Beeck EF, Mackenbach JP, Looman CWN, Kunst AE. Determinants of traffic accident mortality in the Netherlands: a geographical analysis. Int J Epidemiol 1991;20(3):698-706. https://doi.org/10.1093/ije/20.3.698   DOI
12 Lee JY, Lee KW. Clinical characteristics in geriatric trauma victims between a metropolitan city and rural areas. J Korean Soc Emerg Med 2008;19(5):506-12.
13 Sasser SM, Hunt RC, Faul M, Sugerman D, Pearson WS, Dulski T et al. Guidelines for field triage of injured patients: recommendations of the National Expert Panel on Field Triage, 2011. MMWR Recomm Rep 2012;61(Rr-1): 1-20.
14 Svenson JE, Spurlock C, Nypaver M. Factors associated with the higher traumatic death rate among rural children. Ann Emerg Med 1996;27(5):625-32. https://doi.org/10.1016/S0196-0644(96)70167-1   DOI
15 Kim MH, Subramanian SV, Kawachi I, Kim CY. Association between childhood fatal injuries and socioeconomic position at individual and area levels: a multilevel study. J Epidemiol Community Health 2007;61(2):135-40. https://doi.org/10.1136/jech.2006.047738   DOI
16 Lim DK, Chung TN, Lee CJ, Jin SG, Kim EC, Choi SW et al. Prognostic factor for major trauma patients in the emergency medical service system. J Trauma Inj 2011;24(2):89-94.
17 Kim Y, Jung KY, Cho KH, Kim H, Ahn HC, Oh SH et al. Preventable trauma deaths rates and management errors in emergency medical system in Korea. J Korean Soc Emerg Med 2006;17(5):385-94.
18 Kim H, Jung KY, Kim SP, Kim SH, Noh H, Jang HY et al. Changes in preventable death rates and traumatic care systems in Korea. J Korean Soc Emerg Med 2012;23(2):189-97.
19 Choi YE, Lee KS. Multilevel analysis on factors influencing death and transfer in inpatient with severe injury. Korean J Health Policy Adm 2013;23(3):233-43. https://doi.org/10.4332/KJHPA.2013.23.3.233   DOI
20 Lee KH. Optimal trauma care system in Korea. J Korean Med Assoc 2013;56(9):748-50. https://doi.org/10.5124/jkma.2013.56.9.748   DOI
21 Ministry of Land. Infrastructure and Transport. A city work manual. Human Culture Arirang 2015.
22 Park KH, Lee JS, Kim Y, Kim YI. The socioeconomic cost of injuries in South Korea. J Prev Med Public Health 2009;42(1):5-11. https://doi.org/10.3961/jpmph.2009.42.1.5   DOI
23 MacKenzie EJ, Rivara FP, Jurkovich GJ, Nathens AB, Frey KP, Egleston BL et al. A national evaluation of the effect of trauma-center care on mortality. N Engl J Med 2006;354(4): 366-78. https://doi.org/10.1056/NEJMsa052049   DOI
24 Moon SB, Lee SH, Ryoo HW, Kim JK, Ahn JY, Kim SJ et al. Preventable trauma death rate in Daegu, South Korea. Clin Exp Emerg Med 2015;2(4):236. https://doi.org/10.15441/ceem.15.085   DOI