• 제목/요약/키워드: Severity Scoring System

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초등수학영재 선발전형에 활용되는 교사 관찰 추천서의 분석 및 평가에 관한 연구 (Study on the Analysis and Evaluation of 'Observation and Recommendation Letter by Teacher' Which is Utilized in Mathematically Gifted Elementary Students Screening)

  • 김종준;류성림
    • 한국수학교육학회지시리즈C:초등수학교육
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    • 제16권3호
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    • pp.229-250
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    • 2013
  • 본 연구의 목적은 최근 영재 선발을 위해서 도입된 관찰 추천 선발제도에서 교사 관찰 추천서의 활용도를 높이기 위하여 현재 영재 선발전형의 일환으로 제출되는 교사 관찰 추천서를 분석하고 적절한 평가 모형을 개발하여 교사 관찰 추천서의 객관성 확보 방안을 마련하는 것이다. 연구 대상은 2012년 D광역시 소재 D대학부설 영재교육원 선발의 1차 전형에 통과한 초등수학영재 60명에 대한 교사 관찰 추천서이다. 연구 결과 교사 관찰 추천서에 나타난 수학 영재행동특성으로 구체적인 사례보다는 피상적인 진술을 하는 경향이 많았으며, 연구자가 고안한 교사 관찰 추천서의 분석 틀에 따라 빈도분석을 한 결과 특정 문항에 집중되는 경향을 보였다. 이는 관찰하고 서술하기 용이한 부분이 있는 반면 그렇지 못한 부분이 있거나 영재의 특성으로 판단하지 않았다는 것을 보여준다. 따라서 관찰 추천을 하기에 앞서 학생의 영재행동특성을 서술할 수 있는 좀 더 세분화된 교사 관찰 추천서 양식의 개발 및 영재의 관찰 추천과 관련된 교사연수가 체계적으로 이루어져야 한다는 것을 보여준다. 또한 교사 관찰 추천서에 나타난 영재행동특성에 대해서 Rubric 모형을 적용하여 점수화한 값을 기반으로 한 채점자간의 신뢰도는 1차 채점 시에는 상관계수가 .641이었고, 채점 과정에 대한 협의를 거친 후 3주 후에 실시한 2차 채점 시에는 .732로 다소 상승하였다. 이는 1차 채점 이후에 협의과정을 거치면서 채점자간의 엄격성을 조정하였으며, 서술형이기에 나타날 수 있는 다양한 상황에서의 세부적인 판단 기준을 세우고, 새롭게 나타난 상황에 대한 점수 부여의 합의점을 찾았기 때문이라고 볼 수 있다. 즉, 초등수학영재 판별을 위해서는 적절한 모형의 개발만큼이나 평가 모형에 대한 채점자들의 엄밀한 이해와 적용이 필요하다는 것을 시사한다.

상완골 근위부 분쇄 골절에서의 상완골 두 치환술 (Hemiarthroplasty for the Comminuted Fracture of the Proximal Humerus)

  • 서중배;원중희;김용민;최의성;이호승;홍윤철
    • Clinics in Shoulder and Elbow
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    • 제3권2호
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    • pp.61-67
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    • 2000
  • Purpose: Most proximal humeral fractures are minimally displaced and can be treated satisfactorily with a conservative method. But in many comminuted fractures, hemiarthroplasty is usually done as a primary treatment. The authors evaluated how much functional improvement was achieved after hemiarthroplasty and which factors influence on the final functional results. Materials and Methods: Eleven hemiarthroplasties were performed for three- and four-part fractures(including fracture-dislocation) between April 1992 and June 1999. There were eight women and three men, and the mean age was 65 years. According to Neer classification, six was three-part fracture and five was four-part fracture. Six patients were injured on their right shoulder and five on the left shoulder. Among the five four-part fractures, three had axillary nerve injury and among the six three-part fractures, only one patient had axillary nerve injury. The average follow-up period was 2.4 years(1 year-7 years) after operation. The functional results were evaluated with the UCLA scoring system(Modification for hemiarthroplasty). In addition to the overall results, we compared the results according to the classification of the fracture, the cause of injury, and whether the axillary nerve was injured. Results: At the last follow-up, average total UCLA score was 18.2. The mean score for pain was 7.0, mean muscle power and motion score was 5.5 and 5.7 respectively. The pain relief was more satisfactory than any other functional results. The average score for three-part fractures was 22, and the average for four-part fractures was 13.6. The average score for the patients fractured by vehicle accidents was 15.3, and 19.3 for the patients fractured by slip-down injury. In patients without axillary nerve injury, the average score was 20, and with axillary nerve injury, the score was 15. Conclusion: Shoulder hemiarthroplasty, for the treatment of proximal humeral fractures, cannot restore the shoulder function to normal, but can achieve the functional result to some degree, especially for the activity of daily living. And as for pain, we think that it is relatively effective measure. And we think that the severer the comminution, the more the chance of axillary nerve injury, and the poorer the functional results. In conclusion, the severity of initial injury seems to be the major prognostic factor.

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슬관절의 통증과 기능장애의 평가도구에 관한 연구 (The Research of Pain and Functional Disability Assessment Scales for Knee Joint Disease)

  • 정찬영;김은정;황민섭;조현석;김경호;이승덕;김갑성
    • Journal of Acupuncture Research
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    • 제27권2호
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    • pp.123-142
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    • 2010
  • Objectives : The knee pain is the main reason of getting acupuncture treatment. In order to have confidence in the results of a study, it is necessary to establish that questionnaire is both valid and reliable in questionnaire related study. The aim of this study was to review the instruments that are currently in sue for assessing the knee joint. Methods : A literature study was performed to choose appropriate scales for assessment for pain and the function of the knee. Theoretically based scales were selected for review. Therefore, 18 scales for knee and 9 scale for pain were reviewed. the status of scales involved in knee treatment of acupuncture throughout several countries was evaluated. Results & Conclusion : Lysholm Knee Scoring Scale, Cincinnati knee rating system(CKRS) are adequate for ligament injury in knee. International Knee Documentation Committee scoring system(IKDC) may become a publication requirement for journals in view of the international standing of the committee. The available outcome measure for use in osteoarthritis are Western Ontario and McMaster Universities Osteoarthritis Index(WOMAC), Lequesne Functional Severity Index(LFI) and Knee Injury and Osteoarthritis Outcome Score(KOOS), and in rheumatoid arthritis are McMaster-Toronto Arthritis patient function preference questionnaire(MACTAR), Quality of Life-Rheumatoid Arthritis Scale(QoL-RA Scale). Visual analog scale(VAS), verbal rating scale(VRS) are commonly used for the standard pain scale. For long term follow-up study The Medical Outcomes Study Short Form-36(SF-36), Arthritis Impact Measurement Scales(AIMS), Health Assessment Questionnaire(HAQ) should be included. Each measurement has its own composition and characteristics. Their validity, reliability, responsiveness and practical characteristics were already evaluated. We found 20 domestic and 28 overseas papers about knee treatment using acupuncture assessed with knee scales.

Effects of a Mineral-Salt Laxative in Lactation Diets for Primiparous Sows and Their Litters

  • Kim, I.H.;Hancock, J.D.;Kim, C.S.
    • Asian-Australasian Journal of Animal Sciences
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    • 제11권4호
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    • pp.381-384
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    • 1998
  • Twenty-three crossbred (Yorkshire $\times$ Duroc $\times$ Hampshire $\times$ Chester White) primiparous sows were used to evaluate the effects of the mineral-salt laxative in lactation diets on sow and litter performance. The sows were fed a sorghum-extruded soybean-based diet with .85% lysine, .90% Ca, .80% P, and 3.2 Mcal ME/kg. Sow body weight (p > .54) and backfat loss (p > .61), average daily feed intake (p > .42), and litter weight gain (p > .74) were not affected by the mineral-salt laxative in the diet. However, survivability of piglets was greater (p < .06) for sows with the mineral-salt laxative in their diet and, thus, number of pigs weaned was increased. As expected, fecal moisture was increased (p < .09) in sows fed the mineral-salt laxative. Apparent digestibilities of DM, N, and GE were not affected by treatment (p > .26). After weaning, stomachs were collected and scored for ulcers and keratinization using a scoring system of 0 = normal to 3 = severe. Severity of ulceration and keratinization was not significantly affected by treatment (row mean scores differ test p > .25), but scores for sows fed the diet containing the mineral-salt laxative were numerically lower than sows fed the control diet. Thus, our data indicate that sows fed the mineral-salt laxative during lactation had improved piglet survivability, greater fecal moisture, and tended to have fewer lesions in the mucosa of the stomach.

Thoracic Myelopathy Caused by Ossification of the Ligamentum Flavum

  • Hur, Hyuk;Lee, Jung-Kil;Lee, Jae-Hyun;Kim, Jae-Hyoo;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • 제46권3호
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    • pp.189-194
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    • 2009
  • Objectives : Ossification of the ligamentum flavum (OLF) is a rare cause of thoracic myelopathy. The aim of this study was to identify factors associated with the surgical outcome on the basis of preoperative clinical and radiological findings. Methods : Data obtained in 26 patients whot underwent posterior decompression for thoracic myelopathy, caused by thoracic OLF, were analyzed retrospectively. Patient age, duration of symptoms, OLF type, preoperative and postoperative neurological status using the Japanese Orthopedic Association (JOA) scoring system, surgical outcome, and other factors were reviewed. We compared the various factors and postoperative prognosis. All patients had undergone decompressive laminectomy and excision of the OLF. Results : Using the JOA score, the functional improvement was excellent in 8 patients, good in 14, fair in 2, and unchanged in 2. A mean preoperative JOA score of 6.65 improved to 8.17 after an average of 27.3 months. According to our analysis, age, gender, duration of symptoms, the involved spinal level, coexisting spinal disorders, associated trauma, intramedullary signal change, and dural adhesions were not related to the surgical outcome. However, the preoperative JOA score and type of OLF were the most important predictors of the surgical outcome. Conclusion : Early diagnosis and sufficient surgical decompression could improve the functional prognosis for thoracic OLF. The postoperative results were found to be significantly associated with the preoperative severity of myelopathy and type of OLF.

Therapeutic Effect of Majoon Mundi and Qairooti Karnab in Dā al-Ṣadaf (Psoriasis): A Case Series

  • Siddiqui, Gulnaz Fatima;Siddiqui, Shahid Akhtar;Jabeen, Arzeena;Qamaruddin, Qamaruddin;Kazmi, Munawwar Husain
    • 셀메드
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    • 제9권4호
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    • pp.8.1-8.5
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    • 2019
  • Introduction: Psoriasis is a major health concern around the world. Physicians of the Unani system of medicine have been treating psoriasis for centuries. Aim: The purpose of our study was to assess the effect of Majoon Mundi (a semisolid Unani medication intended for oral intake used as blood purifier) and Qairooti Karnab (a Unani medication in paste form intended for topical application used as emollient) in the treatment $na{\ddot{i}}ve$ psoriasis cases and to collect data to warrant further clinical trials. Material and Methods: Psoriasis cases were diagnosed clinically. Data were collected during treatment of five patients of psoriasis treated with the Majoon Mundi (oral intake of 5 gm twice daily with 200 ml of water for 12 weeks) and Qairooti Karnab (topical application on affected sites twice a day for 12 weeks). Patients were treated for 12 weeks. Treatment response was seen with clinical improvement in skin lesions and measurement of Psoriasis Area and Severity Index (PASI Scoring) before and after treatment. Results: Reduced PASI Score was observed in all five patients after 12 weeks of treatment [PASI before and after treatment was (mean${\pm}$SD) $20.7{\pm}4.6$ vs. $3.2{\pm}1.8$; p-value <0.05.]. Clinical improvement was noticed within an average of 4 weeks of treatment. Conclusion: Preliminary findings indicate the potential therapeutic role of Majoon Mundi and Qairooti Karnab in the treatment of psoriasis. Clinical trials based on this Unani pharmacopeial formulation should be conducted to explore the therapeutic potential of this formulation in psoriasis

Analysis of Risk Factors for Infection in Orthopedic Trauma Patients

  • Moon, Gi Ho;Cho, Jae-Woo;Kim, Beom Soo;Yeo, Do Hyun;Oh, Jong-Keon
    • Journal of Trauma and Injury
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    • 제32권1호
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    • pp.40-46
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    • 2019
  • Purpose: We perform an analysis of infection risk factors for fracture patients and confirm that the risk factors reported in previous studies increase the risk of actual infection among fractured patients. In addition, injury severity score (ISS) which is used as an evaluation tool for morbidity of trauma patients, confirms whether there is a relationship with infection after orthopedic fracture surgery. Methods: We retrospectively reviewed 1,818 patients who underwent fixation surgery at orthopedic trauma team, focused trauma center from January 1, 2015 to December 31, 2017. Thirty-five patients were infected after fracture surgery. We analyzed age, sex, open fracture criteria based on Gustilo-Aderson classification 3b, anatomical location (upper extremity or lower extremity) of fracture, diabetes, smoking, ISS. Results: Of 1,818 patients, 35 (1.9%) were diagnosed with postoperative infection. Of the 35 infected patients, nine (25.7%) were female and five (14.0%) were upper extremity fractures. Three (8.6%) were diagnosed with diabetes and eight (22.8%) were smokers. Thirteen (37.1%) had ISS less than nine points and six (17.1%) had ISS 15 points or more. Of 1,818 patients, 80 had open fractures. Surgical site infection were diagnosed in 12 (15.0%) of 80. And nine of 12 were checked with Gustilo-Aderson classification 3b or more. Linear logistic regression analysis was performed using statistical analysis program Stata 15 (Stata Corporation, College Station, TX, USA). In addition, independent variables were logistic regression analyzed individually after Propensity scores matching. In all statistical analyzes, only open fracture was identified as a risk factor. Conclusions: The risk factors for infection in fracture patients were found to be significantly influenced by open fracture rather than the underlying disease or anatomical feature of the patient. In the case of ISS, it is considered that there is a limitation. It is necessary to develop a new scoring system that can appropriately approach the morbidity of fracture trauma patients.

신생아 질식 환아에서 저산소성 허혈 뇌증의 정도와 급성신부전 발생과의 연관성 (The Correlation between the Severity of Hypoxic Ischemic Encephalopathy and the Development of Acute Renal Failure in Asphyxiated Neonates)

  • 박성신;정성훈;송준혁;김선경;조병수;김성도
    • Childhood Kidney Diseases
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    • 제11권1호
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    • pp.32-40
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    • 2007
  • 목적 : 급성신부전은 질식 신생아의 사망률과 신경학적 예후와 관련이 있는 것으로 알려져 있다. 이에 본 저자들은 신생아 질식 환아에서 급성신부전의 발생률을 알아보고, 질식과 저산소성 허혈 뇌증의 정도와 급성신부전과의 연관성을 알아보고자 이번 연구를 시행하였다. 방법 : 신생아 질식으로 진단 받은 환아 33명과 임신 기간과 출생체중으로 짝지어진 환아 33명의 의무기록을 후향적으로 검토하였다. 5분 아프가 점수에 의해 신생아 질식의 정도를 경증(6 또는 7), 중등도(4 또는 5), 중증(3 이하)으로 세분하였으며, Sarnat and Sarnat stage에 의해 저산소성 허혈 뇌증의 단계를 분류하였다. 생후 3일에 측정한 혈청 크레아티닌, 혈액요소질소, 전해질 수치와 소변배출량, 혈뇨와 단백뇨 유무에 대한 기록을 검토하였다. 영상 검사를 통해 진단 받은 뇌실 내 출혈의 유무와 정도를 비교하였다. 결과 : 질식군 8명(24.2%)에서 급성신부전이 발생하였다. 이 중 3명(37.5%)이 감뇨성 급성신부전을 보였다. 경증 질식 1명(10.0%), 중등도 질식 2명(18.2%), 중증 질식 5명(41.7%)에서 급성 신부전이 발생하였다(P>0.05). 뇌증 1단계 1명(25%), 뇌증 2단계 4명(50%), 뇌증 3단계 3명(75%)에서 급성신부전이 발생하였다(P<0.01). 5분 아프가 점수에 의한 질식의 정도와 저산소성 허혈뇌증 단계와의 통계학적 연관성은 없었다. 뇌실내 출혈 1단계 1명(7.7%), 2단계 0명, 3단계 2명(66.7%), 4단계 2명(100%)에서 급성신부전이 발생하였다(P<0.01). 급성신부전이 발생한 집단에서 발생하지 않은 집단보다 사망률이 더 높았다. (P<0.05). 감뇨성과 비감뇨성 급성신부전 간의 차이는 없었다. 결론 : 저산소성 허혈 뇌증이 심할수록 급성신부전 발생률이 높았으며, 급성신부전 발생 집단에서 예후가 더 좋지 않았다. 저산소성 허혈 뇌증환아에서 급성신부전을 조기에 진단하여 적절한 수액 및 전해질 공급을 하여야겠다.

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관동맥질환의 진단을 위한 아데노신 Tc-99m sestaMIBI SPECT의 재현성 (Reproducibility of Adenosine Tc-99m sestaMIBI SPECT for the Diagnosis of Coronary Artery Disease)

  • 이덕영;배진호;이상우;천경아;유정수;안병철;하정희;채성철;이규보;이재태
    • 대한핵의학회지
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    • 제39권6호
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    • pp.473-480
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    • 2005
  • 목적: 아데노신 부하 Tc-99m MIBI SPECT는 관동맥질환의 진단, 예후 평가, 치료 방침의 설정, 치료 효과 판정 및 경과 관찰에 유용성이 있다고 알려져 있다. 치료 효과 판정 및 치료 방침 설정을 위해서는 검사 방법의 재현성이 높아야 한다. 본 연구는 아데노신 부하 Tc-99m MIBI SPECT의 재현 성능을 평가하기 위하여 동일인에서 2회 연속적으로 시행한 아데노신 부하 Tc-99m MIBI SPECT에서 약물주사에 따른 혈역학적 변화와 부작용의 빈도, 영상에 나타난 심근분절의 방사능섭취 정도의 차이를 알아 보고자 하였다. 대상 및 방법: 관동맥질환이 의심되거나 관동맥질환으로 진단된 후 추적검사를 위하여 아데노신 부하 Tc-99m MIBT SPECT를 시행한 30명의 환자를 대상으로 2-11 일(평균: 4.1 일)의 간격으로 검사를 반복하였다. 관류영상의 육안적 판독은 좌심실의 단층 영상을 18분절로 구분하여, 섭취 정도에 따라 4등급으로 분류하였고, 관류 정도의 평가는 2명의 핵의학 전공의사가 각각 평가한 후 일치하지 않은 경우에는 두 판독자 간에 토의로 합의된 소견으로 비교하였다. 결과: 아데노신 주사에 따른 수축기혈압, 이완기 혈압 및 맥박 수의 변화는 두 검사 사이에 유의한 차이가 없었고, 두 번의 검사를 시행하는 동안 검사를 중지하거나 부작용 치료를 위한 처치를 받아야 만큼 중독한 부작용의 발생은 없었다. 관류점수상 540분절 중 439분절에서 완전하게 일치하였고(일치도 81.3%, tau B index 0.73%), 1점 차이(97분절, 18%), 2점 차이(4분절, 0.7%)있었으나 3점 이상의 차이가 있은 경우는 없었다. 두 검사에서 측정된 관류결손의 범위와 중증도점수 사이에는 각각 $\gamma$-값 0.982와0.965의 높은 양의 상관성을 나타내었다(p<0.001, respectively). 결론: 연속적으로 2회 시행한 아데노신 부하 Tc-99m MIBI SPECT는 부하에 따른 혈역학적 변화 및 부작용의 발생이 유사하였고, 심근분절의 관류상태의 시각적 평가 및 관류결손의 정량적 판정에서 매우 높은 재현성을 보여주었다. 그러므로 아데노신 Tc-99m MIBI SPECT는 관동맥질환이 의심되거나 관동맥질환으로 진단된 환자에서 약물치료나 중재적 시술 또는 외과적 수술 치료 후 심근관류상태의 경시적 변화를 평가하는데 유용하게 이용될 수 있을 것이라 판단된다.

응급의료전달체계의 각 요인이 중증외상환자의 예후에 미치는 영향 분석 (Prognostic Factor, for Major Trauma Patients in the Emergency Medical Service System)

  • 임득호;정태녕;이창재;진수근;김의중;최성욱;김옥준
    • Journal of Trauma and Injury
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    • 제24권2호
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    • pp.89-94
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    • 2011
  • Purpose: A few studies have assessed the factors affecting the prognoses for major trauma patients and those improving the circumstances when dealing with the trauma system. In that light, we analyzed factors, such as pre-hospital factors, the time to admission, the length of stay in the emergency department (ED) and emergency operation, influencing the outcomes for trauma patients. Methods: The patients who visited our emergency department from April 1, 2009, to February 29, 2011, due to major trauma were enrolled in the study. The inclusion criterion was a revised trauma score (RTS) < 7 or injury severity score (ISS) ${\geq}$ 16. We used reviews of medical records, to analyze each step of emergency medical care with respect to patients' sex, age, visit time and visit date. Continuous variables were described as a median with an interquartile range, and we compared the variables between the survival and the mortality groups by using the Mann-Whitney U test. Fisher's exact test was used for nominal variables. Using the variables that showed statistical significance in univariate comparisons, we performed a logistic regression analysis, and we tested the model's adequacy by the using the Hosmer-Lemeshow method. Results: A total of 261 patients with major trauma satisfied either the RTS score criterion or the ISS score criterion. Excluding 12 patients with missing data, 249 patients were included in this study. The overall mortality rate was 16.9%. Time to ED arrival, time to admission, time of ED stay, RTS, ISS, and visit date being a holiday showed statistically significant differences between the survival and the mortality groups in the univariate analysis. RTS, ISS, length of ED stay, and visit date being a holiday showed statistical significance in the multivariate analysis. Conclusion: The mortality rate did not show a significant relationship with the time to ED arrival, use of 119, on time to admission. Rather, it elicited a quite significant correlation with the trauma scoring system (RTS and ISS), the time of ED stay, and the visit date being a holiday.