• Title/Summary/Keyword: Severity Score

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Mortality Reduction in Major Trauma Patients after Establishment of a Level I Trauma Center in Korea: A Single-Center Experience

  • Roh, Young Il;Kim, Hyung Il;Cha, Yong Sung;Cha, Kyoung-Chul;Kim, Hyun;Lee, Kang Hyun;Hwang, Sung Oh;Kim, Oh Hyun
    • Journal of Trauma and Injury
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    • v.30 no.4
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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.

PREVALENCE AND SEVERITY OF MALOCCLUSION IN CHILDREN 13 TO 15 YEARS OF AGE LIVING IN SEOUL (서울시내에 거주하는 13세-15세 청소년들의 부정교합에 관한 역학적 연구)

  • Song, Kyung-Won;Kim, Jin-Tae
    • Journal of the korean academy of Pediatric Dentistry
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    • v.11 no.1
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    • pp.121-130
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    • 1984
  • Childrens between the ages of 13 and 15 years, living in Seoul, were examined in order to determine the prevalence and severity of malocclusion in the permanent dentition. This survey encompassed 981 children and an individual chart was prepared for each subject recording an original HMAR score and classification of occlusion according to Angle. Also, subjective evaluation of "treatment needs" was carried out in 581 children. The results were as follows: 1. Of the 981 children in this survey, 12,1 percent showed excellent occlusion. (0 point) 2. The 14 percent of the children who had a score of 24 and above all appeared to belong to the "treatment highly desirable" or "treatment mandatory" category. 3. The incorporation of SAR (Supplementary Assessment Record) into the HMAR can provide more sensitive method for evaluating severity of malocclusion. 4. According to Angle's classification 77.4 percent of all malocclusion belonged to Class I, 1.3 percent to Class II, Division 1, 0.9 percent to Class II, Division 2, and 11.3 percent to Class III. 5. The mean HMAR score for Class I was significantly lower than for either Class II, Division 1 or Class III. (P < 0.05) 6. A close relationship was found between the degree of "treatment needs" and the value obtained by the HMAR scoring. (chi-square test, p < 0.05) The differences between the mean HMAR scores of the various subjectively defined categories were statistically significant. (P < 0.001)

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Age-related Injury Profile in Childhood (소아환아의 연령별 손상특성)

  • Ahn, Kyung A;Kim, Eun Sook;Lim, Kyung Soo
    • Journal of Trauma and Injury
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    • v.22 no.1
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    • pp.87-96
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    • 2009
  • Purpose: Injuries are the most important cause of morbidity and mortality in the childhood population worldwide. Thus, this study was down to investigate the type and the severity of injuries according to the age group in childhood. Methods: A survey of injury information and a chart review were done on 378 children (257 boys, 121 girls) who visited the Emergency Departments of Asan Medical Center from March 1, 2009, to March 31, 2009. To determine differences in injury mechanism, accident place, injury site, New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS), we divided the 378 patients into 4 group: under 1 year, 1 to 4 years, 5 to 9 years, and 10 to 15 years. Results: The mean (${\pm}SD$) age of the study group was 5.1 (${\pm}4.4$) years. Two year olds formed the largest group of injured children, with 77 cases (20.4% of the total). The most common cause of injury in childhood was being hit by an object (26.2%). Falls were frequent in the under-1-year group (22.2%) and slip downs (30.1%) were more frequent in 1-to-4-year group. More than half (53.4%) of the injuries occurred in the home, and the most common places of home-related injuries were the living room (41.1%) and the bedroom (31.2%). The mean (${\pm}SD$) NISS was 1.5 (${\pm}1.8$), and traffic accidents had the highest NISS ($2.8{\pm}5.1$). Injuries occurred most frequently during the evening. The peak period was 4:00 PM to 8:00 PM (33.7%). Conclusion: Patterns of childhood injury by age group were considerably different, and less severe and nonhospitalized injuries were common. Thus, need to improve surveillance of a variety of injuries, promote intersectional collaboration, build institutional capacities and mobilize community support and policy as an investment in prevention.

Comparison between Korean Triage and Acuity Scale and Injury Severity Scoring System in Emergency Trauma Patients (외상환자의 한국형 중증도 분류와 손상중증도 점수체계의 비교)

  • Choi, YoonHee;Kim, BoHwa;Shin, JiEun;Jang, MyungJin;Lee, EunJa
    • Journal of East-West Nursing Research
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    • v.28 no.1
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    • pp.10-20
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    • 2022
  • Purpose: We compared the Korean Triage and Acuity Scale (KTAS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) determined the validity of KTAS for classifying trauma patients. Methods: A retrospective chart review of 10,865 trauma patients (aged ≥15 years) who visited a single regional trauma and emergency medical center from January 1, 2016, to December 31, 2020, was conducted. Data were collected from the Korean Trauma Data Bank. Based on KTAS classification, the rates of intensive care unit admission, surgery and intervention, transfusion, emergency room (ER) and hospital mortality, and ER stay time were investigated. Data were analyzed using Chi-square test, Pearson's correlation coefficient, receiver operating characteristic curve, and area under the ROC curve. Results: In the KTAS, severe trauma patients (ISS ≥16) were classified as Level 1 (79.6%), 2 (44.8%), 3 (15.5%), 4 (4.0%) and 5 (7.6%). The following were the predictive powers of KTAS, ISS, and RTS for different parameters: surgery and intervention rate, KTAS (.71), ISS (.70), and RTS (.63); transfusion rate within 4h, KTAS (.82), ISS (.82), and RTS (.74); ER stay time within 90 min, KTAS (.72), ISS (.62), and RTS (.56); and ER mortality, KTAS (.84), ISS (.72), and RTS (.88). These findings were statistically significant (p<.001). The sensitivity and specificity of KTAS for trauma patients were .88 (.87~.90), and .38 (.37~.39), respectively. Conclusion: KTAS is a useful classification system that can predict the clinical outcomes of patients with trauma, and effectively triage acutely ill trauma patients, thus provide appropriate treatment.

The Relationship between Risk of Eating Disorder and Severity of State-Trait Anxiety (일부 대학생의 상태-특성 불안 정도와 식사 장애 위험 정도의 관계)

  • Nam Hee-Jung;Kim Young-Soon
    • The Korean Journal of Food And Nutrition
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    • v.18 no.3
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    • pp.229-240
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    • 2005
  • This quantitative study was investigated to examine the relationship between severity of state-trait anxiety and disordered eating patterns in some university students. This study used a cross-sectional study design. Total 347 students participated in this study (88 male and 259 female) among three universities. The assessment of eating disorder was conducted by Eating Attitudes Test (EAT-26), a score of >or=20 identified individuals likely to have an eating disorder, including anorexia nervosa and bulimia nervosa. Scores of healthy dietary behaviors were obtained by self-assessment instrument on healthy diet scale(20-item questionnaire), and severity of state-trait anxiety was calculated by state-trait anxiety inventory(Total 40- item questionnaire). In groups for each state anxiety and trait anxiety, there were divided between 50 percentile point of cumulatived scores of state anxiety and trait anxiety in all subjects. Linear regression analysis showed overall significant difference between dietary patterns(anorexia nervosa and healthy dietary behaviors) and severity of state-trait anxiety in all sex. Our results indicated that severity of state-trait anxiety may marked eating disorder symptomatology on dimensions of eating disorder prevention.

Software Quality Prediction based on Defect Severity (결함 심각도에 기반한 소프트웨어 품질 예측)

  • Hong, Euy-Seok
    • Journal of the Korea Society of Computer and Information
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    • v.20 no.5
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    • pp.73-81
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    • 2015
  • Most of the software fault prediction studies focused on the binary classification model that predicts whether an input entity has faults or not. However the ability to predict entity fault-proneness in various severity categories is more useful because not all faults have the same severity. In this paper, we propose fault prediction models at different severity levels of faults using traditional size and complexity metrics. They are ternary classification models and use four machine learning algorithms for their training. Empirical analysis is performed using two NASA public data sets and a performance measure, accuracy. The evaluation results show that backpropagation neural network model outperforms other models on both data sets, with about 81% and 88% in terms of accuracy score respectively.

Influencing factors of the severity of occupational fall injury (직업손상과 관련된 추락환자의 중증도에 영향을 미치는 요인)

  • Ju, Jeong-Mi;Tak, Yang-Ju
    • The Korean Journal of Emergency Medical Services
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    • v.20 no.2
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    • pp.113-125
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    • 2016
  • Purpose: The purpose of this study was to investigate factors influencing severity of occupational fall injury. Methods: A self-reported questionnaire was completed by 105 patients sustaining occupational fall injury between July 2010 and January 2013. The study instruments were developed by the National Traumatic Occupational Fatalities and National Electronic Injury Surveillance System. The questionnaire consisted of general characteristics of the subjects (30 items), workplace characteristics (12 items) and disaster characteristic (13 items). Results: Demographic factors, except age, did not affect the severity of injury. Injured patients aged 50-59 years tended to have more severe injuries than those aged 39 years. Type of transport vehicles, conditions, and the circumstances of the fall influenced injury severity. Patients transported by 119 ambulance suffered more severe fall injuries than those who were not. Electrical workers did not receive safety education wihin a year. Critical height in severe injuries was > 6 meters. Conclusion: Occupational fall injuries were influenced by patient age, types of transport vehicles, fall height, size of workplace, and safety education experience.

A cross-sectional study of the association between mobile phone use and symptoms of ill health

  • Cho, Yong Min;Lim, Hee Jin;Jang, Hoon;Kim, Kyunghee;Choi, Jae Wook;Shin, Chol;Lee, Seung Ku;Kwon, Jong Hwa;Kim, Nam
    • Environmental Analysis Health and Toxicology
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    • v.31
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    • pp.22.1-22.7
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    • 2016
  • Objectives This study analyzed the associations between mobile phone call frequency and duration with non-specific symptoms. Methods This study was conducted with a population group including 532 non-patient adults established by the Korean Genome and Epidemiology Study. The pattern of phone call using a mobile phone was investigated through face-to-face interview. Structured methods applied to quantitatively assess health effects are Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale (PSS), Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey where a higher score represents a higher greater health effect. Results The average daily phone call frequency showed a significant correlation with the PSS score in female subjects. Increases in the average duration of one phone call were significantly correlated with increases in the severity of headaches in both sexes. The mean (standard deviation) HIT-6 score in the subgroup of subjects whose average duration of one phone call was five minutes or longer was 45.98 (8.15), as compared with 42.48 (7.20) in those whose average duration of one phone call was <5 minutes. The severity of headaches was divided into three levels according to the HIT-6 score (little or no impact/moderate impact/substantial or severe impact), and a logistic regression analysis was performed to investigate the association between an increased phone call duration and the headache severity. When the average duration of one phone call was five minutes or longer, the odds ratio (ORs) and the 95% confidence intervals (CIs) for the moderate impact group were 2.22 and 1.18 to 4.19, respectively. The OR and 95% CI for the substantial or severe impact group were 4.44 and 2.11 to 8.90, respectively. Conclusions Mobile phone call duration was not significantly associated with stress, sleep, cognitive function, or depression, but was associated with the severity of headaches.

Analysis of the In-Patients Who were Admitted due to Bicycle Related Injuries (자전거 사고로 입원한 환자에 대한 분석)

  • Lee, Dong-Hoon;Kim, Byung-Kuk;Yoon, Hyung-Ku;Shin, Dong-Eun;Lee, In-Sung
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.9 no.1
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    • pp.58-64
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    • 2010
  • Purpose: Bicycle riding is an increasingly popular sports and leisure activity in Korea. The aim of this study was to identify injury patterns of admitted patients who were injured from bicycle riding. Materials and Methods: This study examined 71 patients from Jan. 2008 to May 2009. There were 54 male and 17 female patients. We investigated the injured body parts, mechanisms of injury, location of injury, types of bicycles, purpose of bicycle riding, any concomitant luggage or passenger on rear seat, injury seasons and the helmet use. We analyzed the data using Injury Severity Score(ISS). Results: There were 11 cases of ISS 1, 41 cases of ISS 4, 2 cases of ISS 5, 13 cases of ISS 9, one case of ISS 13, two cases of ISS 16 and one case of ISS 29 among the 71 patients. 36 patients(50.7%) underwent surgery for upper and lower extremity injuries, two patients for vertebral body fractures, 8 patients for facial bone injuries and one patient for abdominal organ injury. There were 10 head injuries among whom three patients received treatment in ICU(4.2%). Conclusion: Bicycle riding can cause severe injuries with subsequent admission and major surgeries. Several measures including constructing more bicycle road, public campaign and wearing protective gears should be instituted.

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Relation between Serum S100β and Severity and Prognosis in Traumatic Brain Injury (외상성 뇌손상 환자에 있어서 S100β의 혈중 농도와 뇌손상의 정도 및 예후의 관계)

  • Kim, Oh Hyun;Lee, Kang Hyun;Yoon, Kap Jun;Park, Kyung Hye;Jang, Yong Su;Kim, Hyun;Hwang, Sung Oh
    • Journal of Trauma and Injury
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    • v.20 no.2
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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.