• Title/Summary/Keyword: Injury Pyramid

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The Pyramid of Injury: Estimation of the Scale of Adolescent Injuries According to Severity

  • Han, Hyejin;Park, Bomi;Park, Bohyun;Park, Namsoo;Park, Ju Ok;Ahn, Ki Ok;Tak, Yang Ju;Lee, Hye Ah;Park, Hyesook
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.163-168
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    • 2018
  • Objectives: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. Methods: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. Results: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. Conclusions: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.

The Selection and Supplementation of Core Data for Injury Surveillance (손상감시를 위한 핵심데이터 선정과 보완)

  • Lim, Joon-Kyu;Kim, Han Kyoul;Rhee, Hyun-Sill
    • Journal of Digital Convergence
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    • v.18 no.9
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    • pp.265-275
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    • 2020
  • The burden of injury is widely considered to be very severe in our society. Nonetheless, we don't have enough data for injury surveillance. The objective of this research is to select and supplement CORE DATA for injury surveillance. For this purpose, this study had analyzed the literature such as the Quality Assessment Report about 'Causes of Death Statistics', 'Health Insurance Statistics' and 'Hospital Discharge Injury Surveillance' according to the six dimension of Statistics Quality. The analysis result is that 'Cause of Death Statistics' and 'Health Insurance Statistics' have the usefulness as the CORE DATA for injury surveillance. But there is a significant shortcoming in the Health Insurance Statistics, which is that there is a lack of the data about the external causes of injury. For supplementing the defect, this study proposes the system that the medical institutions should obligatorily report the external causes of injury when claim National Health Insurance Medical Care Expenses. As the results of this system, we can expect 'Establishing of Injury pyramid', 'Data Connecting with the National Pension' and 'Improving the Promptness of Injury Data'. And we expect the follow-up study for the realization of this system.

Effect of Bupleuri Radix on HSP70 Expression and Hippocampus of Ischemically Damaged Aged BCAO Rats (시호(柴胡)가 뇌허혈 유발 노령 흰쥐의 해마 손상 및 HSP70 발현에 미치는 영향)

  • Bae, Cheol-Hwan;Jeong, Sung-Hyun;Shin, Gil-Cho;Lee, Won-Chul;Kim, Jin-Su
    • The Journal of Internal Korean Medicine
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    • v.25 no.4
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    • pp.105-116
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    • 2004
  • Objective : In this study, we used the aged bilateral common carotid artery occlusion (BCAO) rats were used to measure the effect of Bupleuri Radix (Si-Ho) on the brain ischemic injury, because aging is an important factor in storke, Method : The brian ischemic injury was induced by temporary closing of carotids on both sides in a low blood pressure state. Bupleuri Radix (Si-Ho) was orally administered in 18-month-old BCAO rats. Result : The Ischemic Damaged Hippocampus and HSP expression were analyzed by the immunohistochemical staining and the result were as follows: 1. The low numbers of pyramid cells in the hippocampus CA1 area for the ischemically injured experimental group rose to numbers simillar to those of the control group. 2. The thin neuronal cell layer in the hippocampus CA1 area for the ischemically injured experimental group returned to thickness simillar to those of the control group. 3. The normalized optical density of HSP70 expression was suppressed in CA2, DG and CA1 expression was significantly suppressed in the experimental group compared to the control group. Conclusion : These results suggested that Bupleuri Radix (Si-Ho) has a neuroprotective effect by reducing neural cell injury in the initial ischemic state.

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Using a Kirschner wire as an internal splint at nasal fractures accompanied fracture of frontal process of maxilla or perpendicular plate of ethmoid (상악골 전두돌기 골절 및 사골 수직판 골절을 동반한 비골 골절에서 K 강선을 이용한 내고정)

  • Rho, Kyoung Hwan;Yoon, Eul Sik;Yoon, Byung Min;Dhong, Eun Sang
    • Archives of Plastic Surgery
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    • v.36 no.5
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    • pp.623-628
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    • 2009
  • Purpose: In cases where nasal fractures involve frontal process of maxilla or perpendicular plate of ethmoid, 4 - 5 days of nasal packing may not provide sufficient support for avoiding displacement after packing removal. Therefore a single Kirschner - wire(K - wire) is used as an internal splint when nasal fractures involve the above two areas. Methods: Thirty five patients during the last 3 practical years were treated with a K -wire pinning according to the anatomic locations of nasal fractures. We performed a retrospective study using 13 nasal fractures out of total 35 patients. Among 13 cases, 10 patients involved frontal process of maxilla, and 3 patients were diagnosed as bilateral nasal side wall fractures accompanied with fractures of perpendicular plate of ethmoid. One patient of the last three cases had been augmented with dorsal silicone implant long before the trauma. We analyzed the anteroposterior displacement of key stone area and the width between both lateral walls by comparing immediate postoperative radiographs with 2 month follow - ups. To reduce the errors, the same measurements were taken by two different inspectors, and the mean of each inspector's measurements was compared. Patient satisfaction was analyzed using a questionnaire regarding the esthetic and functional outcomes. Results: Ten patients underwent a longitudinal K - wire fixation in submucoperiosteal plane underneath the frontal process of maxilla. And three patients underwent a transverse K - wire fixation from the one side of lateral wall to the perpendicular plate of ethmoid and to the other side of lateral wall. The mean postoperative anteroposterior displacement of the key stone area measured by two inspectors were 1.84% and 3.06%; mean narrowing of bony pyramid were 1.33% and 1.48%, respectively. Subjective satisfaction scores regarding the esthetic appearance and the maintenance of nasal shape compared with immediate post - operative state with the long term ones were not different (p>0.05). Conclusion: K - wire pinning after closed reduction is a reliable and useful method for the treatment of nasal fractures involving frontal process of maxilla or perpendicular plate of ethmoid. This is because it achieves longer intranasal support after reduction. This method also leaves conspicuous external scar, and minimal soft - tissue injury.