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: To systematically review the risk of permanent disability related to road traffic injuries (RTIs) and to determine the implications for future research regarding permanent impairment following road traffic crashes. METHODS: We conducted this systematic review according to the preferred reporting items for systematic reviews and meta-analysis statement. An extended search of the literature was carried out in 4 major electronic databases for scientific research papers published from January 1980 to February 2020. Two teams include 2 reviewers each, screened independently the titles/abstracts, and after that, reviewed the full text of the included studies. The quality of the studies was assessed using the strengthening the reporting of observational studies in epidemiology (STROBE) checklist. A third reviewer was assessed any discrepancy and all data of included studies were extracted. Finally, the data were systematically analyzed, and the related data were interpreted. RESULTS: Five out of 16 studies were evaluated as high-quality according to the STROBE checklist. Fifteen studies ranked the initial injuries according to the abbreviated injury scale 2005. Five studies reported the total risk of permanent medical impairment following RTIs which varied from 2% to 23% for car occupants and 2.8% to 46% for cyclists. Seven studies reported the risk of permanent medical impairment of the different body regions. Eleven studies stated the most common body region to develop permanent impairment, of which 6 studies demonstrated that injuries of the cervical spine and neck were at the highest risk of becoming permanent injured. CONCLUSION The finding of this review revealed the necessity of providing a globally validated method to evaluate permanent medical impairment following RTIs across the world. This would facilitate decision-making about traffic injuries and efficient management to reduce the financial and psychological burdens for individuals and communities.
Humans ; Accidents, Traffic ; Disabled Persons ; Abbreviated Injury Scale ; Databases, Factual ; Wounds and Injuries/etiology*

PURPOSE: The Glasgow Coma Scale (GCS), though it is widely used for triage, has been criticized as being unnecessarily complex. Recently, a 3-point Simplified Motor Score (SMS, defined as obeys commands=2; localizes pain=1; withdrawals to pain or worse=0) was developed from the motor component of the GCS and was found to have a similar test performance for triage after traumatic brain injury when compared with the GCS as the criterion standard. The purpose of this study was to validate the SMS. METHODS: We analyzed the patients who visited Kyungpook National University Hospital emergency center after traumatic brain injury from 2006 January to 2006 June. The test performance of the GCS, its motor component, and SMS relative to three clinically relevant traumatic brain injury outcomes (abnormal brain CT scans, Abbreviated Injury Scale (AIS)> or =4, and mortality) were evaluated with areas under the receiver operating characteristic curves (AUCs). RESULTS: Of 504 patients included in the analysis, 25.6% had an abnormal brain CT scans, 13.1% had AIS> or = 4, and 5.0% died. The AUCs for the GCS, its motor component, and SMS with respect to the abnormal CT scans were 0.776, 0.715, and 0.716, and respectively, those for AIS> or =4 and mortality, were 0.969, 0.973, and 0.968, and 0.931, 0.909, and 0.909, respectively. CONCLUSION: The 3-point SMS demonstrated similar test performance when compared with the 15-point GCS score and its motor component for triage after traumatic brain injury in our populations.
Abbreviated Injury Scale ; Area Under Curve ; Brain ; Brain Injuries ; Emergencies ; Glasgow Coma Scale ; Humans ; ROC Curve ; Triage

PURPOSE: This study was conducted to construct traffic-accident-related injury pyramid based on the New Injury Severity Score (NISS). METHODS: We constructed injury episodes to use the Traffic Accident Insurance database (1997~2001) and calculated the NISS by Abbreviated Injury Scale (AIS). All episodes were classified into three groups by using the NISS: minor group (1~10), moderate group (11~25), and severe group (25~75). Seventy-five points were assigned to all death episodes. We constructed a traffic-accident-related injury pyramid by using an NISS criterion. We compared frequencies and percentiles of episodes in the NISS-based injury pyramid. RESULTS: The number of episodes was 2,012,135. Of these, 1,331,599 episodes involved males, and the other 680,536 episodes involved females. The number of death episodes was 2,091 in 1997, 1,971 in 1998, 2,430 in 1999, 2,546 in 2000 and 141 in 2002. The mean NISS was 6.89+/-6.31, and the percents for the minor group, the moderate group, and the severe group were 85.58%, 13.39%, and 1.03%, respectively. The percent of males in the severe group was higher than that of females by 2.43 times. The percent of older persons (>46 yrs) in the severe and moderate groups was higher than that of young adults (16-45 yrs) The percents of belt-unattached episodes, pedestrian episodes, and separated-car accident episodes in the severe group were higher than those of bet-attached episodes, passenger or driver episodes, and car-to-car accident episodes. The mean out-patient-department follow-up period and the mean loss rate of labor ability increased from the minor group through the moderate group to the severe group. CONCLUSION: We confirmed the characteristics of the traffic-accident-related injury pyramid.
Abbreviated Injury Scale ; Accidents, Traffic* ; Female ; Follow-Up Studies ; Humans ; Injury Severity Score* ; Insurance ; Male ; Young Adult

PURPOSE: This study aimed to determine the mortality rate in patients with severe trauma and the risk factors for trauma mortality based on 3 years' data in a regional trauma center in Korea. METHODS: We reviewed the medical records of severe trauma patients admitted to Ajou University Hospital with an Injury Severity Score (ISS) > 15 between January 2010 and December 2012. Pearson chi-square tests and Student t-tests were conducted to examine the differences between the survived and deceased groups. To identify factors associated with mortality after severe trauma, multivariate logistic regression was performed. RESULTS: There were 915 (743 survived and 172 deceased) enrolled patients with overall mortality of 18.8%. Age, blunt trauma, systolic blood pressure (SBP) at admission, Glasgow Coma Scale (GCS) at admission, head or neck Abbreviated Injury Scale (AIS) score, and ISS were significantly different between the groups. Age by point increase (odds ratio [OR], 1.016; P = 0.001), SBP < or = 90 mmHg (OR, 2.570; P < 0.001), GCS score < or = 8 (OR, 6.229; P < 0.001), head or neck AIS score > or = 4 (OR, 1.912; P = 0.003), and ISS by point increase (OR, 1.042; P < 0.001) were significant risk factors. CONCLUSION: In severe trauma patients, age, initial SBP, GCS score, head or neck AIS score, and ISS were associated with mortality.
Abbreviated Injury Scale ; Blood Pressure ; Glasgow Coma Scale ; Head ; Humans ; Injury Severity Score ; Korea ; Logistic Models ; Medical Records ; Mortality* ; Neck ; Risk Factors* ; Trauma Centers ; Wounds and Injuries

PURPOSE: Few studies have been done for spinal injuries after skiing and snowboarding accidents. Assuming that the riding patterns of skiing and snowboarding were different, we analyzed the differences between the mechanisms, diagnoses and levels of spinal injuries caused by them. The purpose of this study was to gain a better understanding of spinal hazards associated with skiing and snowboarding in order to educate skiers and snowboarders. METHODS: We conducted a prospective study of 96 patients who had sustained spinal injuries as a result of skiing and snowboarding accidents from January 2003 to March 2006. We used a questionnaire, radiological studies, history taking, and physical examinations. We analyzed the mechanism of injury, the level of spinal injury, the severity of spinal injury, and the Abbreviated Injury Scale scores (AIS score). We used the t-test and the chi-square test. RESULTS: The skiing and the snowboarding injury group included in 96 patients. The skiing injury group included 30 patients (31.2%), and the snowboarding injury group included the remaining 66 patients (69.8%). The primary mechanism of injury in skiing was collisions and in snowboarding was slip downs (p=0.508). The primary level of spinal injury in skiing and snowboarding was at the L-spine level (p=0.547). The most common athlete ability of the injured person was at the intermediate level (p=0.954). The injured were most commonly at the beginner or the intermediate level (p=0.302). The primary diagnosis of spinal injury in skiing and snowboarding was back spain (p=0.686). The AIS scores did not differed between the two groups (p=0.986). CONCLUSION: The most common spinal injury after skiing and snowboarding accidents was back sprain. There was no difference in the severity of spinal injury between skiing and snowboarding accidents.
Abbreviated Injury Scale ; Athletes ; Diagnosis ; Humans ; Physical Examination ; Prospective Studies ; Surveys and Questionnaires ; Skiing* ; Spain ; Spinal Injuries* ; Sprains and Strains

PURPOSE: This study aimed to investigate the incidence and risk factors of early postoperative small bowel obstruction (EPSBO) after laparotomy for trauma patients. METHODS: From 2009 to 2016, consecutive patients who had undergone laparotomy for trauma were retrospectively evaluated. EPSBO was defined as the presence of signs and symptoms of obstruction between postoperative days 7 and 30, or obstruction occurring anytime within 30 days and lasting more 7 days. RESULTS: Among 297 patients who met the inclusion criteria, 72 (24.2%) developed EPSBO. The length of hospital stay was significantly longer in patients with EPSBO than in those without EPSBO (median [interquartile range], 34 [21–48] days 24 [14–38] days, P < 0.001). Multivariate logistic analysis identified male sex (adjusted odds ratio [AOR], 3.026; P = 0.008), intraoperative crystalloid (AOR, 1.130; P = 0.031), and Abbreviated Injury Scale (AIS) score for mesenteric injury (AOR, 1.397; P < 0.001) as independent risk factors for EPSBO. The incidence of adhesive small bowel adhesion after 30 days postoperatively did not significantly differ between the 2 groups (with EPSBO, 5.6% without EPSBO, 5.3%; P = 0.571). Most of the patients with EPSBO were recovered by conservative treatment (95.8%). CONCLUSION: After laparotomy for trauma patients, the incidence of EPSBO was 24.2% in our study. EPSBO was associated with a longer hospital stay. Male sex, use of intraoperative crystalloid, and AIS score for mesenteric injury were significant independent risk factors for EPSBO. Patients with these risk factors should be followed-up more carefully.
Abbreviated Injury Scale ; Abdominal Injuries ; Adhesives ; Humans ; Ileus ; Incidence ; Laparotomy ; Length of Stay ; Male ; Odds Ratio ; Retrospective Studies ; Risk Factors

OBJECTIVE: The aims of this study were to refer descriptive statistics of the disability duration in musculoskeletal injured patients in the automobile accidents. METHOD: The authors chose 469,319 injured patients in traffic accidents as subjects that met inclusion criteria with 8 representative Abbreviated Injury Scale (AIS) comparable with 4th edition of Korean standard classification of diseases. Mean, standard deviation, mode, median, maximum and minimum of 8 representative AIS code were calculated. RESULTS: Mean disability duration for minor cervical sprain was 18.8 days, that of moderate cervical disc herniation was 56.2 days, that of serious cervical disc herniation was 141.5 days, that of minor lumbar sprain was 21.2 days, that of moderate lumbar disc herniation was 53.5 days, that of serious lumbar disc herniation was 128.1 days, that of sprain of 3 major joint in lower limb without desmorrhexis was 24.0 days, and that of dislocation or desmorrhexis of 3 major joint in lower limb was 101.2 days. CONCLUSION: Disability duration of the representative musculoskeletal diseases comparable to AIS code in 4th edition of Korean standard classification of diseases was presented and this study can be utilized as a basic recommended disability duration of automobile injured persons.
Abbreviated Injury Scale ; Accidents, Traffic ; Automobiles* ; Classification ; Dislocations ; Humans ; Insurance, Disability ; Joints ; Length of Stay ; Lower Extremity ; Musculoskeletal Diseases ; Sprains and Strains

PURPOSE: As medicine has progressed, the human average lifetime has increased. Thus the number of geriatric patients has increased and, in particular, the number of older drivers has increased. Mortality rates for older trauma patients are higher than those for any other age group, but little research has been done about the severity of injuries to older patients involved in vehicle accidents. This study evaluated a number of factors and correlations involving old driver trauma patients. METHODS: We prospectively analyzed clinical information on 155 trauma patients over 65 years of age who were involved in vehicle accidents and visited the emergency department of Chosun University Hospital between Jan 2007 and Aug 2008. The following variables were examined for their ability to predict severity of injury: age, gender, vital signs, and mechanism of injury along with the Glasgow Coma Scale (GCS), the Abbreviated Injury Scale (AIS), and the Injury Severity Score(ISS). We divided the ISS scores into three groups: mild (1~8), moderate (9~15), and severe(above 16). RESULTS: Most cases involved men (94.2%), and a majority involved agriculture (65.8%). The most common vehicle was the motorcycle (48.4%), and 51 (32.9%) patients were drunk at the time of the accident. Many had acquired their driver's licenses more than 30 years earlier (40.7%), and almost all of the patients (81.9%) never wore any safety devices. The patients who had multiple underlying diseases, coupled living type, low blood pressure at admittance, and more time since they had acquired their licenses scored higher on mean ISS than the other cases. CONCLUSION: Old trauma patients had more longer admission days, had longer recovery times, and received more expensive treatment. For the same level of trauma, they took longer to heal than younger patients and experienced higher rates of mortality. Therefore, when the old driver trauma patients visit the emergency department, doctors need to perform more careful studies and provide a higher level of critical care. To lessen the number of old driver trauma patients, we should educate older drivers about safe driving methods and about the use of safety device, and we should enforce traffic laws and laws about drinking and driving.
Abbreviated Injury Scale ; Agriculture ; Critical Care ; Drinking ; Emergencies ; Glasgow Coma Scale ; Humans ; Hypotension ; Jurisprudence ; Licensure ; Male ; Motorcycles ; Prospective Studies ; Protective Devices ; Vital Signs

PURPOSE: Skiing and snowboarding are becoming increasingly popular. Accordingly, the incidences of injuries among skiers and snowboarders are also increasing. The purpose of this study was to investigate the injury patterns of and the contributing factors to head injuries of skiers and snowboarders and to evaluate the differences in characteristics between skiing and snowboarding head injuries. METHODS: One-hundred patients who visited the emergency department of Wonju Christian Hospital between January 2005 and March 2007 due to head injuries from skiing and snowboarding were enrolled. The mechanisms and the histories of the injuries were investigated by surveying the patients, and the degrees of head injuries were estimated by using brain CT and the Glasgow Coma Scale. The degrees and the characteristics of brain injuries were also analyzed and compared between skiers and snowboarders. RESULTS: Out of 100 patients, 39 were injured by skiing, and 61 were injured by snowboarding. The mean age of the skiers was 26.7+/-10.0, and that of the snowboarders was 26.7+/-6.2. The percentage of male skiers was 43.6%, and that of snowboarders was 63.9%. The most frequent initial chief complaints of head-injured skiers and snowboarders were headache and mental change. The most common mechanism of injuries was a slip down. The mean Abbreviated Injury Scale Score (AIS score) of the skier group was 4.5+/-2.1 and that of the snowboarder group was 5.9+/-5.0 (p=0.222). The percentage of helmet users was 7.1% among skiers and 20.8% among snowboarders (p=0.346). Head injuries were composed of cerebral concussion (92.0%) and intracranial hemorrhage (8.0%). Intracranial hemorrhage was most frequently caused by falling down (62.5%). CONCLUSION: The most common type of head injury to skiers and snowboarders was cerebral concussion, and severe damage was usually caused by jumping and falling down. No differences in the characteristics of the head injuries existed between skiing and snowboarding injuries.
Abbreviated Injury Scale ; Brain ; Brain Concussion ; Brain Injuries ; Craniocerebral Trauma ; Emergencies ; Glasgow Coma Scale ; Head ; Head Protective Devices ; Headache ; Humans ; Incidence ; Intracranial Hemorrhages ; Male ; Skiing