• 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.

• Journal of Korean Neurosurgical Society
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• v.52 no.3
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• pp.200-203
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• 2012

Objective : The sub-axial injury classification (SLIC) and severity scale was developed to decide whether to operate the cervical injured patient or not, but the reliability of SLIC and severity scale among the different physicians was not well known. Therefore, we evaluated the reliability of SLIC among a spine surgeon, a resident of neurosurgery and a neuro-radiologist. Methods : In retrograde review in single hospital from 2002 to 2009 years, 75 cases of sub-axial spine injured patients underwent operation. Each case was blindly reviewed for the SLIC and severity scale by 3 different observers by two times with 4 weeks interval with randomly allocated. The compared axis was the injury morphology score, the disco-ligamentous complex score, the neurological status score and total SLIC score; the neurological status score was derived from the review of medical record. The kappa value was used for the statistical analysis. Results : Interobserver agreement of SLIC and severity scale was substantial agreement in the score of injury morphology [intraclass correlation (ICC)=0.603] and total SLIC and severity sacle (ICC value=0.775), but was fair agreement in the disco-ligamentous complex score (ICC value= 0.304). Intraobserver agreements were almost perfect agreement in whole scales with ICC of 0.974 in a spine surgeon, 0.948 in a resident of neurosurgery, and 0.963 in a neuro-radiologist. Conclusion : The SLIC and severity scale is comprehensive and easily applicable tool in spine injured patient. Moreover, it is very useful tool to communicate among spine surgeons, residents of neurosurgery and neuro-radiologists with sufficient reproducibility.

• Journal of Korean Academy of Nursing
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• v.38 no.6
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• pp.923-932
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• 2008

Purpose: This study was conducted to investigate the individual and cross influences of age, gender, and severity on recovery of patients with brain injury. Methods: For the purpose of the study, traumatic or spontaneous brain injury patients admitted to the intensive care unit (ICU) were conveniently selected. The data regarding outcomes were collected 3 months after admission. Results: Individual influences of the study variables on patients' recovery were significant, except for gender. But while the individual influence of gender on recovery was not significant, cross influence of gender and age was significant, but only for the sub-dimension of 'arousalbility and awareness'. The study results also showed that 3-way cross influence of gender, age, and severity was only significant on the sub-dimension of 'arousalbility and awareness'. Conclusion: The sub-dimension of recovery cross influenced by the demographic factors of gender and age, and severity was 'arousalbility and awareness'. This might indicate that the study variables that cross influencing recovery had more influence on consciousness compared to physical function and psycho-social adaptation.

• 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.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.240-247
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• 2022

Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m². An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

• Journal of Preventive Medicine and Public Health
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• v.32 no.4
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• pp.538-545
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• 1999

Objective : To compare the predictive power of International Classification of Diseases 10th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with Trauma and Injury Severity Score(TRISS) and International Classification of Diseases 9th Edition Clinical Modification(ICD-9CM) based ICISS in the injury severity measure. Methods : ICD-10 version of Survival Risk Ratios(SRRs) was derived from 47,750 trauma patients from 35 Emergency Centers for 1 year. The predictive power of TRISS, the ICD-9CM based ICISS and ICD-10 based ICISS were compared in a group of 367 severely injured patients admitted to two university hospitals. The predictive power was compared by using the measures of discrimination(disparity, sensitivity, specificity, misclassification rates, and ROC curve analysis) and calibration(Hosmer-Lemeshow goodness-of-fit statistics), all calculated by logistic regression procedure. Results : ICD-10 based ICISS showed a lower performance than TRISS and ICD-9CM based ICISS. When age and Revised Trauma Score(RTS) were incorporated into the survival probability model, however, ICD-10 based ICISS full model showed a similar predictive power compared with TRISS and ICD-9CM based ICISS full model. ICD-10 based ICISS had some disadvantages in predicting outcomes among patients with intracranial injuries. However, such weakness was largely compensated by incorporating age and RTS in the model. Conclusions : The ICISS methodology can be extended to ICD-10 horizon as a standard injury severity measure in the place of TRISS, especially when age and RTS were incorporated in the model. In patients with intracranial injuries, the predictive power of ICD-10 based ICISS was relatively low because of differences in the classifying system between ICD-10 and ICD-9CM.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.39 no.3
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• pp.391-398
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• 2019

In general, truck-involved crashes increase severity in terms of both injury level and crash impact level. Recently, although the frequency and fatality of truck-involved crashes in Korea are rising, their associative studies are very limited. Therefore, the objective of this study is to identify critical factors influencing on injury severity of truck-involved crashes on Korean freeway system. To carry out this objective, this study uses an ordered probit model (OPM) based on a 6-year crash dataset from 2012 to 2017. From the analysis, eight variables were found to have a great effect on injury severity: older driver, crash speed, rear-end collision, number of vehicles involved, drowsy driving, nighttime (0:00 to 6:00) driving, overturn or rollover, and vehicle's fire after crash. However, injury severity was less severe in crashes under snowy condition and crashes to traffic facilities (i.e., crash alone).

• KSCE Journal of Civil and Environmental Engineering Research
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• v.28 no.3D
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• pp.383-390
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• 2008

Construction safety control system had improved constantly but the severity rate of injury don't reduced, safety level of construction don't progressed as usual. In order to reduce of the severity rate of injury safety control in site is important but it needs to improve form of system that introduce obligation of safety design and design safety appraisement, an effect use method of safety control cost. The safety control cost is problem that reduce than design cost accordance bidding rate and use a little safety facility cost compare with labor cost. This study tried reduce the severity rate of injury by propose effective improvement scheme through relevant problem analysis to the safety control cost and remove caution that the severity rate of injury don't reduced.

• The Korean Journal of Emergency Medical Services
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• v.20 no.3
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• pp.7-19
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• 2016

Purpose: The purpose of the study was to investigate the correlation between injury and injury severity score (ISS) in geriatric traffic accident patients transported by 119 emergency medical technicians (EMTs). Methods: The subjects were 240 traffic accident patients over 65 years old transported by 119 rescue services emergency departments in Busan from January 1, 2014 to August 31, 2015. Results: ISS increased in motorcycle traffic accidents (p=.026), truck injuries (p=.005), and head and neck injury (p<.001). Vital signs were evaluated by 119 rescue EMT. ISS increased in cases of unresponsive unconsciousness (p<.001), hypotension (p=.001), and bradycardia (p<.001). The need for bleeding control and dressing by the EMTs increased ISS significantly (p=.022). Conclusion: In the initial evaluation of geriatric traffic patients, ISS can increase in motor cycle accidents and truck injuries. Due to high ISS, patients with head and neck injury, chest injury, hypotension, or tachycardia should be transferred to advanced level hospitals.

• 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.