• Title/Summary/Keyword: 외상중증도

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Factors Influencing Prognosis of Traumatized Tooth in Primary Tooth Intrusion (유치 함입 시 외상 치아의 예후에 영향을 미치는 요인)

  • Chae, Yongkwon;Han, Yoonkyung;Nam, Okhyung;Kim, Misun;Lee, Hyoseol;Kim, Kwangchul;Choi, Sungchul
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.29-37
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    • 2019
  • The purpose of this study was to investigate the characteristics of intrusion in primary dentition and to evaluate factors influencing complications of primary and permanent dentition during long-term follow-up period. 61 patients (84 teeth) were selected in this study. Medical records of 61 patients were reviewed and age, gender, cause of injury, site of injury, severity of traumatic injury, other injuries associated with trauma, treatment method, and complications of primary and permanent dentition were examined. Collected data were statistically evaluated using Chi-square test and Fisher's exact test. Intrusion in primary anterior teeth was predominant in boys over girls and fall was the most common cause of trauma. It was most common at home and occurred most in the primary maxillary central incisors. Severity had an effect on the incidence of sequelae in permanent successors (p = 0.014). The incidence of complications was significantly lower in patients with soft tissue injuries than in patients with other periodontal injuries (p = 0.000).

Acute Traumatic Coagulopathy in Severe Trauma Patients (중증 외상환자의 급성 외상응고장애 조기 예측인자 분석)

  • Lee, Dong Eun;Seo, Kang Suk;Lee, Mi Jin;Shin, Su Jeong;Ryoo, Hyun Wook;Kim, Jong Kun;Park, Jung Bae
    • Journal of Trauma and Injury
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    • v.25 no.3
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    • pp.72-78
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    • 2012
  • Purpose: Clinical observation and research findings show that acute traumatic coagulopathy (ATC) is a major factor that must be addressed in the early care of severe trauma patients. ATC is associated with increased transfusion requirements and poor clinical outcomes. This study aimed to correlate the early predictable factors of ATC with the outcomes in severe trauma patients. Methods: Retrospective data from the trauma registry on severe trauma patients (Injury Severity Score (ISS) ${\geq}16$) were used to identify variables independently associated with coagulopathy. Univariate associations were calculated, and a multivariable logistic regression analysis was used to determine variables independently associated with ATC. Results: Patients were mostly male, aged $51.9{\pm}17.8$ years, with an injury severity score of $24.1{\pm}12.4$. ATC, as diagnosed in the emergency department (ED), occurred in 17% of the severe trauma patients. Using a multivariable logistic regression analysis, early predictable variables independently associated with ATC were base deficit (odds ratio (OR): 13.03; 95% confidence interval (CI): 3.47-48.93), acute liver injury (OR: 4.24; 95% CI: 1.06-17.00), and transfer from another hospital (OR: 21.00; 95% CI: 3.23-136.60). Conclusion: ATC is associated with mortality in severe trauma patients, and some variables associated with trauma and shock are an independent predictors of ATC. These variables contribute to the early recognition and management of coagulopathy, which may improve the outcome from trauma resuscitation.

Injury Analysis of a 12-passenger Van Rollover Accident (12인승 밴 전복사고의 상해 분석)

  • Kim, S.C.;Choi, H.Y.;Kim, B.W.;Park, G.J.;An, S.M.;Lee, K.H.
    • Journal of Auto-vehicle Safety Association
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    • v.10 no.1
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    • pp.20-26
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    • 2018
  • The fatality of rollover accidents in motor vehicle crashes is high despite their low incidence. Through the investigation of a 12-passenger van rollover accident in which 10 passengers were involved, we intend to analyze the correlation between the severity of the injury and the position of the occupants. We collected accident information from medical records, interviews, photo-images of the damaged van, field surveys, and the results of the Korean New Car Assessment Program (KNCAP). Based on the occupants' position, we classified injury sites and estimated injury severity. Passenger injury severity was evaluated by trauma score calculation. The initiation type of the rollover accident was passenger side 'fall-over' and the Collision Deformation Classification (CDC) code for the damaged van was 00TDZO3. The crash of the van involved 10 passengers, with an average age of $16.3{\pm}4.2years$. Few of the occupants had fastened seat belts at the time of the incident, and there was no airbag installed. One patient sustained severe liver injury and another was diagnosed with a fracture of the right humerus. The most common injuries were at the upper extremities and the neck. The average of Injury Severity Score (ISS) was $4.8{\pm}5.9$, and the average ISS of right-seated, mid-seated and left-seated occupants was $7.5{\pm}9.3$, $1.5{\pm}0.7$, and $3.3{\pm}2.1$ respectively (p>0.05). In the rollover (to-passenger side) accident of occupant unfastened, the average ISS of right-seated occupants (near side) was higher, but there was no statistically significant difference.

Repair of Posttraumatic Tricuspid Regurgitation Using Artificial Chordae and an Annuloplasty Ring (인공 건삭과 판막륜 성형술을 이용한 외상 후 삼첨판 부전증의 치료)

  • Son, Kuk-Hui;Son, Ho-Sung;Chung, Jae-Ho;Chung, Won-Jae;Sun, Kyung;Lee, Sung-Ho
    • Journal of Chest Surgery
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    • v.41 no.4
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    • pp.489-491
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    • 2008
  • A 52-year-old man was taken to the emergency room following a motor vehicle accident. An echocardiogram showed moderate to severe tricuspid regurgitation due to rupture of the anterior chordae. An operation to repair the tarumatic tricuspid regurgitation was recommended; however, the patient refused because he was asymptomatic. Two years later, he developed mild generalized edema and dyspnea. The echocardiogram revealed progressive severe tricuspid regurgitation and annular dilatation. We treated the tricuspid regurgitation successfully using artificial chordae and ring annuloplasty.

회원병원 소개 - 온세상을 건강한 미소로... - 창원파티마병원 -

  • 한국가톨릭의료협회
    • Health and Mission
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    • s.17
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    • pp.24-27
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    • 2009
  • 지난 6.29일자 중앙일보에 보도에 의하면 창원파티마병원은 2005년에 이어 2008년에도 보건복지가족부 주관 전국의료기관평가서 최우수병원으로 선정되었다. 의료서비스 및 환자만족도 등 20개 부문 중 19개 부문에서 A등급을 받아 평가 대상 의료기관 중 최고의 성적을 거두었다. 창원파티마병원은 1969년 마산시 대성동에서 4개 진료과, 10개 병상의 마산파티마병원에서 출발하여 2002년 창원으로 이전, 진료를 시작한 이래 응급환자의 진료에 만전을 기하기 위해 응급의료센터를 개설하고, 보건복지가족부 지정 중증외상 및 응급뇌질환 특성화후보센터를 운영하고 있다. 말기 암 환자를 위한 호스피스 병동을 지역최초로 개설하였고, 전신 암 조기진단장비인 PET-CT 등 첨단 장비를 지속적으로 보강하여 보다 질 높은 의료서비스 제공을 위해 노력하고 있다. 또한 온생명 Care 캠페인을 통해 지구의 환경을 보전하기 위한 환경 운동을 전개하는 한편 다문화 가정 지원사업, 환자와 보호자를 위한 사랑의 음악회, 찾아가는 시민강좌 등 다양한 사회공헌 활동을 하고 있다.

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Predictive Indicators for the Severity of Pediatric Trauma and the Prevention of Injuries According to the General Characteristics and Pre-hospital Factors of Severe Pediatric Trauma Patients (소아 중증 외상환자의 병원 전 요인에 따른 중증 손상의 예측과 손상의 예방)

  • Woo, Jae-Hyug;Yang, Hyuk Jun;Lim, Yong Su;Cho, Jin Seong;Kim, Jin Joo;Park, Won Bin;Jang, Jae Ho;Lee, Gun
    • Journal of Trauma and Injury
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    • v.27 no.3
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    • pp.43-49
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    • 2014
  • Purpose: Trauma is one of the most common causes of death for children, and identifying severely injured children quickly in an overcrowded emergency room (ER) is difficult. Therefore, severe injury must be prevented, and the severity of injuries in children must be determined easily from their general characteristics and pre-hospital factors. Methods: Injured children younger than 15 years of age who visited the ER from June 2011 to May 2013 were enrolled. According to the revised trauma score (RTS) of the patients, the study population was divided in two groups, a severe group (RTS<7) and a mild group ($RTS{\geq}7$). The general characteristics and the pre-hospital factors were compared between the two groups. Results: Six hundred seventy-three children were enrolled, their mean age was 8.03 (${\pm}4.45$) years, and 476 (70.73%) patients were male. Of these patients, 22 patients (3.27%) were in the severe group, and 651 patients (96.73%) were in the mild group. Fewer males were in the severe group than in the mild group (50.00% vs. 71.43%, p=0.030), and children in the severe group were younger than children in the mild group (3.50 vs. 8.00 years, p=0.049). In the severe group, toddlers (54.55%, p=0.036) were the most common age group. Severe injuries occurred more often in spring (32.81%) and summer (54.56%) than in autumn (9.09%) and winter (4.55%) (p=0.026). The most common places of injury in the severe group were roads (50.00%, p=0.009), and the most common mechanisms of injury in the severe group were traffic accidents (50.00%), followed by falls (31.82%) (p=0.011). Most severely injured children were transferred by ambulance (72.73%, p=0.000). Conclusion: The results of this study may be helpful for identifying severely injured children quickly in the field and the ER. To prevent severe pediatric injuries, precautions and policies based on these results should be established.

Clinical Characteristics of Patients with Traumatic Diaphragm Injury and Comparison of Scoring Systems as Predictors (외상성 횡격막 손상환자의 임상적 고찰과 예후 예측 인자의 유용성 비교)

  • Lee Sang Jin;Jung Jin Hee;Sohn Dong Suep;Cho Dai Yun
    • Journal of Chest Surgery
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    • v.38 no.1 s.246
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    • pp.56-62
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    • 2005
  • Because of high morbidity and mortality, traumatic diaphragm injury remains a diagnostic challenge. In this study, we evaluate that some factors and scores can be used as predictors. Material and Method: From May 1995 to June 2003, 23 patients with traumatic diaphragm injury were enrolled. We examined the clinical features of patients. RTS, TRISS, ISS and APACHE II scores for each patient are calculated for analyzing the relationship of mortality and ICU duration. Result: The study identified 15 men $(65.2{\%})$ and 8women $(34.8{\%})$. There are right sided diaphragmatic injury in 11 patients $(47.8{\%})$, left sided in 11 $(47.8{\%})$, and both sided in 1 ($0.4{\%}$). Plain X-ray, CT, upper GI contrast study and esophagogastroscopy were used as diagnostic tools. Age, hemodynamic status, early diagnosis are not associated with outcome. As prognostic factor, RTS and ISS are associated with mortality and there was negative relationship between RTS and ICU duration (r=0.737, p=0.026). Conclusion: An early diagnosis of traumatic diaphragm injury can frequently be missed in the acute trauma setting. So high index of suspicion and a careful examination are important in multiple trauma patients. An RTS can probably be used effectively as a predictor for the severity and prognosis in patients with traumatic diaphragm injury.

Correlation between Young and Burgess Classification and Transcatheter Angiographic Embolization in Severe Trauma Patients (중증 외상 환자의 골반골절에서 경피적 혈관 색전술과 Young과 Burgess 분류의 상관관계)

  • Cha, Yong Han;Sul, Young Hoon;Kim, Ha Yong;Choy, Won Sik
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.144-148
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    • 2015
  • Purpose: Immediate identification of vascular injury requiring embolization in patients with pelvic bone fracture isn't an easy task. There have been many trials finding indicators of embolization for patients with pelvic bone fracture. Although Young and Burgess classification is useful in decision making of treatment, it is reported to have little value as indicator of embolization in major trauma patients. The aim of this study is to find out Young and burgess classification on predicting vessel injury by analzyng pelvic radiograph taken from major trauma patients with pelvic bone fracture. Methods: Among major trauma patients with injury severity scores (ISS) higher than 15 who visited our emergency room from January 2011 to June 2014, 200 patients were found with pelvic bone fracture in trauma series and thus pelvic CT angiography was taken. Setting aside patients with exclusion criteria, 153 patients were enrolled in this study for analysis of Young and Burgess classification. Results: The most common mechanism of injury was lateral compression in both groups. There was no statistical significant difference in Young and Burgess classification (p=0.397). The obturator artery was the most commonly injured artery in both groups. Six patients had more than one site of bleeding. Conclusion: Prediction of transcatheter angiographic embolization using Young and Burgess classification in severe trauma patients is difficult and requires additional studies.

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Evaluation the Usefulness of Individual factors for Determining the Severity and Predicting Prognosis of Trauma Victims (외상 환자의 중증도 판단과 예후 예측을 위한 개별 인자들의 유용성 평가)

  • Kim, Sung Yoon;So, Byung Hak;Kim, Hyung Min;Jeong, Won Jung;Cha, Kyung Man;Choi, Seung Pill
    • Journal of Trauma and Injury
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    • v.28 no.3
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    • pp.134-143
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    • 2015
  • Purpose: Many patients are injured by trauma. And some of them expire due to severity of trauma. Various scoring systems have been introduced in grading severity and predicting mortality of trauma patients. This study is to evaluation the usefulness of factors for determining the severity and predicting the prognosis of the trauma victims. Methods: Data on the patients who visited our Emergency departments from January 2010 to December 2011 were retrospectively reviewed using electronic medical records. The patients were activated severe trauma team calling system. The patients were categorized as survivors and non-survivors. Univariated associations were calculated, and a multiple logistic regression analysis was used to determine variables associated with hospital mortality. Results: Two hundred sixty two(262) patients were enrolled, and the mortality rate was 25.6%. By multivariate analysis, lower respiration rate, lower Glasgow Coma Score, higher International Normalized Ratio and emergency transfusion within 6 hours were expected as severity and prognosis predict factors (each of odds ratio were 24.907, 14.282, 2.667 and 16.144). Conclusion: As predict factors, respiration rate, Glasgow Coma Score, International Normalized Ratio and emergency transfusion, are useful determining the severity and predicting prognosis of trauma victims.

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A Comparison of the Effectiveness of Before and After the Trauma Team's Establishment: Treatment Outcomes and Lengths of Stay in the Emergency Department (중증외상팀의 운영 전후 손상환자의 응급실체류시간과 치료결과 비교)

  • Kwon, Cheong-Hoon;Park, Chang-Min;Park, Young-Tae
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.75-81
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    • 2011
  • Purpose: The aim of this study was to analyze the influence of a trauma team's management. Methods: A total of 181 patients with severe trauma were retrospectively divided into two groups. Of these 181 patients, 81 patients without a trauma team admitted between April and October 2008 were assigned to Group 1, and 100 patients with a Trauma team admitted between April and October 2009 were assigned to Group II. We compared general characteristics, the length of stay in the emergency department (ED) and treatment outcomes (24-h packed RBC transfusion, length of intensive care unit (ICU) stay, length of hospital stay, in-hospital mortality, 24-h mortality) between these two groups. Results: The length of stay in the ED was significantly reduced in Group II compared to Group I ($p$=0.025). No significant differences were found in mean arterial pressure, Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score, in-hospital mortality and 24-h mortality between the two groups. However, Group II had a lower amount of 24-h packed RBC transfusion and a shorter length of ICU and hospital stay than Group I, although these differences were not statistically significant. Conclusion: Through the establishment of a trauma team, the length of stay in the ED can be reduced remarkably. Furthermore, the need for 24-h packed RBC transfusions and the length of stay in the ICU and hospital were found to be decreased in patients managed by a trauma team.