• Journal of Trauma and Injury
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• 제20권2호
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• pp.138-143
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• 2007

Purpose: $S100{\beta}$, a marker of traumatic brain injury (TBI), has been increasingly focused upon during recent years. $S100{\beta}$, is easily measured not only in cerebrospinal fluid (CSF) but also in serum. After TBI, serum S 10019, has been found to be increased at an early stage. The purpose of this study was to evaluate the clinical correlations between serum $S100{\beta}$, and neurologic outcome, and severity in traumatic brain injury. Methods: From August 2006 to October 2006, we made a protocol and studied prospectively 42 patients who visited the emergency room with TBI. Venous blood samples for $S100{\beta}$, protein were taken within six hours after TBI and vital signs, as well as the Glasgow Coma Scale (GCS), were recorded. The final diagnosis and the severity were evaluated using the Abbreviated Injury Score (AIS), and the prognosis of the patients was evaluated using the Glasgow Outcome Score (GOS). Results: Thirty-eight patients showed a favorable prognosis (discharge, recovery, transfer), and four showed an unfavorable prognosis. Serum $S100{\beta}$, was higher in patients with an unfavorable prognosis than in patients with a favorable prognosis, and a significant difference existed between the two groups ($0.74{\pm}1.50\;{\mu}g/L$ vs $7.62{\pm}6.53\;{\mu}g/L$ P=0.002). A negative correlation existed between serum $S100{\beta}$, and the Revised Traumatic Score (R2=-0.34, P=0.03), and a positive correlation existed between serum $S100{\beta}$, and the Injury Severity Score (R2=0.33, P=0.03). Furthermore, the correlation between serum $S100{\beta}$, and the initial GCS and the GCS 24 hours after admission to the ER were negative (R2=-0.62, P<0.001; R2=-0.47, P=0.005). Regarding the GOS, the mean serum concentration of $S100{\beta}$, was $7.62\;{\ss}{\partial}/L$ (SD=${\pm}6.53$) in the expired patients, $1.15\;{\mu}g/L$ in the mildly disable patient, and $0.727\;{\mu}g/L$ (SD=${\pm}0.73$) in the recovered patients. These differences are statistically significant (p<0.001). Conclusion: In traumatic brain injury, a higher level of serum concentration of $S100{\beta}$, has a poor prognosis for neurologic outcome.

• Kidney Research and Clinical Practice
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• 제37권4호
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• pp.366-372
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• 2018

Background: An inactivated Hantaan virus vaccine (iHV) has been broadly used as a preventive strategy for hemorrhagic fever with renal syndrome (HFRS) by the South Korean Army. After the vaccination program was initiated, the overall incidence of HFRS cases was reduced in the military population. While there are about 400 HFRS cases annually, few studies have demonstrated the efficacy of the iHV in field settings. Therefore, this study aimed to evaluate the iHV efficacy on HFRS severity. Methods: From 2009 to 2017, HFRS cases were collected in South Korean Army hospitals along with patients' vaccination history. HFRS patients were classified retrospectively into two groups according to vaccination records: no history of iHV vaccination and valid vaccination. Vaccine efficacy on the severity of acute kidney injury (AKI) stage and dialysis events were investigated. Results: The effects of the iHV on renal injury severity in between 18 valid vaccinated and 110 non-vaccinated patients were respectively evaluated. In the valid vaccination group, six of the 18 HFRS patients (33.3%) had stage 3 AKI, compared to 60 of the 110 (54.5%) patients in the non-vaccination group. The iHV efficacy against disease progression ($VE_p$) was 58.1% (95% confidence interval, 31.3% to 88.0%). Conclusion: The iHV efficacy against the progression of HFRS failed to demonstrate statistically significant protection. However, different severity profiles were observed between the iHV and non-vaccination groups. Additional studies with larger populations are needed to demonstrate the effectiveness of the iHV in patients with HFRS.

• 자동차안전학회지
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• 제12권2호
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• pp.40-46
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• 2020

Modern traffic accidents are a complex occurrence. Various indicators are needed to analyze traffic accidents. Countries that have been investigating traffic accidents for a long time accumulate various data to analyze traffic accidents. The Korean In-Depth Accident Study (KIDAS) database collected damaged vehicles and severity of injury caused by Collision Deformation Classification code (CDC code), Abbreviated Injury Scale (AIS), and Injury Severity Score (ISS). As a result of the investigation, data relating to the injuries of the occupants can be easily obtained, but it was difficult to analyze human severity based on the information of the damaged vehicle. This study suggests a method to measure the speed change at the time of an accident, which is one of the most important indicators in the vehicle crash database, to help advance KIDAS research.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.120-125
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• 2017

Purpose: The aim of this study was to identify clinical outcome and characteristics of trauma patients via emergency medical services (EMS). Methods: Medical records of the trauma patients visiting the emergency department were retrospectively collected and analyzed from January 2015 to June 2016 in the single institution. Of 529 registered patients, 371 patients were transported by - were enrolled. The parameters including age, gender, injury mechanism, Glasgow coma scale on arrival, presence of shock (systemic blood pressure <90 mmHg) on arrival, time to arrival from accident to emergency room (ER), need for emergency procedures such as operation or angioembolization, need for intensive care unit (ICU) admission, injury severity score (ISS), the trauma and injury severity score, revised trauma score (RTS), length of stay, and mortality rate were collected. The SAS version 9.4 (SAS Institute, Cary, NC, USA) was used for the data analysis. Results: Arrival time from the field to the ER was significantly shorter in EMS group. However, overall outcomes including mortalities, length of stay in the ICU and hospital were same between both groups. Age, ISS, RTS, and injury mechanisms were significantly different in both groups. ISS, RTS, and age showed significant influence on mortality statistically (p<0.05). Conclusions: The time to arrival of EMS was fast but had no effect on length of hospital stay, mortality rate. Further research that incorporates pre-hospital factors influence clinical outcomes should be conducted to evaluate the effectiveness of such a system in trauma care of Korea.

• 한국직업건강간호학회지
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• 제9권1호
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• pp.18-29
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• 2000

Back injury is frequent in industry workers and is a common cause of productivity loss. It has been reported that the insured of industrial accident insurance tend to stay in hospital longer than that of other types of insurance. The purpose of this study was to identify factors affecting the length of hospital stay for the treatment of back injury in the workers under industrial accident insurance. The results of this study help insurers develop reasonable industrial accident insurance policy for back injury claims and prevention strategies of work-related back injury. A total of 2,949 patients whose industrial accident insurance claim has been approved for the treatment of work-related back injury from January to December 1999 were included in this study. Relationship between the length of hospital stay and characteristics of patient, work place, back injury, and hospital were assessed using ANOVA, t-test, simple linear regression and multiple resgression. The major findings of this study are as follows : 1. The average length of hospital stay(LOS) was 91.82 days, respectively. 2. Characteristics of Patient LOS of male patients was longer than that of female patients, there was positive correlation between age and LOS and between average wage and LOS. Working period was negatively correlated with LOS. Distance from resident to hospital was positively correlated with LOS and LOS was significantly different dependign on type of duty. 3. Characteristics of Work Place LOS was significantly different depending on types of industry and geographical region of work place. Size of work place was positively correlated with LOS. 4. Characteristics of Back Injury Occupational back pain required shorter LOS compared with back injury due to electric shock. Number of concomitant illnesses and severity of disability were positively correlated with LOS. 5. Characteristics of Hospital Patients treated in community hospitals required significantly longer LOS. Treatment in hospitals with rehabilitation program required decreased LOS. This was more prominent as number of physicians specialized in rehabilitation. 6. Multiple regression analysis revealed that distance form resident to hospital, geographical region of work place, size of work place, number of concomitant illnesses, severity of disability, and type of hospital were factors affecting LOS.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권4호
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• pp.289-296
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• 2018

Purpose: We aimed to study the pattern of liver-injury in children with dengue fever (DF) and validate serum aminotransferase ${\geq}1,000IU/L$ as a marker of severe DF. Methods: Children admitted with DF were included. DF was defined by presence of clinical criteria and positive serological or antigen tests in absence of other etiology. DF severity was graded as dengue without or with warning signs and severe dengue. Liver-injury was defined as alanine aminotransferase (ALT) more than twice the upper limit of normal (boys, 30 IU/L; girls, 21 IU/L). Results: Of 372 children with DF, 144 (38.7%) had liver-injury. Risk of liver-injury and aminotransferase levels increased with DF severity (p<0.001). Recommended ALT and aspartate aminotransferase (AST) cut-off at ${\geq}1,000IU/L$ had sensitivity 4.8% (5/105), specificity 99.3% (265/267) for detection of severe DF. In children with ALT and AST <1,000 IU/L (n=365), the area under receiver operating curves for prediction for severe DF, were 0.651 (95% confidence interval [CI], 0.588-0.714; p<0.001) for ALT and 0.647 (95% CI, 0.582-0.712; p<0.001) for AST. Serum ALT at 376 IU/L and AST at 635 IU/L had sensitivity and specificity comparable to ${\geq}1,000IU/L$ for defining severe DF. Conclusion: Liver-injury is common in DF. The ALT and AST levels increase with DF severity. ALT and AST levels of ${\geq}1,000IU/L$ could be lowered to 376 IU/L and 635 IU/L respectively for defining severe DF.

• Journal of Trauma and Injury
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• 제30권4호
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• pp.131-139
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• 2017

Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

• Journal of Trauma and Injury
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• 제31권3호
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• pp.135-142
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• 2018

Purpose: When hemodynamically unstable patients with blunt major trauma arrive at the emergency department (ED), the safety of performing early whole-body computed tomography (WBCT) is concerning. Some clinicians perform central venous catheterization (CVC) before WBCT (pre-computed tomography [CT] group) for hemodynamic stabilization. However, as no study has reported the factors affecting this decision, we compared clinical characteristics and outcomes of the pre- and post-CT groups and determined factors affecting this decision. Methods: This retrospective study included 70 hemodynamically unstable patients with chest or/and abdominal blunt injury who underwent WBCT and CVC between March 2013 and November 2017. Results: Univariate analysis revealed that the injury severity score, intubation, pulse pressure, focused assessment with sonography in trauma positivity score, and pH were different between the pre-CT (34 patients, 48.6%) and post-CT (all, p<0.05) groups. Multivariate analysis revealed that injury severity score (ISS) and intubation were factors affecting the decision to perform CVC before CT (p=0.003 and p=0.043). Regarding clinical outcomes, the interval from ED arrival to CT (p=0.011) and definite bleeding control (p=0.038), and hospital and intensive care unit lengths of stay (p=0.018 and p=0.053) were longer in the pre-CT group than in the post-CT group. Although not significant, the pre-CT group had lower survival rates at 24 hours and 28 days than the post-CT group (p=0.168 and p=0.226). Conclusions: Clinicians have a tendency to perform CVC before CT in patients with blunt major trauma and high ISS and intubation.

• Journal of Trauma and Injury
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• 제36권4호
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• pp.329-336
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• 2023

Purpose: In this study, we aimed to compare the characteristics of patients with trauma by age group in a single center in Korea to identify the clinical characteristics and analyze the risk factors affecting mortality. Methods: Patients aged ≥18 years who visited the Chungbuk National University Hospital Regional Trauma Center between January 2016 and December 2022 were included. The accident mechanism, severity of the injury, and outcomes were compared by classifying the patients into group A (18-64 years), group B (65-79 years), and group C (≥80 years). In addition, logistic regression analysis was performed to identify factors affecting death. Results: The most common injury mechanism was traffic accidents in group A (40.9%) and slipping in group B (37.0%) and group C (56.2%). Although group A had the highest intensive care unit admission rate (38.0%), group C had the highest mortality rate (9.5%). In the regression analysis, 3 to 8 points on the Glasgow Coma Scale had the highest odds ratio for mortality, and red blood cell transfusion within 24 hours, intensive care unit admission, age, and Injury Severity Score were the predictors of death. Conclusions: For patients with trauma, the mechanism, injured body region, and severity of injury differed among the age groups. The high mortality rate of elderly patients suggests the need for different treatment approaches for trauma patients according to age. Identifying factors affecting clinical patterns and mortality according to age groups can help improve the prognosis of trauma patients in the future.

• 한국도로학회논문집
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• 제18권6호
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• pp.173-180
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• 2016

OBJECTIVES : Fixed roadside objects are a threat to drivers when their vehicles deviate from the road. Therefore, such roadside objects need to be suitably dealt with to decrease accidents. This study determines the factors affecting the severity of accidents because of fixed roadside objects. METHODS : This study analyzed the crash severity impact of fixed roadside objects by using ordered probit regression as the analysis methodology. In this research, data from 896 traffic accidents reported in the last three years were used. These accidents consisted of sole-car accidents, fixed roadside object accidents, and lane-departure accidents on the national highway of Korea. The accident severity was classified as light injury, severe injury, and death. The factors relating to the road and the driver were collected as independent variables. RESULTS : The result of the analysis showed that the variables of the crash severity impact are the collision location (left side), gender of the driver (female), alcohol use, collision facility (roadside trees, traffic signals, telephone poles), and type of road (rural segments). Additionally, the collision location (left side), gender of the driver (female), alcohol use, collision facility (street trees, traffic signals, telephone poles), and type of road (rural segments), in order of influence, were found to be the factors affecting the crash severity in accidents due to fixed roadside objects. CONCLUSIONS : An alternative solution is urgently required to reduce the crash severity in accidents due to fixed roadside objects. Such a solution can consider the appropriate places to install breakaway devices and energy-absorbing systems.