No abstract available.
Accidents, Traffic* ; Emergencies* ; Emergency Service, Hospital* ; Injury Severity Score*

PURPOSE: Alcohol intake is commonly found in injured patients, and alcohol affects base deficit independently with trauma. The purpose of this study was to evaluate the effect of alcohol on base deficit in trauma patients. METHODS: Data was retrospectively collected from trauma patients over 18 years of age who were admitted at the emergency center between October 2005 and July 2006. Blood sampling for alcohol level, base deficit evaluation were done within first hour for all patients. Patients were divided according to the serum alcohol level into an alcohol group(serum alcohol level> or =10 mg/dl) and a non-alcohol group. The patients were also stratified into minor (ISS< or =15) and major (ISS> or =16) injury groups according to their injury severity score (ISS). RESULTS: The study enrolled 63 patients of whom 37 fell into the alcohol group and 26 into the non-alcohol group. The mean alcohol level within the alcohol group was 210+/-85 mg/dl. Base deficit and serum lactate were not found to be significantly different in minor and major injuries, and ISS, base deficit were not significantly different with serum alcohol level. Base deficit was somewhat higher on average but not statistically significant in the non-alcohol group than in the alcohol group (-3.0+/-4.5 vs. -1.8+/-6.7 mmol/L, p=0.444). The base deficit was higher for the major injury-alcohol group than for the major injury-non-alcohol group, but this difference also did not achieve statistical significance (-4.6 +/-5.8 vs -2.4+/-8.1 mmol/L, p=0.117) CONCLUSION: In the severely injured patients, base deficit appears to be increased with alcohol but we found no statistically significant differences in base deficit and ISS between alcohol group and non-alcohol group of injured patients.
Emergencies ; Humans ; Injury Severity Score ; Lactic Acid ; Retrospective Studies

The TRISS (Revised Trauma Score and Injury Severity Score) method of trauma care evaluation was applied to 476 consecutive trauma patients admitted to our medical center over a 6-month period. Male to female ratio was 8:1, with a mean age of 24.7 years. Penetrating injury was the most common mechanism of injury (62%), with the chest as the most common region injured (36%). Mean probability of survival of 476 patients was 0.9802 and a predicted mortality of 9.4 patients. The overall mortality was 5.4 per cent with 26 actual deaths. As 93 per cent of patients had injuries to isolated anatomic regions, using the TRISS method, assigning numerical values to noninjured anatomic regions mathematically increased their probability of survival, even though the isolated injury was life-threatening. Consideration should be taken before adapting the TRISS method as the gold standard in evaluating trauma care in the local setting

PURPOSE: To study the clinical results of AO type C pelvic ring injuries and identify the prognostic factors. MATERIALS AND METHODS: 25 patients were treated for C type pelvic ring fractures between January 1995 and August 2002. The injury mechanism, associated injuries, time from injury to surgery, ICU care, Injury Severity Score, fracture site of posterior ring, displacement, surgical method, and complications were analyzed. Radiological and clinical evaluations of the results were conducted using the Majeed's score. Of the 25 patients, 16 were male, 9 were female, with an average age of 41.6 years. All except one patient had associated injuries and 12 patients had neurological complications. There were 17, 7 and 1 case of C1, C2 and C3 type injuries respectively. Twenty three cases underwent surgical treatment. RESULTS: The average Majeed's score was 66.6 points, and 15 patients (60%) had good or excellent results. The complications included 3 cases of non-union and 1 case of SI joint infection were complications. The clinical results were worse in those patients with neurological symptoms. CONCLUSION: Satisfactory results were obtained after surgical treatment of C type pelvic ring injuries. Neurological injuries affected the clinical outcome and appropriate fixation of the anterior ring was needed for stable fixation of C type pelvic ring injuries.
Female ; Humans ; Injury Severity Score ; Joints ; Male ; Pelvis

Chemical and Drug Induced Liver Injury ; pathology ; Humans ; Injury Severity Score ; Liver ; pathology

PURPOSE: To estimate the incidence and risk of significant renal injury quantitatively in the admitted patients with abdominal trauma. MATERIALS AND METHODS: From January 1992 to July 1997, 511 patients who admitted to departments of urology and general surgery due to major abdominal trauma with and without renal injury were included in this study. The risk of renal injury was defined as the percentage of square of Abbreviated Injury Scale of kidney in the Injury Severity Score(ISS) per each patient. The patients were classified to 5 groups according to the causes of trauma as traffic accident, falls, assault, other blunt and stab Injury, then compared the incidence and risk of renal injury each other. RESULTS: The overall incidence of significant renal injury was 14.9%, and the incidence according to the causes was 27.0%,20.8%, 16.1%, 14.3% and 10.7% in falls, assault, stab injury, other blunt and traffic accident, respectively. The overall risk of significant renal injury estimated by ISS was 15.7% and the risk according to the causes was 26.7%,24.9%, 11.9%,9.9% and 4.9% in assault, falls, traffic accident, other blunt and stab injury, respectively Mean ISS in the patients with renal injury was markedly higher than that of the patients without renal injury(27.5 vs 13.6)(p < 0.01). CONCLUSIONS: Our study shows that both the incidence and risk of significant renal injury in the admitted patients with abdominal trauma can be expected in the probability of 15% or so, and according to the causes, those in the traumatized patients by the assault and falls mark high.
Abbreviated Injury Scale ; Accidents, Traffic ; Humans ; Incidence* ; Injury Severity Score ; Kidney ; Urology

PURPOSE: The purpose of this study is to assess healthrelated quality of life (HRQOL) in patients with injury in the Emergency department, to compare that HRQOLs with normal control group, and to offer the results of this study as basic data on the HRQOL in Korean patients with injury, in the Emergency department. METHODS: Between November 1, 2003, and March 2, 2004, 266 eligible injury patients who had visited our emergency center were enrolled in the study. The HRQOL was measured by using the Korean Short Form Health Survey-36 (KSF-36)and the Korean EuroQol 5 dimensions (KEQ-5D). The HRQOL was assessed at 10 days after injury. The severity of injury was measured by using the Injury Severity Score (ISS). RESULTS: Of the 266 subjects, 164 (61.7%) were men and 102 (38.3%) were women, with a mean (+/-SD) age of 42.8 (+/-15.2) and mean ISS (+/-SD) of 4.54 (+/-3.98). The KSF- 36 and KEQ-5D scores in patients with injury were significantly lower than those in the normal control group. The HRQOL scores of each group by cause of injury had significant differences in the KSF-36 MCS and the KEQ-5D utility index, but they had no significant differences in the KSF-36 PCS. Women were more likely to have poor HRQOLs than men, but no statistical significance was found. Patients with non-intentional injury and hospitalized were more likely to have poor HRQOLs than patients with intentional injury and discharged, but the statistical significance varied with the measurement tool. CONCLUSION: In this study, we observed that the HRLOQs in patients with injury were lower than those in healthy subjects. However, if more definite feature of HRLOQ in patients with injury are to be defined, a study with a large epidemiologic controlled injury group and with detailed adjustments of the variable is needed.
Emergencies* ; Emergency Service, Hospital* ; Female ; Humans ; Injury Severity Score ; Male ; Quality of Life* ; Wounds and Injuries

Since Boehler's sentinel description, a universally acceptable thoracolumber fracture classification has eluded spine surgeons. The concept of the stability of a thoracolumbar injury changed continuously from the two column concept of Holdsworth to the three column theory of Denis. With the advent of sophisticated imaging techniques, improved biomechanical understanding, and in order to meet the high expectations of patients, several classification systems have been forwarded by the stalwarts in the field. Each successive system has contributed significantly to the understanding and prediction of treatment outcome. Load sharing classification by McCormack attempted to rationalize the use of short segment posterior instrumentation. Magerl et al. developed a comprehensive classification system based on progressive morphological damage determined by three fundamental forces: compression, distraction, and axial torque. Vaccaro et al. devised the thoracolumbar injury severity score based on three independent variables: the morphology of the injury, posterior ligamentous complex (PLC) integrity, and neurological status at the time of injury. But, there are limitations to the classification system, especially when magnetic resonance imaging yields a PLC status as indeterminant. In the absence of a universally acceptable classification system, it is important to understand the underlying concepts of the fractures. The author concisely reviews the subject from its inception in the year 1929 to the present day.
Classification* ; Humans ; Injury Severity Score ; Ligaments ; Magnetic Resonance Imaging ; Spine ; Torque ; Treatment Outcome

PURPOSE: We tried to apply an Emergency-Departmentbased In-depth Injury Surveillance System designed on the basis of the International Classification of External Causes of Injuries (ICECI). METHODS: We registered prospectively all victims presenting with an injury from August 2004 to February 2005 at a local emergency center with 530 inpatient beds and 24 emergency beds. We evaluated the distribution and the proportion by injury-related factors and compared the severity by using the New Injury Severity Score (NISS), the Revised Trauma Score (RTS), the International Classification of Disease-10-based Injury Severity Score (ICISS). RESULTS: The total number of cases was 2,994 and 58.4% of those involved male. Accidental injuries were much greater in number (88.2%) than intentional injuries (10.7%). By mechanism, falls, motor vehicle accidents, piercing/cutting/biting, burns, poisoning/chemical, and other blunt injuries accounted for 28.3%, 14.0%, 13.8%, 3.9%, 2.8%, and 21.5%, respectively, of all injuries. The most common activity was unpaid work (27.3%) and the most common place was a home/residence or institute (44.1%). By severity based on the NISS, mild (below 8 points), moderate (9 to 24 points), and severe (above 25 points) injuries accounted for 89.6%, 9.6%, and 0.8%, respectively, of all injuries. The ICISS and the NISS showed a strongly negative correlation (correlation coefficient= -0.656, p<0.001), and the ICISS and the RTS showed a strongly positive correlation (correlation coefficient = 0.518, p<0.001). CONCLUSION: The In-depth EDISS based on the ICECI was a useful tool for the surveillance of injury-related factors and was a feasible method for measuring and comparing injury severity.
Burns ; Classification ; Emergencies* ; Humans ; Injury Severity Score ; Inpatients ; Male ; Motor Vehicles ; Prospective Studies ; Wounds, Nonpenetrating

BACKGROUND: Trauma is a major cause of death for individuals under the age of 45 years and the third leading cause of death for all ages. So, it has been recognized as an important socioeconomic problem. The purpose of this study was to evaluate the outcome of surgical care of traumatized parients. METHODS: We retrospectively analyzed data of patients who had undergone surgical operation on head, abdomen, or chest trauma from January 1, 1995 to December 31, 1995. TRISS method and W- and Z- statistics were used to evaluate the trauma outcome and the quality assurance of surgical treatment. RESULTS: Two hundred and sixty eight patients were enrolled in this study. Traffic accident in injury mechanisms was the most common(n=185, 69.2%), and severely injured patients with over ISS 16 were 205 of total 268 patients(76.5%). Crude mortality rate was 11.6% (non-survivors/number of patients : 31/268). By TRISS method, predicted mortality rate was 10.1%, excess mortality rate was 14.2%, and W value was - 1.43 indicating less actual survivors than predicted, but absolute Z score was 0.91 and it was statistically not significant. CONCLUSION: These data show that trauma outcome and quality of surgical care in our hospital is adequate. We also suggest that it will provide a valuable data for further studies.
Abdomen ; Accidents, Traffic ; Cause of Death ; Head ; Humans ; Injury Severity Score* ; Mortality ; Retrospective Studies ; Survivors ; Thorax