• 자동차안전학회지
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• 제6권1호
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• pp.22-26
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• 2014

Fatality of accidents on curved roads where rollover accidents are likely to take place was higher than that on straight roads. We ought to investigate factors affecting injury severity of occupant in a vehicle rollover accident. From January 2011 to December 2013, we collected data about rollover motor vehicle crash accident. We surveyed occupant's injury, vehicle type, safety devices, type of rollover accident and the number of turn in accident. Of the 132 subjects, 56.1% were males, 50.8% were drivers, 48.5% fastened seat belt, and air bag deployed in 12.1%. Among injuries sustained head, chest and abdomen were major sites of severe injury(Abbreviated injury scale>2). Seat belt use, rollover type, and the number of 1/4 turn were found to have significant positive correlations with Injury Severity Score. The regression analysis herein found significance in safety belt use and the number of 1/4 turn. Seat belt use was a significant factor affecting injury severe of occupant in rollover accident.

• 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.78-84
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• 2008

Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.

• 한국도로학회논문집
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• 제16권5호
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• pp.143-154
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• 2014

PURPOSES : This study drew factors affecting motorcycle accidents in Seoul by severity using an ordered probit model and aimed to analyze and verify the drawn influence factors. METHODS : As the severity of the accidents could be classified into three types (fatal injury, serious injury and minor injury), this study drew the factors affecting accidents by a comparative analysis employing an ordered probit model, removed the variables that would not secure significance sequentially to construct a model with high explanatory power regarding the factors affecting the severity of motorcycle accidents, and calculated the marginal effect of each factor to understand the degree of each factor's impact on the severity. First, Model 1 put in all variables; Model 2 was constructed by removing the variables of the road surface conditions that could not meet the level of significance (p=0.608); Model 3 was constructed by removing gender variable (p=0.423); and Model 4 was constructed finally by removing age variable (p=0.320). RESULTS : As a result of an analysis, statistically significant variables were time of occurrence, type of accident, road alignment and motorcycle displacement, and it turned out that the impacts on the severity were in the following order: a road alignment of left downhill, the type of motorcycle-to-vehicle accidents and a road alignment of a flatland on the left. The significance of the models was tested using the likelihood ratio, the level of significance and suitability statistics about them, and as a result of the test, the significance level and suitability of the constructed models were all excellent. In addition, the model accuracy indicating the accuracy of a predicted value compared to that of the value actually observed was 70.3% for minor injury; 70.1% for serious injury; and 68.6% for fatal injury, and the overall accuracy was 70.2%, which was very high. CONCLUSIONS : As a result of an analysis of motorcycle accidents in Seoul through the ordered probit model and the marginal effect, it turned out that their severity increased in nighttime accidents as compared to daytime ones and gradually increased in the order of motorcycle-to-vehicle accidents, motorcycle-to-person ones and the ones involving motorcycle only. As a result of an analysis, the severity of accidents in road alignments of left downhill, left flatland and straight downhill increased as compared to those in a road alignment of straight flatland and that the severity of accidents of motorcycles with a displacement larger than 50cc was higher than that of those with a displacement smaller than 50cc.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.141-147
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• 2005

Purpose: Recently, The new Injury Severity Score (NISS) has become a more accurate predictor of mortality than the traditional Injury Severity Score (ISS) in the trauma population. Trauma Score Injury Severity Score (TRISS) method, regarded as the gold standard for mortality prediction in trauma patients, still contains the ISS as an essential factor within its formula. The purpose of this study was to determine whether a simple modification of the TRISS by replacing the ISS with the NISS would improve the prediction of in-hospital mortality in a trauma population with blunt head and neck trauma. Objects and Methods: The study population consisted of 641 patients from a regional emergency medical center in Kyoungsangnam-do. Demographic data, clinical information, the final diagnosis, and the outcome for each patient were collected in a retrospective manner. the ISS, NISS, TRISS, and modified TRISS were calculated for each patients. The discrimination and the calibration of the ISS, NISS, modified TRISS and conventional TRISS models were compared using receiver operator characteristic (ROC) curves, areas under the ROC curve (AUC) and Hosmer-Lemeshow statistics. Results: The AUC of the ISS, NISS, modified TRISS, and conventional TRISS were 0.885, 0.941, 0.971, and 0.918 respectively. Statistical differences were found between the ISS and the NISS (p=0.008) and between the modified TRISS and the conventional TRISS (p=0.009). Hosmer-Lemeshow chi square values were 13.2, 2.3, 50.1, and 13.8, respectively; only the conventional TRISS failed to achieve the level of and an excellent calibration model (p<0.001). Conclusion: The modified TRISS is a more accurate predictor of in-hospital mortality than the conventional TRISS in a trauma population of blunt head and neck trauma.

• 대한정형외과학회지
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• 제55권5호
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• pp.383-396
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• 2020

목적: 중등도 이상의 손상 환자를 대상으로 손상의 중증도에 따른 정형외과적 손상의 손상기전, 부위, 유형, 치료적 접근 및 그 치료결과를 분석하고자 한다. 대상 및 방법: 2014년부터 2019년까지 응급실/외상센터가 운영되지 않은 기간을 제외한 57개월 동안 국립중앙의료원 외상센터로 입원한 손상 중증도 점수(Injury Severity Score, ISS) 9점 이상의 환자들 중 정형외과적 손상이 동반된 778명을 대상으로 후향적 연구를 시행하였다. ISS와 생리학적 지표를 기준으로 한 손상의 중증도에 따라 중등도 손상군(1군, 679명)과 중증 손상군(2군, 99명)으로 분류하고 손상기전, 비정형외과적 손상을 평가하였다. 정형외과적 손상은 침범된 해부학적 영역과 골격구조의 수와 유형을 평가하였고, 치료적 접근 방법을 세분화하여 비교하였다. 치료결과는 재원기간을 포함하여 재원기간 내 발현된 전신 합병증과 사망률을 평가하였고 사망률에 미치는 요인을 분석하였다. 결과: 2군이 보다 젊고, 남성의 빈도가 높았고 고에너지 손상기전 및 동반 손상의 빈도가 유의하게 증가되었다. 정형외과적 손상 중 침범된 골격계의 수는 2군에서 유의하게 많아지면서 하지를 주로 침범한 1군에 비해 2군에서는 골반, 척추, 상지 영역의 침범이 유의하게 증가하였다. 정형외과적 손상은 환자의 임상적 상태에 따라 확정적 또는 단계적 치료가 시행되었으며 다발성 중증 손상을 보이는 2군에서는 일시적 외고정술을 이용한 단계적 수술의 빈도가 유의하게 높았고 1군에서는 생리학적 안정화를 이룬 뒤 확정적 수술을 시행하는 빈도가 유의하게 높았다. 중증도가 높아질수록 재원기간 역시 길어졌으며 재원기간 내 총 전신 합병증은 약 4.9%, 총 사망률는 약 4.5%였다. 중증도가 높아질수록 사망률은 유의하게 높아졌다(1군 2.9%, 2군 15.2%; p<0.0001). 사망률에 미치는 요인 중 고령과 높은 ISS가 중요한 요인으로 확인되었다. 결론: 손상의 중등도가 높을수록 고에너지 손상기전에 의한 손상의 발생 빈도가 높아지며 보다 젊고, 남성의 빈도와 동반 손상의 빈도가 높아졌다. 정형외과적 손상 역시 다발성 손상의 빈도와 중증도가 유의하게 증가되면서 정형외과적 외고정장치를 이용한 내고정술 등이 단계적 치료의 일환으로 시행된 경우가 유의하게 높아지는 경향을 보였다. 또한 재원기간, 전신 합병증 및 사망률 역시 유의하게 증가되는 경향을 보이며, 사망률에는 높은 연령과 ISS가 중요한 영향을 미치는 것으로 확인되었다.

• 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.

• Journal of Trauma and Injury
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• 제22권2호
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• pp.128-133
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• 2009

Purpose: Bicycle riding is a healthy and cheap form of transportation and a popular form of recreation. This study aims to evaluate the epidemiology and the factors affecting the severity of bicycle-related injuries and to find effective methods for preventing injuries. Methods: This is a retrospective study of the patients'characteristics, the injury severity, the injury location, the effect of safety equipment on the bicycle injury based on information collected through the NEDIS (National Emergency Department Information System) from 1,284,429 patients who visited 55 emergency rooms nationwide. Results: During the research period throughout 55 emergency rooms 5,671 patients were seen because of bicycle injuries. The male-to-female ratio was 3.1:1, the median age 28 years old, and 42.6% of the patients were younger than 20 years old. Injury sites were mostly in the extremities(46.7%), the head(32.4%), and the face(14%), and 70.3% of severely injured patients had accompanying head trauma. Males aged 65 and older was possibly associated with severe head trauma. Of the patients who provided helmet information 4.8%(71patients) used helmets, and 95.2%(1392 patients) did not. In this group of patients providing helmet information, none of those wearing helmets died, but 0.4% of those not wearing helmets died. Conclusion: In this study, most bicycle injuries occurred in young adult men. From now, there seems to be a need for more effort on publicity activities on bicycle injuries and on the education of children and teenagers, who show a high incidence rate, and of senior citizens (over 65 years old) who show a high severity rate, about using a safety helmet to reduce the severity of injury.

• Journal of Preventive Medicine and Public Health
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• 제51권3호
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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.

• 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.