• Fire Science and Engineering
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• v.33 no.2
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• pp.139-144
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• 2019

The increase in the elderly population also increased the damage and deaths of the elderly drivers. However, studies on the severity and severity of the elderly driver are not actively conducted and the factors are unknown. In this study, I tried to find out the factors affecting the damage and severity of the elderly driver in the frontal collision and to utilize them additionally in the severity classification. Collision Deformation Classification (CDC) Code was used to check the extent of damage to the vehicle. Abbreviated Injury Scale (AIS) was used to determine the injury parts and severity of injury, and the Injury Severity Score (ISS) to confirm the severity of the patient. The odds ratios of severe injury patients were found to be 7.381 in the subjects with 5 or more deformation extent and the ${\beta}$ value of the deformation extent was 0.453 in the analysis of the severity by linear regression analysis. Therefore, the degree of deformation extent of 5 or more can be suggested as a criterion that can be used additionally to the severity classification in the elderly driver.

• Journal of the Korean Orthopaedic Association
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• v.55 no.5
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• pp.383-396
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• 2020

Purpose: This study compared the injury mechanism, site, type, initial management approach of orthopedic injury, and outcomes according to the injury severity in moderate-to-severe injured patients. Materials and Methods: During 57-month, excluding the period when the authors' emergency/trauma center was not operating, from 2014 to 2019, a retrospective study was conducted on 778 patients with orthopedic injuries among patients with an Injury Severity Score (ISS)>9 scored. The patients were classified into moderate-injured group (group-1, 679) and severe-injured group (group-2, 99) according to the injury severity based on the ISS and physiologic parameters. The injury mechanism and non-orthopedic injury were evaluated. Orthopedic injuries were assessed according to the injury pattern and the number of anatomical regions and bone sites involved. The management approach for the orthopedic injuries in two groups was compared. Outcomes (hospital stay, systemic complications, and in-hospital mortality) were evaluated, and the risk factors for mortality were analyzed. Results: In group-2, the incidence of younger males, high-energy mechanisms, and accompanying injuries was significantly higher than in group-1. The number of anatomical regions and bone sites involved increased in group-2. The involvement of the pelvis, spine, and upper extremity was significantly higher in group-2, whereas group-1 was involved mainly by the lower extremities. Depending on the patient's condition, definitive or staged management for orthopedic injuries may be used. Group-1 was treated mainly with definite fixation after the physiological stabilization process, and group-2 was treated with staged management using temporary external fixation. The hospital stay was significantly longer in group-2. The overall systematic complications and in-hospital mortality was approximately 4.9% and 4.5%. A higher injury severity was associated with higher in-hospital mortality (2.9%, 15.2%; p<0.0001). Increasing age and high ISS are independent risk factors for mortality. Conclusion: A higher severity of injury was associated with a higher incidence of high-energy mechanism, younger, male, accompanying injuries, and the frequency and severity of orthopedic injuries. Severe polytrauma patients were treated mainly with a staged approach, such as external fixation. The hospital stay, systematic complications, and in-hospital mortality were significantly higher in severe-injured patients. Age and ISS are strong predictors of in-hospital mortality in polytrauma.

• Proceedings of the Korea Contents Association Conference
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• 2013.05a
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• pp.209-210
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• 2013

본 연구에서는 보건복지부에서 중증 응급환자를 위한 '중증질환별 특성화 센터'로 지정된 안양의 H병원에서 오토바이 사고로 인해 응급실을 내원하여 중증외상 환자로 분류된 환자를 대상으로 보건복지부 중앙응급의료센터에서 정한 중증외상 등록체계를 바탕으로 중증도를 분석하여 손상기전과 생존의 영향을 미치는 인자에 대하여 알아보고자 한다.

• Proceedings of the Korea Contents Association Conference
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• 2011.05a
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• pp.199-200
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• 2011

중증외상 환자의 사망률을 높이는 출혈의 형태에는 정맥손상으로 인한 출혈과 골절 및 장기손상에 의한 동맥손상 출혈, 골수 내 출혈이 있을 수 있는데, 이중에서 동맥손상에 의한 출혈은 진단이 지연되면 다량의 출혈로 인한 생체활력 징후가 불안정하며 사망률이 높아지는 아주 중요한 질환이다. 응급실을 내원한 중증외상 환자로 등록된 환자 중 혈관조영술을 시행 받고, 동맥 파열이 진단되어 동맥색전술을 시행 받은 환자를 대상으로 생존의 영향을 미치는 인자에 대하여 알아보고자 하며 생존 군과 사망 군을 비교하여 동맥촬영 및 색전술이 적절한 치료방법으로 유용성과 적절한 시행시점을 연구하기 위함이다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.4
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• pp.332-339
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• 2016

This study examined the intensity of the association of factors affecting major burns by statistical analysis for patients injured by the release of chemical hazards. A total of 446 patients were evaluated as chemical injury patients, who had visited the emergency room from 1/Jan/2010 to 31/Dec/2014. The major burn was used as a dependent variable representing the severity of chemical injury. A chi-square test (CST) and binary logistic regression test (BLRA) were used as the statistical analysis method for determining the association between major burns and the independent variables. In CST, female and their presence at an incident scene, multiple site injury were associated with major burn (p<0.05). In BLRA, the presence at an incident scene and spills (comparing explosion), discharge (comparing admission) were associated with major burns (p<0.05). In this study, the presence at an incident scene was the most significant factor concerning major burns. Furthermore, gender and injury number, exposure mechanism (spill comparing explosion), and disposition (discharge comparing admission) were also associated with major burns.

• Journal of East-West Nursing Research
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• v.28 no.1
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• pp.10-20
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• 2022

Purpose: We compared the Korean Triage and Acuity Scale (KTAS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) determined the validity of KTAS for classifying trauma patients. Methods: A retrospective chart review of 10,865 trauma patients (aged ≥15 years) who visited a single regional trauma and emergency medical center from January 1, 2016, to December 31, 2020, was conducted. Data were collected from the Korean Trauma Data Bank. Based on KTAS classification, the rates of intensive care unit admission, surgery and intervention, transfusion, emergency room (ER) and hospital mortality, and ER stay time were investigated. Data were analyzed using Chi-square test, Pearson's correlation coefficient, receiver operating characteristic curve, and area under the ROC curve. Results: In the KTAS, severe trauma patients (ISS ≥16) were classified as Level 1 (79.6%), 2 (44.8%), 3 (15.5%), 4 (4.0%) and 5 (7.6%). The following were the predictive powers of KTAS, ISS, and RTS for different parameters: surgery and intervention rate, KTAS (.71), ISS (.70), and RTS (.63); transfusion rate within 4h, KTAS (.82), ISS (.82), and RTS (.74); ER stay time within 90 min, KTAS (.72), ISS (.62), and RTS (.56); and ER mortality, KTAS (.84), ISS (.72), and RTS (.88). These findings were statistically significant (p<.001). The sensitivity and specificity of KTAS for trauma patients were .88 (.87~.90), and .38 (.37~.39), respectively. Conclusion: KTAS is a useful classification system that can predict the clinical outcomes of patients with trauma, and effectively triage acutely ill trauma patients, thus provide appropriate treatment.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.6
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• pp.2668-2676
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• 2011

In order to analyze the variation in length of stay(LOS) of injury inpatients, we developed severity-adjusted LOS model using Korean National Discharge In-depth Injury Survey data of Center for Disease Control. Appling this model, we calculated predicted values and, after standardizing LOS using the differences from the actual values, analyzed the variation in LOS. Major factors affecting severity-adjusted LOS of injury inpatients were found to be severity, surgery(or no surgery), age, injury mechanism and channel of hospitalization. Result of analysis of the differences between the actual values and predicted values adjusted by decision tree model suggested that there were statistically significant differences by hospital size(number of beds), type of insurance and location of institution. In order to reduce the variation in LOS, efforts should be exerted in developing nationwide treatment protocol, inducing medical institutions to utilize it, and furthermore systematically evaluating it to reduce the variation continually.

• Tuberculosis and Respiratory Diseases
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• v.46 no.2
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• pp.204-214
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• 1999

Background: Resting pulmonary function tests(PFTs) are routinely used in the evaluation of pulmonary impairment/disability. But the significance of the cardiopulmonary exercise test(CPX) in the evaluation of pulmonary impairment is controvertible. Many experts believe that dyspnea, though a necessary part of the assessment, is not a reliable predictor of impairment. Nevertheless, oxygen requirements of an organism at rest are different from at activity or exercising, and a clear relationship between resting PFTs and exercise tolerance has not been established in patients with chronic pulmonary disease. As well, the relationship between resting PFTs and dyspnea is complex. To investigate the relationship of dyspnea, resting PFTs, and CPX, we evaluated the patients of stabilized chronic pulmonary disease with clinical dyspnea rating(baseline dyspnea index, BDI), resting PFTs, and CPX. Method: The 50 patients were divided into two groups: non-severe and severe group on basis of results of resting PFTs(by criteria of ATS), CPX(by criteria of ATS or Ortega), and dyspnea rating(by focal score of BDI). Groups were compared with respect to pulmonary function, indices of CPX, and dyspnea rating. Results: 1. According to the criteria of pulmonary impairment with resting PFTs, $VO_2$max, and focal score of BDI were significantly low in the severe group(p<0.01). According to the criteria of $VO_2$max(ml/kg/min) and $VO_2$max(%), the parameters of resting PFTs, except $FEV_1$ were not significantly different between non-severe and severe(p>0.05). According to focal score($FEV_1$(%), FVC(%), MW(%), $FEV_1/FVC$, and $VO_2$max were significantly lower in the severe group(p<0.01). However, in the more severe dyspneic group(focal score<5), only $VO_2$max(ml/kg/min) and $VO_2$max(%) were low(p<0.01). $FEV_1$(%) was correlated with $VO_2$max(%)(r=0.52;p<0.01), but not predictive of exercise performance. The focal score had the correlation with max WR(%) (r=0.55;p<0.01). Sensitivity and specificity analysis were utilized to compare the different criteria used to evaluate the severity of pulmonary impairment, revealed that the classification would be different according to the criteria used. And focal score for dyspnea showed similar sensitivity and specificity. Conclusion : According to these result, resting PFTs were not superior to rating of dyspnea in prediction of exercise performance in patients with chronic pulmonary diseases and less correlative with focal score for dyspnea than $VO_2$max and max WR. Therefore, if not contraindicated, CPX would be considered to evaluate the severity of pulmonary impairment in patients with chronic pulmonary diseases, including with severe resting PFTs. Current criteria used to evaluate the severity of impairment were insufficient in considering the degree of dyspnea, so new criteria, including the severity of dyspnea, may be necessary.

• Journal of the Korea Society of Computer and Information
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• v.25 no.11
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• pp.239-244
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• 2020

The purpose of this study is to provide basic data for injury prevention measures through the risk factors of injury occurrence by comprehending injury characteristics of the trauma patients visiting a regional emergency medical center according to distribution based on external causes and injury severity score. This study was analyzed using SPSS-Window(ver. 20.1) for 2585 trauma patients who visited a regional emergency medical center and the research period is for four months from 1st of September, 2019 to 31th of December, 2019. The following were the results of the research. First, it is shown from the analyzed data that the proportion of males (61.3%) is greater than that of females (38.7%) and the group aged from 20 to 50 had a significantly higher occurrence rate of injury but in terms of injury severity, 50 takes up the great proportion(P<.001). Second, roads and traffic areas (35.1%) were the highest in the place of occurrence of injury(P<.001). Third, the time of injury occurrence was as high as 12-18 hours(35.8%)(P<.001). Fourth, the injury part was highest in the head and face (55.4%)(P<.001). Fifth, the type of injury was higher in open wounds (31.2%)(P<.001). Therefore, it is required to establish detailed injury prevention policies according to the characteristics of injury severity.

• Journal of the Korean Society of Radiology
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• v.6 no.2
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• pp.107-114
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• 2012

The study was conducted in patients who had undergone angiography and arterial embolization after being diagnosed with arterial bleeding among those registered with severe trauma at the admission to the department of emergency due to accidents. In the study, comparison was done between the survived group and the nonsurvived group to investigate the usefulness and the optimal performance timing of angiography and embolization as the survival-affecting factors and treatment methods for patients. The study was performed as a retrospective analysis in 45 patients who had undergone angiography and arterial embolization among those categorized as severe trauma patients from the emergency department of H hospital located in Gyeonggi-do from July, 2006 until December, 2010. The Injury Severity Score (ISS), the Revised Trauma Score (RTS), the hematocrit were the main outcome measurements. Arterial embolization was technically successful in all cases, transcatheter arterial embolization of arterial bleeding is a useful procedure in lowering the mortality and complication in severe trauma patients. and RTS, ISS, Hematocrit were the predictable early mortality factors. So bad vital sign patients must be progressed rapidly.