1.Mortality and Morbidity in Severely Traumatized Elderly Patients.
Byungchul YU ; Min CHUNG ; Giljae LEE ; Jungnam LEE
The Korean Journal of Critical Care Medicine 2014;29(2):88-92
BACKGROUND: As the population ages, the elderly will constitute a prominent proportion of trauma patients. The elderly suffer more severe outcomes from injuries compared with the young. In this study, we examined the relationship between mortality and complications with age. METHODS: This study was a retrospective review of 256 major trauma patients (Injury Severity Score > 15) admitted to an emergency center over a two-year period. Age-dependent mortality and complications were evaluated. RESULTS: Of 256 patients, 209 (81.6%) were male and the mean age was 47.2 years. There was a trend between increasing age and increasing mortality, but this was not statistically significant. Increasing age was correlated with frequency of complications. CONCLUSIONS: Age was confirmed to be an independent predictor of mortality in major trauma. We documented that elderly trauma patients suffer from complications more frequently compared with their younger counterparts. Appropriate and specific triage and management guidelines for elderly trauma patients are needed.
Aged*
;
Emergencies
;
Humans
;
Male
;
Mortality*
;
Retrospective Studies
;
Triage
2.Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease.
Sungwook CHA ; Kyung Jin KIM ; Seongmin KWEON ; Sinae LEE ; Byungchul MIN ; Eunsung KIM ; Jungwook LEE
Yeungnam University Journal of Medicine 2017;34(1):111-114
Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.
Angiography
;
Behcet Syndrome
;
Capsule Opacification
;
Central Serous Chorioretinopathy*
;
Glaucoma
;
Humans
;
Indocyanine Green
;
Male
;
Optic Neuritis
;
Retinal Detachment
;
Retinal Vasculitis
;
Tomography, Optical Coherence
;
Uveitis
3.Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit.
Min A LEE ; Kang Kook CHOI ; Byungchul YU ; Jae Jeong PARK ; Youngeun PARK ; Jihun GWAK ; Jungnam LEE ; Yang Bin JEON ; Dae Sung MA ; Gil Jae LEE
Korean Journal of Critical Care Medicine 2017;32(4):340-346
BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE*
;
Cardiovascular System
;
Complement System Proteins
;
Critical Care*
;
Critical Illness
;
Humans
;
Injury Severity Score
;
Intensive Care Units*
;
Mortality
;
Multiple Trauma
;
Retrospective Studies
;
Survival Rate
;
Trauma Centers
4.Central serous chorioretinopathy associated with low dose systemic corticosteroid treatment of Behcet's disease
Sungwook CHA ; Kyung Jin KIM ; Seongmin KWEON ; Sinae LEE ; Byungchul MIN ; Eunsung KIM ; Jungwook LEE
Yeungnam University Journal of Medicine 2017;34(1):111-114
Central serous chorioretinopathy may induce poor eyesight and serous retinal detachment. However, its exact cause has not been well established thus far. It can be associated with systemic high-dose corticosteroid treatment mainly for young and middle-aged men and may spontaneously regress or recur after withdrawal from corticosteroid. After corticosteroid administration for Behcet's disease, it is necessary to identify any ocular symptoms. Behcet's disease can lead to the development of ocular complications, such as uveitis, hypopyon, retinal vasculitis, optic neuritis, angiogenesis, secondary cataract, and glaucoma. It is possible to diagnose any of these complications via optical coherence tomography and digital indocyanine green angiography. It is easy to neglect an ocular symptom that may appear after a low-dose corticosteroid treatment as an ocular complication in patients with Behcet's disease. Thus, we report on a case concerning high-dose corticosteroid treatment with a literature review.
Angiography
;
Behcet Syndrome
;
Capsule Opacification
;
Central Serous Chorioretinopathy
;
Glaucoma
;
Humans
;
Indocyanine Green
;
Male
;
Optic Neuritis
;
Retinal Detachment
;
Retinal Vasculitis
;
Tomography, Optical Coherence
;
Uveitis
5.Development of Korean Teaching Model for Surgical Procedures in Trauma -Essential Surgical Procedures in Trauma Course-
Hohyun KIM ; Chan Yong PARK ; Hyun Min CHO ; Kwang Hee YEO ; Jae Hun KIM ; Byungchul YU ; Seung Je GO ; Oh Sang KWON
Journal of the Korean Society of Traumatology 2019;32(1):8-16
PURPOSE:
The Essential Surgical Procedures in Trauma (ESPIT) course was developed as a model to teach necessary surgical procedures to trauma physicians. Its goals are to improve knowledge, self-confidence, and technical competence.
METHODS:
The ESPIT course consisted of five lectures and a porcine lab operative experience. The ESPIT course has been run seven times between February 2014 and April 2016. ESPIT participants completed a questionnaire to assess self-efficacy regarding essential surgical procedures in trauma before and immediately after taking the ESPIT course. Sixty-three participants who completed both pre- and post-course questionnaires on self-efficacy were enrolled in this study.
RESULTS:
The overall post-ESPIT mean self-efficacy score was higher than the pre-ESPIT mean self-efficacy score (8.3±1.30 and 4.5±2.13, respectively) (p<0.001). Self-efficacy was significantly improved after the ESPIT course in general surgeons (p<0.001), thoracic and cardiovascular surgeons (p<0.001), emergency medicine doctors, and others (neurosurgeons, orthopedic surgeons) (p<0.001). The differences in self-efficacy score according to career stage (<1 year, 1–3 years, 3–5 years, and >5 years) were also statistically significant (p<0.001).
CONCLUSIONS
The data of the ESPIT participants indicated that they felt that the ESPIT course improved their self-efficacy with regard to essential surgical procedures in trauma. The ESPIT course may be an effective strategy for teaching surgical procedures, thus promoting better management of traumatic injuries.
6.Acute Physiology and Chronic Health Evaluation II Score and Sequential Organ Failure Assessment Score as Predictors for Severe Trauma Patients in the Intensive Care Unit
Min A LEE ; Kang Kook CHOI ; Byungchul YU ; Jae Jeong PARK ; Youngeun PARK ; Jihun GWAK ; Jungnam LEE ; Yang Bin JEON ; Dae Sung MA ; Gil Jae LEE
The Korean Journal of Critical Care Medicine 2017;32(4):340-346
BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) II scoring system and the Sequential Organ Failure Assessment (SOFA) scoring system are widely used for critically ill patients. We evaluated whether APACHE II score and SOFA score predict the outcome for trauma patients in the intensive care unit (ICU). METHODS: We retrospectively analyzed trauma patients admitted to the ICU in a single trauma center between January 2014 and December 2015. The APACHE II score was figured out based on the data acquired from the first 24 hours of admission; the SOFA score was evaluated based on the first 3 days in the ICU. A total of 241 patients were available for analysis. Injury Severity score, APACHE II score, and SOFA score were evaluated. RESULTS: The overall survival rate was 83.4%. The non-survival group had a significantly high APACHE II score (24.1 ± 8.1 vs. 12.3 ± 7.2, P < 0.001) and SOFA score (7.7 ± 1.7 vs. 4.3 ± 1.9, P < 0.001) at admission. SOFA score had the highest areas under the curve (0.904). During the first 3 days, SOFA score remained high in the non-survival group. In the non-survival group, cardiovascular system, neurological system, renal system, and coagulation system scores were significantly higher. CONCLUSIONS: In ICU trauma patients, both SOFA and APACHE II scores were good predictors of outcome, with the SOFA score being the most effective. In trauma ICU patients, the trauma scoring system should be complemented, recognizing that multi-organ failure is an important factor for mortality.
APACHE
;
Cardiovascular System
;
Complement System Proteins
;
Critical Care
;
Critical Illness
;
Humans
;
Injury Severity Score
;
Intensive Care Units
;
Mortality
;
Multiple Trauma
;
Retrospective Studies
;
Survival Rate
;
Trauma Centers