• Journal of Trauma and Injury
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• v.34 no.1
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• pp.3-12
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• 2021

Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

• 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 Trauma and Injury
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• v.25 no.4
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• pp.223-229
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• 2012

Purpose: The arterial base deficit and the serum lactate level are widely recognized indicators of injury severity, adequacy of resuscitation and outcome. The purpose of this study is to evaluate the usefulness of the arterial base deficit as an injury-severity indicator in multiple-trauma patients with head injuries. Methods: Data were retrospectively collected from trauma patients over 18 years of age who had been admitted at the emergency center between October 2005 and July 2006. The patients were divided into head-injury and non-head-injury groups. These patients were then sub-divided into minor ($$ISS{\leq_-}15$$)-injury and major ($$ISS{\geq_-}16$$)-injury groups according to their injury severity scores (ISS). We analyzed the differences in the base deficits and the serum lactate levels between the major- and the minor-injury sub-groups in both the head-injury and the non-head-injury groups. Results: In the non-head-injury group, we found statistically significant differences in the arterial base deficit between the major-injury and the minor-injury sub-groups($-6.86{\pm}2.40mmol/L$ vs. $-1.37{\pm}0.73mmol/L$, p=0.010). In the head-injury group, no significant differences were noted between the two sub-groups($-2.50{\pm}1.28mmol/L$ vs. $-1.51{\pm}0.74mmol/L$, p=0.897). Moreover, the differences in arterial base deficit between the major-injury and the minor-injury sub-groups were not significant both for either single-head-trauma or multiple-head-trauma patients (p=0.643 vs. p=0.832). Conclusion: We conclude that neither the arterial base deficit nor the serum lactate level can be used to predict injury severity in multiple-trauma patients with head injuries.

• Journal of Auto-vehicle Safety Association
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• v.10 no.2
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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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• v.24 no.1
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• pp.31-36
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• 2011

Purpose: This study was conducted to evaluate the correlations among pulmonary contusion severity, trauma score and cardiac troponin I (cTnI) level. Methods: We prospectively evaluated patients with multiple injuries who had been admitted to the emergency department (ED) from July 2007 to July 2008. We first measured the total creatinine kinase (CK), the MB fraction of CK (CK-MB), TnI, and myoglobin within 2 hours after the injury. We then checked the electrocardiogram, x-ray, and computed tomography (CT) results. Finally, we assessed the injuries as variables and then compared the results for patients with elevated TnI levels (group A) and patients whose TnI levels fell within the normal range (group B). Results: Eighty-six of the 92 patients admitted to the ED were enrolled. The pulmonary contusion score (PCS) was well correlated with $PaO_2/FiO_2$. TnI levels were correlated with PCS. When TnI levels were above 0.86 ng/ml, the mortality was estimated with 100% sensitivity and 86.1% specificity. Conclusion: Pulmonary contusion severity is correlated with TnI level. When the PCS is high and the cTnI level is elevated in multiple-injury patients, we recommend continuous cardiac monitoring and further evaluation

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.158-164
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• 2014

Purpose: Numerous studies have investigated the pattern of traumatic death with a focus on the injury mechanism, the severity of the injury and the presence of hemorrhage. Acute coagulopathy has been treated as only one of many complications. The purpose of this study was to investigate the influence of acute coagulopathy on acute and early death due to trauma. Methods: A retrospective analysis of trauma patients with injury severity score (ISS)${\geq}25$ who had been treated between January 2011 and December 2012 was conducted. Based on the time of injury, traumatic death was categorized into acute (within 48 hours) and early (from 3 to 7 days). The correlations between various parameters within 24 hours after injury and time of death were analyzed. Results: A total of 124 patients were enrolled. Of them, 8.1% (n=10) of the patients experienced acute mortality. For those patients, significant differences in initial systolic blood pressure, coagulopathy score, amount of transfusion, abbreviated injury scale of the head and neck, the abdomen and the extremities were noted. Early mortality was experienced by 7.0% (n=8) of the patients, only coagulopathy score was found to be a significant independent risk factor for acute (odds ratio: 3.127; 95% confidence interval: 1.185-8.252; p=0.021) and early mortality (odds ratio: 2.470; 95% confidence interval: 1.029-5.929; p=0.043). Conclusion: Acute traumatic coagulopathy has an important role in the mortality, even after the acute phase. Early management and prevention of acute coagulopathy may improve survival of trauma patients.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.134-141
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• 2009

Purpose: Patients with traumatic brain injury (TBI) were referred from other hospitals for further management. In addition, patients routinely underwent computed tomography examinations of the head (HCT) in the referral hospitals. The purpose of this study was to evaluate retrospectively the utility of routine HCT scans according to the severity of TBI. Methods: Patients with TBI referred to our hospital between December 2005 and July 2008 were included in this study. We investigated HCT findings, indications for repeat HCT examinations (routine versus a neurological change), and neurosurgical interventions. The head injury severity was divided into three categories according to the Glasgow Coma Scale (GCS) score, including mild, moderate, and severe TBI. The use of neurosurgical interventions between patients who underwent routine HCT scans and patients who underwent HCT scans for a neurological change were compared according to the severity of TBI. Results: A total of 81 patients met the entry criteria for this study. Among these patients, 67%(n=54) of the patients underwent HCT scans on a routine basis, whereas 33%(n=27) of the patients underwent HCT scans for a neurological change. A total of 21 patients showed signs of a worsening condition on the HCT scans. Neurosurgical intervention was required for 23(28.4%) patients. For patients who underwent routine HCT examinations, no patient with mild TBI underwent a neurosurgical intervention. However, one patient with moderate TBI and three(13%) patients with severe TBI underwent neurosurgical interventions. The kappa index, the level of agreement for HCT indications of intervention and referral reasons for intervention, was 0.65 for high hierarchy hospitals and 0.06 for low hierarchy hospitals. Conclusion: Routine serial HCT examinations in the referred hospitals would be useful for patients with severe head injury and for patients from low hierarchy hospitals where no emergency physicians or neurosurgeons are available.

• Journal of Trauma and Injury
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• v.36 no.3
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• pp.187-195
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• 2023

Purpose: This study aimed to determine the risk factors associated with the severity of fall-related injuries among patients who suffered a fall from similar heights and analyze differences in injury sites according to intentionality and injury severity. Methods: The Emergency Department-based Injury In-depth Surveillance (EDIIS) data collected between 2019 and 2020 were used in this retrospective study. Patients with fall-related injuries who fell from a height of ≥6 and <9 m were included. Patients were categorized into the severe and mild/moderate groups according to their excessive mortality ratio-adjusted Injury Severity Score (EMRISS) and the intention and non-intention groups. Injury-related and outcome-related factors were compared between the groups. Results: In total, 33,046 patients sustained fall-related injuries. Among them, 543 were enrolled for analysis. A total of 256 and 287 patients were included in the severe and mild/moderate groups, respectively, and 93 and 450 patients were included in the intention and non-intention groups, respectively. The median age was 50 years (range, 39-60 years) and 45 years (range, 27-56 years) in the severe and mild/moderate groups, respectively (P<0.001). In multivariable analysis, higher height (odds ratio [OR] 1.638; 95% confidence interval [Cl], 1.279-2.098) and accompanying foot injury (OR, 0.466; 95% CI, 0.263-0.828) were independently associated with injury severity (EMR-ISS ≥25) and intentionality of fall (OR, 0.722; 95% CI, 0.418-1.248) was not associated with injury severity. The incidence of forearm injuries was four (4.3%) and 58 cases (12.9%, P=0.018) and that of foot injuries was 20 (21.5%) and 54 cases (12.0%, P=0.015) in the intention versus non-intention groups, respectively. Conclusions: Among patients who fell from a similar height, age, and fall height were associated with severe fall-related injuries. Intentionality was not related to injury severity, and patients with foot injury were less likely to experience serious injuries. Injuries in the lower and upper extremities were more common in intentional and unintentional falls, respectively.

• Anxiety and mood
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• v.9 no.1
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• pp.54-60
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• 2013

Objectives : Posttraumatic stress disorder (PTSD) is classified as an anxiety disorder. PTSD occurrence is known to be increased in middle-aged and older people, female, and individuals with a previous history of psychiatric disorders, lower education levels, low socioeconomic status, and severely injured patients. Anxiety symptoms are also related to later development of PTSD. In this study, we investigate the influences of injury severity and sociodemographic factors on severe anxiety in PTSD patients with no previous history of psychiatric disorders. Methods : Forty-one PTSD patients without previous history of psychiatric disorders were recruited from the psychiatric clinic at Chosun University Hospital. Subjects underwent psychiatric and physical examinations including the Injury Severity Score (ISS), Beck Anxiety Inventory (BAI), and Korean-Wechsler Adult Intelligence Scale (K-WAIS). We defined severe anxiety as a BAI scores of 30 or more. Logistic regression analyses and multi-step model selection were applied to identify predictive factors for severe anxiety. Results : In univariate analysis, age, ISS, and socioeconomic status were found to be significant factors. Through multivariate logistic regression analyses and a stepwise model selection, we found the combination of age and ISS to be the best-fitted model for affecting severe anxiety in PTSD patients without a previous history of psychiatric disorders. Conclusion : Our findings suggest that the combination of age and ISS could develop severe anxiety in PTSD patients with no previous history of psychiatric disorders.

• The Journal of Information Systems
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• v.31 no.2
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• pp.217-238
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• 2022

Purpose This study aims to develop a work-related injury and illness monitoring geographic information system that analyzes and visualizes the types of work-related injury and illness based on workers' compensation insurance big data. Design/methodology/approach Using the developed system, we explained the process of monitoring the areas of the applied workplace, medical care application, index, and medical care institution. We also showed examples of analyzing the index and medical care institution area. By applying the system, we can intuitively recognize the current status of workers' compensation insurance and confirm the basic information necessary for managing the current status of workers' compensation insurance. Findings We generated more helpful information by combining workers' compensation insurance data and designated medical care institution data. We were able to apply the severity score and the vulnerability index of work-related injury and illness to the system as a demonstration. To efficiently manage workers' compensation insurance, it was necessary to integrate workers' compensation insurance and designated medical care institution data, as well as the data from various sources.