• Journal of Trauma and Injury
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• 제19권1호
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• pp.35-40
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• 2006

Purpose: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. Methods: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. Results: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). Conclusion: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.

• Journal of Korean Neurosurgical Society
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• 제57권3호
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• pp.174-177
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• 2015

Objective : For improving the drawbacks of previous thoracolumbar spine trauma classification, the Spine Trauma Study Group was developed new classification, Thoracolumbar Injury Classification and Severity Score (TLICS). The simplicity of this scoring system makes it useful clinical application. However, considering criteria of Korean Health Insurance Review and Assessment Service (HIRA), the usefulness of TLICS system is still controversial in the treatment decision of thoracolumbar spine injury. Methods : Total 100 patients, who admitted to our hospital due to acute traumatic thoracolumbar injury, were enrolled. In 45, surgical treatment was performed and surgical treatment was decided following the criteria of HIRA in all patients. With assessing of TLICS score and Denis's classification, the treatment guidelines of TLICS and Denis's classification were applied to the criteria of Korean HIRA. Results : According to the Denis's three-column spine system, numbers of patients with 2 or 3 column injuries were 94. Only 45 of 94 patients (47.9%) with middle column injury fulfilled the criteria of HIRA. According to TLICS system, operation required fractures (score>4) were 31 and all patients except one fulfilled the criteria of HIRA. Conservative treatment required fractures (score<4) were 52 and borderline fracture (score=4) were 17. Conclusion : The TLICS system is very useful system for decision of surgical indication in acute traumatic thoracolumbar injury. However, the decision of treatment in TLICS score 4 should be carefully considered. Furthermore, definite criteria of posterior ligamentous complex (PLC) injury may be necessary because the differentiation of PLC injury between TLICS score 2 and 3 is very difficult.

• 한국안전학회지
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• 제23권2호
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• pp.65-71
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• 2008

As the interest in traffic safety has been increasing recently, social movement is being made to reduce the number of traffic accidents and the view on improving the mobility of the existing roads is being converted into on establishing traffic safety as a priority. The increase of traffic accidents related to an intersection in a state that traffic accidents are decreasing overall may suggests the necessity to investigate the specific causes. In addition, we have to consider them when establishing the measures against traffic accidents in a intersection by investigating and analyzing the influences and factors that may affect traffic accidents. To induce the accident severity model, we collected the factors that affect accidents and then applied the Poisson Regression Model among nonlinear regression analysis by verifying the distribution of variables. As a result of the analysis, it turned out that the volume of traffic on main roads, the right turn ratio on sub-roads, the number of ways out on sub-roads, the number of exclusive roads for a left turn, the signals for a right turn on main roads, and an intersect angle were the factors that affect the accident severity.

• Journal of Trauma and Injury
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• 제28권3호
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• pp.134-143
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• 2015

Purpose: Many patients are injured by trauma. And some of them expire due to severity of trauma. Various scoring systems have been introduced in grading severity and predicting mortality of trauma patients. This study is to evaluation the usefulness of factors for determining the severity and predicting the prognosis of the trauma victims. Methods: Data on the patients who visited our Emergency departments from January 2010 to December 2011 were retrospectively reviewed using electronic medical records. The patients were activated severe trauma team calling system. The patients were categorized as survivors and non-survivors. Univariated associations were calculated, and a multiple logistic regression analysis was used to determine variables associated with hospital mortality. Results: Two hundred sixty two(262) patients were enrolled, and the mortality rate was 25.6%. By multivariate analysis, lower respiration rate, lower Glasgow Coma Score, higher International Normalized Ratio and emergency transfusion within 6 hours were expected as severity and prognosis predict factors (each of odds ratio were 24.907, 14.282, 2.667 and 16.144). Conclusion: As predict factors, respiration rate, Glasgow Coma Score, International Normalized Ratio and emergency transfusion, are useful determining the severity and predicting prognosis of trauma victims.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.94-100
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• 2005

Background: Although trauma has been the major cause of death in korea, there are few reports describing the epidemiologic characteristics of trauma victims according to age-group. Thus, this study aimed to describe the epidemiologic characteristics of trauma victims visiting an urban emergency medical center in Korea. Method: This study was conducted with all trauma victims who visited the emergency departments of Asan Medical Center from April 11, 2005 to May 10, 2005. After the subjects were divided into three groups such as child (${\leq}14$ years old), adult(15-64 years old) and elderly(${\geq}65$ years old), the prehospital courses, injury mechanisms, injury severities and clinical results were compared. Result: Among total 5,927 patients who visited the emergency medical center, 896(15.1%) patients were trauma victims. Although child under the age of 15 comprised 28.7% of the total trauma victims, less severe injuries(injury severity score < 9) accounted for 97.7% of the cases. The hospitalization rate for injury among child was 21.5%. however, although elderly aged 65 comprised only 5.9% of the total trauma victims, more severe injuries(injury severity score ${\geq}9$) accounted for 30.2% of the cases. The hospitalization rate for injury among elderly was 56.4%. Conclusion: Patterns of injury and clinical results by age-group were considerably different. less severe and non-hospitalized injuries were more common in child than other age-groups. while severe and hospitalized injuries were common in elderly.

• Journal of Trauma and Injury
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• 제26권3호
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• pp.175-182
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• 2013

Purpose: Crushing injuries by car tires result from a combination of friction, shearing, and compression forces and the severity of injury is influenced by the acceleration. Because car-tire injuries of the lower leg in children are common these days but they have received little attention; thus, our purpose was to look closely into this problem. Methods: A retrospective analysis was conducted of data from children under 15 years old age who visited an emergency department because of a car-tire-related crushing injury to the lower leg in pedestrian traffic accident from January 2008 to September 2012. The patient's age, sex, site of injury, degree of injury, associated injuries, type of surgery, and complications were reviewed. Results: There were 39 children, the mean age was 8.0 years, and 71.8% were boys. The dorsal part of the leg was involved most frequently. According to the severity classification, 15 children were grade I, 6 were grade II, and 18 were grade III. Among 24 patients, 13 were treated with skin graft and 3 were treated using a sural flap. Twelve patients developed complications, such as hypertrophic scarring, contractures, and deformities with significant bone loss. Conclusion: Various degrees of skin or soft tissue defects were caused in children by car tires. In this study, patients were often also had tendon or bone damage. Proper and timely initial treatments are needed to reduce the incidence of infection, the number of operative procedures, and the hospital stay.

• Journal of Trauma and Injury
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• 제26권4호
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• pp.273-279
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• 2013

Purpose: In patients with splenic trauma, Computed Tomography (CT) scan is helpful in selecting treatment options and evaluating resolution after NOM (Non-Operative Management). The purpose of this study was to suggest a CT based hemoperitoneum (HP) scoring system that can easily be used by clinicians to evaluate the severity of injury and recovery. Methods: A retrospective review of patients with splenic trauma admitted to our hospital between May 2003 and January 2013 was conducted. Patients diagnosed with isolated spleen injury who had a CT scan on admission were included. 1 or 2 points were given according to location and amount of hematoma in the CT image. Using the existing ultrasonography (US) based HP scoring system, the same method was applied to obtain our CT based HP scoring (CBHS) system, which ranges from 0 to 8 points. The CBHS system can be easily used by clinicians for a quick assessment of splenic injury. Results: Of the 39 patients meeting the inclusion criteria, 6 patients were managed operatively and 33 nonoperatively. There was a significant difference in CBHS between the OM (operative management) group and the NOM group.(p=0.03) CBHS showed correlation with Hb (hemoglobin), Hct (hematocrit), spleen injury grade(AAST), and Hounsfield unit of ROI (Region of interest). (p=0.17, p=0.18, p<0.000, p=0.02, respectively) After successful NOM with stabilized Hb level, the amount of hemoperitoneum was scored in the follow-up CT. CBHS demonstrated correlation with decreased spleen injury grade, decreased Hounsfield unit of ROI (Region of interest) (p=0.039, p=0.049, respectively), and also objectively reflected patient recovery. Conclusion: CBHS can be used as an objective and intuitive tool for clinicians in grading the severity of splenic injury by scoring the amount of hemoperitoneum, and in assessing recovery.

• 한국정보시스템학회지:정보시스템연구
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• 제31권2호
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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.

• 스마트미디어저널
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• 제5권4호
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• pp.75-82
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• 2016

우리나라의 경제 성장과 도로 환경의 변화를 통해 국내 자동차 시장이 성장하였으나, 이로 인해 교통사고율 또한 증가하였고, 인명 피해가 심각한 수준이다. 이에 따라, 정부에서는 교통사고 데이터를 개방하고 문제를 해결하기 위한 정책을 수립 및 추진 중이다. 본 논문에서는 교통사고 데이터를 이용하여 클래스의 불균형을 해소하고, Hybrid Model 구축을 통한 교통사고 예측을 위해 원본 교통사고 데이터와 Sampling을 수행한 데이터를 학습 데이터로 사용한다. 두 학습데이터에 연관규칙 학습기법인 FP-Growth 알고리즘을 이용하여 교통사고 상해 심각도와 연관된 패턴을 학습한다. 두 학습 데이터의 연관 패턴을 분석을 통해 같은 연관된 패턴을 추출하고 의사결정트리와 다항 로지스틱 회귀분석기법에 연관된 속성에 가중치를 부여하여 융합형 Hybrid Model을 구축하고 교통사고 피해자 상해 심각도를 예측하는 방법에 대해 제안한다.

• 보건행정학회지
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• 제11권1호
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• pp.1-18
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• 2001

The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.