• Journal of Mechanical Science and Technology
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• 제14권11호
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• pp.1232-1243
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• 2000

Motor vehicle accidents in rear impacts cause more than fifty percents of drivers to suffer from neck injuries. It is known that most neck injuries are associated with rear-end collisions at a speed lower than 32 km/h and between the Abbreviated Injury Scale (AIS) 1 and AIS 2. Two different types of low speed crash tests such as the frontal barrier and rear moving barrier crashes have been conducted by following the procedure of the Research Committee for Automobile Repairs (RCAR). The injury for the neck and the Head Injury Criteria (HIC) were measured by using the sensors mounted on dummies. We reviewed neck injures and the relationship between the neck and head injuries, and examined the deceleration of the body. Using the experimental test data at the neck, we investigated an improved neck injury criterion Nij. Also, the effects of the position of a head restraint on reducing the frequency and severity of the neck injury in rear-end collisions were investigated.

• Journal of Trauma and Injury
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• 제31권2호
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• pp.58-65
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• 2018

Purpose: Many doctors have difficulty in deciding the treatment duration in trauma patients to write in the casualty medical certificate. We tried to find a solution for this problem by using abbreviated injury scale (AIS). Methods: A total of 39 patients treated in our regional trauma center who requested an author to write treatment duration on casualty medical certificate from January 2014 to April 2017 were included. And the treatment duration was decided based on the PARK Formula (AIS). PARK Formula $(AIS)=(AIS{\times}2){\sim}([AIS{\times}2]+2)$ Results: Among 39 patients included and 36 (92.3%) had treatment duration on casualty medical certificate within the range of treatment duration calculated by PARK Formula (AIS). Compared to the PARK Formula (AIS), the mean value was 0.13 week (0.90 day) smaller. Comparing the treatment duration between Korean Medical Association (KMA) guideline and PARK Formula (AIS), only 22 patients (56.4%) showed agreement. The mean value was 1.02 week (7.18 days) smaller in KMA guideline. Conclusions: For the decision of the treatment duration in trauma patients, utilizing worldwide used AIS scoring system is very efficient. Using PARK Formula (AIS), doctors can document the treatment duration in the casualty medical certificate with ease. KMA should provide more practical 'treatment duration of each diagnosis in writing casualty medial certificate' for the doctors. We recommend PARK Formula (AIS) as a good alternative for KMA guide.

• 자동차안전학회지
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• 제4권2호
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• pp.22-26
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• 2012

Prasad and Mertz published head injury risk curves for skull fracture and for Abbreviated Injury Scale (AIS) ${\geq}4$ brain injury due to forehead impacts based on the 15 ms HIC criterion. KNCAP adopted the HIC36 criterion for the male dummy and the HIC15 criterion for the female dummy. In this paper, it was studied that which of the HIC15 and HIC36 was more effective for the male dummy head injury evaluation. The frontal US-NCAP data for the 7 vehicles from the NHTSA test database were used to evaluate the head injuries. In the case of using the HIC15 and evaluation range 250~700, the discrimination of the rating for the occupant head injury was increased.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.98-103
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• 2015

Purpose: To compare injury sustained and severity of child occupant according to the types of safety restraint systems in motor vehicle crashes. Methods: This was a retrospective observational study. The study subjects were child occupants under the age of 8 years who visited a local emergency center following a motor vehicle crash from 2010 to 2014. According to safety restraint: child restraint systems (CRS), belted, and unbelted, we compared injuries sustained and injury severity using the maximal Abbreviated Injury Scale (MAIS) and Injury Severity Score (ISS), and analyzed the characteristics of severe injuries (AIS2+). Results: Among 241 subjects, 9.1% were restrained in CRS, 14.5% were only belted, and 76.3% was unbelted at the time of the crashes. Fourteen had severe injuries (AIS2+), all of whom didn't be restrained by CRS. Injuries in face and neck were the highest in unbelted group, and MAIS and ISS were the lowest in CRS group. Conclusion: Among safety restraint systems for child occupant in motor vehicle crashes, the CRS have the preventive effect of face and neck injuries, and are the most effective safety restraint systems.

• 한국화재소방학회논문지
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• 제33권2호
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• pp.139-144
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• 2019

노인인구의 증가로 노인운전자의 손상과 사망자도 증가하였다. 하지만 노인운전자의 손상과 중증도에 대한 연구는 활발히 이루어지지 않아 영향 요인을 파악하지 못하고 있다. 본 연구에서는 정면충돌에서의 노인운전자에 손상과 중증도에 영향을 미치는 요인을 찾아 중증도 분류에 추가적으로 활용하고자 하였다. Collision Deformation Classification Code를 통해 차량 파손 정도를 확인하였으며 간편손상척도(Abbreviated Injury Scale, AIS)로 손상부위와 정도를, 손상중증도점수(Injury Severity Score, ISS)로 환자의 중증도를 확인하였다. 중증외상환자의 발생률은 5이상의 차량 파손 정도를 가진 대상자에서 Odds ratio가 7.381로 나타났으며 선형회귀분석을 통한 중증도 요인 분석에서도 차량 파손 정도의 ${\beta}$값이 0.453으로 나타났다. 따라서 5이상의 차량 파손 정도는 노인운전자에서 중증도 분류에 추가적으로 활용될 수 있는 기준으로 제안될 수 있다.

• Journal of Trauma and Injury
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• 제26권2호
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• pp.47-52
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• 2013

Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

• Journal of Trauma and Injury
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• 제21권2호
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• pp.71-77
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• 2008

Purpose: The Glasgow Coma Scale (GCS), though it is widely used for triage, has been criticized as being unnecessarily complex. Recently, a 3-point Simplified Motor Score (SMS, defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for triage after traumatic brain injury when compared with the GCS as the criterion standard. The purpose of this study was to validate the SMS. Methods: We analyzed the patients who visited Kyungpook National University Hospital emergency center after traumatic brain injury from 2006 January to 2006 June. The test performance of the GCS, its motor component, and SMS relative to three clinically relevant traumatic brain injury outcomes (abnormal brain CT scans, Abbreviated Injury Scale $(AIS){\geq}4$, and mortality) were evaluated with areas under the receiver operating characteristic curves (AUCs). Results: Of 504 patients included in the analysis, 25.6% had an abnormal brain CT scans, 13.1% had $AIS{\geq}4$, and 5.0% died. The AUCs for the GCS, its motor component, and SMS with respect to the abnormal CT scans were 0.776, 0.715, and 0.716, and respectively, those for $AIS{\geq}4$ and mortality, were 0.969, 0.973, and 0.968, and 0.931, 0.909, and 0.909, respectively. Conclusion: The 3-point SMS demonstrated similar test performance when compared with the 15-point GCS score and its motor component for triage after traumatic brain injury in our populations.

• Journal of Trauma and Injury
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• 제33권4호
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• pp.227-235
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• 2020

Purpose: Alcohol intoxication is commonly associated with traumatic brain injury (TBI), but the influence of alcohol on the Glasgow Coma Scale (GCS) score remains unclear. This study investigates the effects of blood alcohol concentration (BAC) on the GCS score in head trauma patients with alcohol intoxication. Methods: In total, 369 head trauma patients with alcohol intoxication in a 1-year period were retrospectively analyzed. The patients underwent head computed tomography and had a BAC ≥80 mg/dL. Patients were divided into TBI and non-TBI groups. Brain injury severity was further classified using the head Abbreviated Injury Score (AIS). The effects according to 5 BAC groups were examined. Results: The TBI group consisted of 64 patients (16.2%). The mean BAC was significantly higher in the non-TBI group (293.4±87.3 mg/dL) than in the TBI group (242.8±89.9 mg/dL). The mean GCS score was significantly lower in the TBI group (10.3±4.6) than in the non-TBI group (13.0±2.5). A higher BAC showed a significant association with a lower mean GCS score in the TBI group, but not in the non-TBI group. Above ≥150 mg/dL, higher BACs showed significant odds ratios for a lower GCS score. Conclusions: The influence of alcohol in patients with head trauma depended on the presence of a brain injury. An association between a higher BAC and a lower GCS score was only observed in patients with TBI. Therefore, if a severe brain injury is suspected based on a GCS evaluation in patients with alcohol intoxication, prompt diagnosis and intensive care should be performed without delay.

• 자동차안전학회지
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• 제10권2호
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• pp.13-19
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• 2018

The purpose of this study was to evaluate the effect of air bag deployment in passenger car head-on collisions on injuries to the driver. The drivers in head-on collisions who were brought to the emergency rooms of two hospitals from January 2011 and October 2014 were evaluated, as were the vehicles involved. The driver injury level were assessed by utilizing Collision Deformation Classification (CDC) codes, and the Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS), respectively. In this study, it was shown that the chest ISS and AIS were significantly high when an air bag only is deployed. A statistically significant difference was found in the crush extent when the driver who fastened the seatbelt was found to be affected more than the ISS 9. Even when an air bag is deployed in a head-on car collision, injury severity can vary according to accident circumstances and crash severity. Accordingly, first aid can be rapidly given, and the injured person can be quickly referred to a hospital, only if the assessment of persons involved in a vehicle accident is accurately carried out.

• Journal of Trauma and Injury
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• 제33권2호
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• pp.88-95
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• 2020

Purpose: The present study will identify risk factors for aspiration in severe trauma patients by comparing patients who showed a sign of aspiration lung disease on chest computed tomography (CT) and those who did not. Methods: We conducted a retrospective review of the Korean Trauma Data Bank between January 2014 and December 2019 in a single regional trauma center. The inclusion criteria were patients aged ≥18 years with chest CT, and who had an Injury Severity Score ≥16. Patients with Abbreviated Injury Scale (AIS)-chest score ≥1 and lack of medical records were excluded. General characteristics and patient status were analyzed. Results: 425 patients were included in the final analysis. There were 48 patients showing aspiration on CT (11.2%) and 377 patients showing no aspiration (88.7%). Aspiration group showed more endotracheal intubation in the ER (p=0.000) and a significantly higher proportion of severe Glasgow Coma Scale (GCS) (p=0.000) patients than the non-aspiration group. In AIS as well, the median AIS head score was higher in the aspiration group (p=0.046). Median oxygen saturation was significantly lower in the aspiration group (p=0.002). In a logistic regression analysis, relative to the GCS mild group, the moderate group showed an odds ratio (OR) for aspiration of 2.976 (CI, 1.024-8.647), and the severe group showed an OR of 5.073 (CI, 2.442-10.539). Conclusions: Poor mental state and head injury increase the risk of aspiration. To confirm for aspiration, it would be useful to perform chest CT for severe trauma patients with a head injury.