• 제목/요약/키워드: injury risk factors

검색결과 342건 처리시간 0.028초

Pitfalls, Complications, and Necessity of Education about REBOA: A Single Regional Trauma Center Study

  • Kim, Sol;Chung, Jae Sik;Jang, Sung Woo;Jung, Pil Young
    • Journal of Trauma and Injury
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    • 제33권3호
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    • pp.153-161
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    • 2020
  • Purpose: Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an emergency procedure and extremely time-dependent, and the proficiency of the physician is important. Due to a lack of REBOA education programs in Republic of Korea, few physicians have been trained in the procedure. In this study, we examined how REBOA education affects clinical outcomes in a single center. Methods: A retrospective study conducted from February 2017 to June 2020 at a regional trauma center. We collected data of patients who underwent REBOA and analyzed the factors that influenced the outcome. The patients were divided into the educated and non-educated groups (based on REBOA training received by their physicians), and the success and failure groups. Results: A total of 24 patients underwent REBOA during the study. There were eight patients in the success group and 16 patients in the failure group. There are no significant differences between the educated and non-educated groups in sex, age, ISS, shock, injury-to-REBOA time, injury mechanism, injury sites, arrest, access site, type of catheter, type of REBOA, target Zone, mortality, and the result of REBOA. The non-educated group had a higher risk for failure compared to the educated group in multivariate analysis (odds ratio [OR] 154.64, 95% confidence interval [CI] 1.11-22.60). Conclusions: Failure in REBOA is harmful to patients. The risk of failure is increased in the non-educated group. Physicians working in the trauma center or emergency department need to complete the REBOA education program.

Driving Conditions and Occupational Accident Management in Large Truck Collisions

  • Jeong, Byung Yong;Lee, Sangbok;Park, Myoung Hwan
    • 대한인간공학회지
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    • 제35권3호
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    • pp.135-142
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    • 2016
  • Objective: Objective of this study is to provide characteristics of injury frequency and severity by driving condition in large truck-related traffic collisions. Background: Traffic accidents involving large trucks draw a lot of attention in accident prevention and management policies since they bring about severe human and financial damages. Method: In order to identify the major risk factors of accidents by driving condition, 255 recognized traffic accidents by large truck drivers were analyzed in terms of time of the day, road type, and shape of the road. Results: The driving conditions in the results are represented by the following form of combination, "Road Type (Non-expressway or Express) - Shape of Roads (Straight, Curved, Downhill, or Intersection) - Time of Accidents (Day or Night)". In the analysis of injury frequency, Non-expressway-Straight-Day condition was the most frequent one. Meanwhile, Expressway-Curved-Day, Non-expressway-Curved-Night and Non-expressway-Intersection-Night were evaluated as high level in view of injury severity. Also, Expressway-Straight-Night is the driving condition that is the highest in risk among the conditions that have to be managed as grade "High". Non-expressway-Straight-Night, Non-expressway-Downhill-Day, and Non-expressway-Curved-Day are also categorized as grade "High". Conclusion and Application: Safety managers in the fields require basic information on accident prevention that can be easily understood. The research findings will serve as a practical guideline for establishing preventive measures for traffic accidents.

소아의 응급질환 - 우리나라 소아 및 청소년의 손상과 급성 중독을 중심으로 - (Clinical aspects of injury and acute poisoning in Korean pediatric patients)

  • 이미진;박준석
    • Clinical and Experimental Pediatrics
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    • 제51권2호
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    • pp.116-121
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    • 2008
  • Unintentional injuries are the most important cause of morbidity and mortality in the pediatric population, and the home is the most common site of injury for children in Korea. The most common cause of injury was slip down. Fall down and burn were frequent in infant/toddlers group, automobile and bicycle accident more frequent in preschool children. Findings from the survey could then be used to provide targets for direct educational efforts by medical services and to direct environmental safety modifications tailored to the unique situation of each family. Pediatric toxic ingestions are treated commonly by pediatricians and emergency physicians. Significant injury after these ingestions is infrequent, but identifying the dangerous ingestion is sometimes a difficult task. By performing a detailed history, focused physical examination, and directed laboratory evaluation, an estimation of risk can be developed. According to recent Korean poison papers, there were bimodal peak of age distribution in poisoned children patient on the whole: infant and adolescents group. Various types of materials belonged the classes of drugs, household products, and industrial solvents. Most of the poisoned children patients had been poisoned accidentally, while most cases of adolescents poisoning had been intentional. More than half of the adolescents group had a suicidal purpose in Korea, so an understanding of the demographic factors associated with self-harm poisoning may provide useful information to improve prevention and treatment strategies.

간경화증 환자에서 경도 외상 후 발생한 지연 비장 파열 (Delayed Splenic Rupture Following Minor Trauma in a Patient with Underlying Liver Cirrhosis)

  • 정경운;이병국;류현호
    • Journal of Trauma and Injury
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    • 제24권1호
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    • pp.52-55
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    • 2011
  • The spleen is the most frequently injured organ following blunt abdominal trauma. However, delayed splenic rupture is rare. As the technical improvement of computed tomography has proceeded, the diagnosis of splenic injury has become easier than before. However, the diagnosis of delayed splenic rupture could be challenging if the trauma is minor and remote. We present a case of delayed splenic rupture in a patient with underlying liver cirrhosis. A 42-year-old male visited our emergency department with pain in the lower left chest following minor blunt trauma. Initial physical exam and abdominal sonography revealed only liver cirrhosis without traumatic injury. On the sixth day after trauma, he complained of abdominal pain and diarrhea after eating snacks. The patient was misdiagnosed as having acute gastroenteritis until he presented with symptoms of shock. Abdominal sonography and computed tomography revealed the splenic rupture. The patient underwent a splenectomy and then underwent a second operation due to postoperative bleeding 20 hours after the first operation. The patient was discharged uneventfully 30 days after trauma. In the present case, the thrombocytopenia and splenomegaly due to liver cirrhosis are suspected of being risk factors for the development of delayed splenic rupture. The physician should keep in mind the possibility of delayed splenic rupture following blunt abdominal or chest trauma.

고등학생 자살 경향성에 영향을 미치는 요소 : 학생 스스로 지각하는 학업성취도를 중심으로 (Factors Related with Suicidality in High-School Students : Focused on Perceived Academic Performance)

  • 곽영숙;신지현
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제22권4호
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    • pp.294-301
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    • 2011
  • Objectives : This study investigated factors related to suicide in high school students and focused on perceived academic performance. Methods : We surveyed 293 grade 10 high-school students in Jeju and Gyeonggi provinces and gave them self-assessment questionnaires. To evaluate the suicide risk, the questionnaire included questions about suicidal thoughts, plans, threats, deliberate self-injury, and suicide attempts from the Scale for Suicide Ideation (SSI). Also, it included the Beck Depression Inventory (BDI), Beck Hopelessness Scale (BHS), Locus of Control Scale (LOC), Rosenberg's Self Esteem Scale (RSE) and Perceived Academic Performance (PAP) to identify factors related to suicide in high school students. Results : Depression, hopelessness, and low self-esteem were related with suicidal thoughts, plans, attempts, and severe suicidal ideation (SSI score${geq}$16). In the multivariate analysis, a low level of PAP (OR=3.796, 95%CI 1.280-11.257) was significantly associated with severe suicidal ideation (SSI score${geq}$16). Deliberate self-injury was most prevalent in failing the PAP group and also having a high level of PAP (OR=6.161, 95%CI 1.474-25.760). Conclusion : The authors found that the suicide risk of high school students is related to depression, hopelessness, low self-esteem and a low level of PAP. These results provide significant indicators in planning an adolescent suicide prevention program.

Age group analysis of patients with dog bite injuries who visited a single regional emergency medical center and factors affecting wound infections

  • Kang, Dong Ho;Choi, Jea Yeon;Choi, Woo Sung;Jang, Jae Ho;Cho, Jin-Seong;Hyun, Sung Youl
    • Journal of Trauma and Injury
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    • 제35권2호
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    • pp.84-91
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    • 2022
  • Purpose: The aim of this study was to analyze by age group the characteristics of patients with dog bite injuries, as well as determine which factors were associated with wound infections in those patients. Methods: We reviewed patients with dog bite injuries who presented to Gachon University Gil Medical Center in Incheon, Korea from January 1, 2014 to December 31, 2018. They were classified by age group: children (0-18 years), adults (19-59 years), or elderly (≥60 years). Event profiles, wound characteristics, and infections were compared across these age groups. Multivariable logistic regression was used to identify factors associated with wound infections. Results: Of the total 972 dog bite injuries, 272 (28.0%) were in children, 606 (62.3%) were in adults, and 94 (9.7%) were in the elderly. The median age was 30 years (interquartile range, 16-48 years) and the majority of patients (60.5%) were female. The most common place of injury was at home (73.8%) and indoors (77.0%). In children, the head and neck were the most frequent sites of injury (43%), while the most frequent site in adults and the elderly (50.8% and 59.6%, respectively) was the upper extremity. The odds ratio (OR) for wound infection was 3.997 (95% confidence interval [CI], 1.279-12.491; P=0.017) for head and neck injuries and 3.881 (95% CI, 1.488-10.122; P=0.006) for lower extremity injuries. The OR for wound infection was 4.769 (95% CI, 2.167-10.494; P<0.001) for significant injuries. Elderly patients had a higher risk for wound infection than other age groups (OR, 2.586; 95% CI, 1.221-5.475; P=0.013). Conclusions: When analyzing patients with dog bite injuries, differences across age groups were found, with the elderly at the highest risk for significant injury and wound infection. It is recommended that age-specific approaches and strategies be used to prevent dog bite wound infections.

여자 체조선수들의 한 발 드롭 착지 시 무릎보호대가 전방십자인대 부상 위험요인에 미치는 영향 (The Effects of Knee Brace on Anterior Cruciate Ligament Injuries Risk Factors During One-Legged Landing of Female Gymnasts)

  • 임비오;김규완;서정석
    • 한국체육학회지인문사회과학편
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    • 제51권4호
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    • pp.419-425
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    • 2012
  • 본 연구의 목적은 여자 체조선수들의 한 발 드롭 착지 시 무릎보호대가 무릎의 전방십자인대 부상 위험요인에 미치는 영향을 규명하는 것이다. 본 연구에 참가한 연구대상은 여자 체조선수 11명으로, 자신의 무릎 높이의 박스 위에서 한 발 드롭 착지 동작을 무릎보호대를 차지 않고 3번, 무릎보호대를 차고 3번씩 총 6회 무작위로 수행하였다. 무릎보호대 착용 유·무에 따른 무릎의 전방십자인대 부상 위험요인에 미치는 영향을 규명하기 위해 종속 t-test를 실시하였다. 연구결과, 여자 체조 선수들은 무릎보호대를 착용하였을 때에는 무릎보호대를 착용하지 않았을 때와 비교하여 한 발 드롭 착지 시 발목중심에서 무릎중심까지의 거리가 유의하게 더 짧게 나타났으며, 무릎의 최대 신전모멘트가 더 감소한 것으로 나타났다. 이러한 결과를 종합해 볼 때, 여자 체조선수의 한 발 드롭 착지 시 무릎보호대의 착용이 무릎의 전방십자인대에 가해지는 부하를 감소시킨 것으로 판단된다.

Necrotizing enterocolitis in newborns: update in pathophysiology and newly emerging therapeutic strategies

  • Choi, Young Youn
    • Clinical and Experimental Pediatrics
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    • 제57권12호
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    • pp.505-513
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    • 2014
  • While the survival of extremely premature infants with respiratory distress syndrome has increased due to advanced respiratory care in recent years, necrotizing enterocolitis (NEC) remains the leading cause of neonatal mortality and morbidity. NEC is more prevalent in lower gestational age and lower birth weight groups. It is characterized by various degrees of mucosal or transmural necrosis of the intestine. Its exact pathogenesis remains unclear, but prematurity, enteral feeding, bacterial products, and intestinal ischemia have all been shown to cause activation of the inflammatory cascade, which is known as the final common pathway of intestinal injury. Awareness of the risk factors for NEC; practices to reduce the risk, including early trophic feeding with breast milk and following the established feeding guidelines; and administration of probiotics have been shown to reduce the incidence of NEC. Despite advancements in the knowledge and understanding of the pathophysiology of NEC, there is currently no universal prevention measure for this serious and often fatal disease. Therefore, new potential techniques to detect early biomarkers or factors specific to intestinal inflammation, as well as further strategies to prevent the activation of the inflammatory cascade, which is important for disease progression, should be investigated.