• Title/Summary/Keyword: Injury Severity

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Non-Operatively Treated Thoracolumbar Burst Fracture with Posterior Ligamentous Complex Injury: Case Report and Consideration on the Limitation of Thoracolumbar Injury Classification and Severity (TLICS) Score

  • Kwon, Woo-Keun;Oh, Jong-Keon;Cho, Jun-Min;Kwon, Taek-Hyun;Park, Youn-Kwan;Moon, Hong Joo;Kim, Joo Han
    • Journal of Trauma and Injury
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    • v.31 no.2
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    • pp.76-81
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    • 2018
  • Fractures at the thoracolumbar region are commonly followed after major traumatic injuries, and up to 20% of these fractures are known to be burst fractures. Making surgical decisions for these patients are of great interest however there is no golden standard so far. Since the introduction of Thoracolumbar Injury Classification and Severity (TLICS) score in 2007, it has been widely used as a referential guideline for making surgical decisions in thoracolumbar fractures. However, there is still limitations in this system. In this clinical case report, we introduce a L1 burst fracture after motor vehicle injury, who was successfully treated conservatively even while she was graded as a TLICS 5 injury. A case report is presented as well as discussion on the limitations of this grading system.

Trauma severity and mandibular fracture patterns in a regional trauma center

  • Lee, Hyeok;Kim, Kwang Seog;Choi, Jun Ho;Hwang, Jae Ha;Lee, Sam Yong
    • Archives of Craniofacial Surgery
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    • v.21 no.5
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    • pp.294-300
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    • 2020
  • Background: Mandibular fractures are one of the most common types of facial fractures, the treatment of which can be delayed due to the severity of the trauma resulting in an increase of complications; thus, early evaluation of trauma severity at the time of visit is important. In South Korea, trauma patients are triaged and intensively treated in designated regional trauma centers. This study aimed to analyze the relationship between trauma severity and mandibular fracture patterns. Methods: A medical records review was performed on patients who visited the regional trauma center at our hospital for mandibular fracture between 2009 and 2018. Epidemiologic data and mandibular fracture patterns were analyzed and compared with the conventional facial injury severity scale (FISS). Results: Among 73 patients, 51 were classified as non-severe trauma patients and 22 as severe trauma patients. A higher trauma severity was associated with older age (odds ratio [OR], 1.164; 95% confidence interval [CI], 1.057-1.404) and lower risk was associated with fractures located in the angle (OR, 0.001; 95% CI, 0-0.022), condylar process (OR, 0.001; 95% CI, 0-0.28), and coronoid process (OR, 0.004; 95% CI, 0-0.985). The risk was lower when the injury mechanism was a pedestrian traffic accident (OR, 0.004; 95% CI, 0-0.417) or fall (OR, 0.004; 95% CI, 0-0.663) compared with an in-car traffic accident. Higher FISS (OR, 1.503; 95% CI, 1.155-2.049) was associated with a higher trauma severity. The proposed model was found to predict the trauma severity better than the model using FISS (p< 0.001). Conclusion: Age, location of mandibular fractures, and injury mechanism showed significant relationships with the trauma severity. Epidemiologic data and patterns of mandibular fractures could predict the trauma severity better than FISS.

Comparison of the Characteristics according to Injury Severity Score between Elderly and Non-elderly with Trauma (노인과 비노인 외상환자의 손상중증도에 따른 특성 비교)

  • Kim, Hyunju;Kim, Younkyoung
    • Journal of Korean Public Health Nursing
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    • v.32 no.2
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    • pp.304-318
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    • 2018
  • Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

A study on the variation of severity adjusted LOS on Injry inpatient in Korea (손상입원환자의 중증도 보정 재원일수의 변이에 관한 연구)

  • Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
    • 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.

The Study of the Subjective Symptoms according to Frontal Lobe Damage and Change in Neurocognitive Function in Traumatic Head Injury Patients (두부외상 환자에서 전두엽 손상과 신경인지기능 변화에 따른 주관적인 증상 연구)

  • Kim, Jun-Won;Han, Doug-Hyun;Kee, Baik-Seok;Park, Doo-Byung
    • Anxiety and mood
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    • v.8 no.1
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    • pp.31-40
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    • 2012
  • Objective : The purpose of this study was to analyze the correlation between symptom severity and neurocognitive factors in traumatic head injury patients. In addition, the effect of frontal lobe damage on these parameters was examined. Methods : We selected 18 patients who had brain damage for the moderate to severe traumatic brain injury (MSTBI) group, and 17 patients who met the diagnostic criteria for post-traumatic stress disorder (PTSD) without the finding of brain damage for the comparison group. For the evaluation of neurocognitive function, K-WAIS, Rey-Kim Memory Test, K-FENT, WCST, and MMPI-2 were used. Results : The results of the comparison (using the malingering scale) revealed that the values of PDS and PK, which express the severity of symptoms, and the values of the validity scale F, F (B), and F (P) were significantly higher in the overly-expressed group. F (B) in overly-expressed group and PK, Pt, and Sc in the properly-expressed group had significant correlation with the severity of symptoms. F (B), S, and Stroop error inhibition in PTSD, and PK, Pt, Sc, and MQ in MSTBI had significant correlation with the severity of symptoms. The results of the comparison based on the finding of frontal lobe damage revealed that PDS, EIQ, and MQ ware significantly higher in the group without brain damage. Conclusions : It was revealed that each neurocognitive factor was correlated with the severity of symptoms. There was a decrease in complaints or symptoms reported by the frontal lobe injury group, and this is believed to be due to degenerative change in the personality and emotional functioning of these patients following frontal lobe damage.

Characteristics of Traffic Accidents on Highways: An Analysis Based on Patients Treated at a Regional Trauma Center

  • Lee, Sung Yong;Sun, Kyung Hoon;Park, Chan Yong;Kim, Tae Hoon
    • Journal of Trauma and Injury
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    • v.34 no.4
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    • pp.263-269
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    • 2021
  • Purpose: There have been increasing concerns about serious traffic accidents on highways. The purpose of this study was to analyze factors affecting traffic accidents on highways and the severity of the resulting injuries. Methods: This retrospective study was conducted at a regional trauma center. We reviewed 594 patients who had been in 114 traffic accidents on highways from January 2018 to June 2020. We collected demographic data, clinical data, accident-related factors, and meteorological data (weather and temperature). Results: Environmental risk factors were found to be significantly associated with the incidence of traffic accidents on highways. Injury severity and the death rate were higher in sedans than in any other type of vehicle. Tunnels were the most common location of accidents, accounting for 47 accidents (41.2%) and 269 injured patients (45.3%). The injury severity of individuals riding in the driver's seat (front seat) was high, regardless of vehicle type. Three meteorological risk factors were found to be significantly associated with traffic accidents: rainy roads (odds ratio [OR] 2.08; 95% confidence interval [CI] 1.84-3.29; p=0.01), icy or snowy roads (OR 5.12; 95% CI 2.88-7.33; p<0.01), and foggy conditions (OR 2.94; 95% CI 2.15-4.03; p<0.05). Conclusions: The injury severity of patients was affected by seat position and type of vehicle, and the frequency of accident was affected by the location. The incidence of traffic accidents was strongly influenced by meteorological conditions (rain, snow/ice, and fog).

Crash Discrimination Algorithm with Two Crash Severity Levels Based on Seat-belt Status (안전띠 착용 유무에 근거한 두 단계의 충돌 가혹도 수준을 갖는 충돌 판별 알고리즘)

  • 박서욱;이재협
    • Transactions of the Korean Society of Automotive Engineers
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    • v.11 no.2
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    • pp.148-156
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    • 2003
  • Many car manufacturers have frequently adopted an aggressive inflator and a lower threshold speed for airbag deployment in order to meet an injury requirement for unbolted occupant at high speed crash test. Consequently, today's occupant safety restraint system has a weakness due to an airbag induced injury at low speed crash event. This paper proposes a new crash algorithm to improve the weakness by suppressing airbag deployment at low speed crash event in case of belted condition. The proposed algorithm consists of two major blocks-crash severity algorithm and deployment logic block. The first block decides crash severity with two levels by means of velocity and crash energy calculation from acceleration signal. The second block implemented by simple AND/OR logic combines the crash severity level and seat belt status information to generate firing commands for airbag and belt pretensioner. Furthermore, it can be extended to adopt additional sensor information from passenger presence detection sensor and safing sensor. A simulation using real crash data for a 1,800cc passenger vehicle has been conducted to verify the performance of proposed algorithm.

A Study on the Crash Severity of Expressway Work Zones Using Decision Tree (의사결정나무를 이용한 고속도로 공사구간 사고 심각도에 관한 연구)

  • PARK, Yong Woo;BACK, Sehum;PARK, Shin Hyoung;KWON, Oh Hoon
    • Journal of Korean Society of Transportation
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    • v.34 no.6
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    • pp.535-547
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    • 2016
  • This study aims to identify factors that affect the degree of injury severity sustained in traffic crashes on work zone of Korean expressways. To this end, decision tree method was applied to identify influential factors on injury severity and compare characteristics of those factors between work zone and non-work zone. The results from the comparison show that the risk of severity was low when traffic volume and heavy vehicle ratio are high because the factors lower the overall section speed. On the other hand, when the traffic volume and the heavy vehicle ratio are low, the section speed increased and the tendency for high injury severity was confirmed. These findings are expected to help transportation planners and engineers understand which risk factors contribute more to severe injury in the work zones such that they can effectively prepare and implement safety countermeasures.

A Study on the Injury Charateristics of Trauma Patients by Madical information -Focused on the Patients in a Regional Emergency Medical center in Gwangju

  • Jeun, Young-Ju
    • 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.

Injury Risk Analysis for Product Disassembly and Reassembly Process in Remanufacturing (재제조에서 제품 해체 및 재조립 공정의 상해 위험성평가)

  • Jeong, Jae Yeong;Park, Sang Jin;Son, Woo Hyun;Mok, Hak Soo
    • Journal of the Korean Society of Safety
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    • v.33 no.2
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    • pp.112-123
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    • 2018
  • In this paper, we focused on the safety of workers in a remanufacturing process where a risk analysis is not carried out and suggested a criteria for evaluating injury risk. We analyzed a disassembly and a reassembly, which are important for the remanufacturing process. The disassembly includes the disassembly of product and the disassembly process of part and the reassembly includes only reassembly of part. First of all, we analyzed the remanufacturing process and a type of injury. Then, we reviewed the standards and determined the criteria for a severity and an occurrence. We set a bigger weight for the severity to allow the greater impact. And the injury risk score was defined as a sum of the weighted severity and the weighted occurrence. We conducted a qualitative analysis of the experience of field workers based on the criteria we set up. Questionnaires for the evaluation were formulated through interviews with experts.