Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

Chest draining is a common procedure for treating pleural effusion. Perforation of the heart is a rare often fatal complication of chest drain insertion. We report a case of a 76-year-old female patient suffering from congestive heart failure. At presentation, unilateral opacity of the left chest observed on a chest X-ray was interpreted as massive pleural effusion, so an attempt was made to drain the left pleural space. Malposition of the chest drain was suspected because blood was draining in a pulsatile way from the catheter. Computed tomography revealed perforation of the left ventricle. Mini-thoracotomy was performed and the drain extracted successfully.
Catheters ; Chest Tubes ; Female ; Heart ; Heart Failure ; Heart Ventricles ; Humans ; Pleural Effusion ; Stress, Psychological ; Thorax

Background: By applying the suggested criteria for needs-based chronic medical care and long-term care delivery system for the elderly, the current status of delivery system was identified and regional delivery systems were categorized according to quantity and quality of delivery system. Methods: National claims data were used for this study. All claims data of medical and long-term care uses by the elderly and all claims data from long-term care hospitals and nursing homes in 2016 were analyzed to categorize the regional medical and long-term care delivery system. The current status of the delivery system with a high possibility of transition to a needs-based appropriate delivery system was identified. The necessary and actual amount of regional supply was calculated based on their needs, and the structure of delivery systems was evaluated in terms of the needs-based quality of the system. Finally, all regions were categorized into 15 types of medical and care delivery systems for the elderly. Results: Of the total 55 regions, 89.1% of regions had an oversupply of elderly medical and care services compared to the necessary supply based on their needs. However, 69.1% of regions met the criteria for less than two types of needs groups, and 21.8% of regions were identified as regions where the numbers of institutions or regions with a high possibility of transition to an appropriate delivery system were below the average levels for all four needs groups. Conclusion In order to establish an appropriate community-based integrated elderly care system, it is necessary to analyze the characteristics of the regional delivery system categories and to plan a needs-based delivery system regionally.

Purpose: Treatment at a dedicated trauma center significantly reduces the mortality rate after trauma. High-quality trauma care requires well-established systems. Moreover, the presence of an on-site trauma surgeon during resuscitation improves outcomes. Although the trauma system history, including trauma centers in South Korea, is relatively short, it has developed rapidly, and trauma surgeons’ roles have also been established. This study aimed to show clinical performance, particularly in trauma surgery, and the outcomes of a regional trauma center serving as a Level 1 trauma center in South Korea. Methods: Using the Korean Trauma Data Bank, data collected at Ajou University Hospital Trauma Center between January 2020 and December 2022 was retrospectively analyzed. Patients’ demographic characteristics, mechanisms of injuries, trauma surgery types, and outcomes were evaluated. Results: There were 9,205 patients admitted with trauma, of whom 1,149 underwent trauma surgery (including laparotomy, thoracotomy, pelvic packing, neck surgery, and peripheral vascular surgery). A total of 1,787 trauma surgeries were performed, and the mean time to surgery for hypotensive patients with hemorrhagic shock from arrival was approximately 50 minutes. Damage control surgery including laparotomy, thoracotomy, and pelvic packing accounted for 12% of cases. It was determined that the mortality rate (excluding death on arrival) was less than 5%, and the length of hospital stay decreased over the study period. Conclusion Clinical performance, particularly in trauma surgery, conducted by dedicated trauma surgeons, has led to favorable clinical outcomes at a regional trauma center in South Korea.

Purpose: Treatment at a dedicated trauma center significantly reduces the mortality rate after trauma. High-quality trauma care requires well-established systems. Moreover, the presence of an on-site trauma surgeon during resuscitation improves outcomes. Although the trauma system history, including trauma centers in South Korea, is relatively short, it has developed rapidly, and trauma surgeons’ roles have also been established. This study aimed to show clinical performance, particularly in trauma surgery, and the outcomes of a regional trauma center serving as a Level 1 trauma center in South Korea. Methods: Using the Korean Trauma Data Bank, data collected at Ajou University Hospital Trauma Center between January 2020 and December 2022 was retrospectively analyzed. Patients’ demographic characteristics, mechanisms of injuries, trauma surgery types, and outcomes were evaluated. Results: There were 9,205 patients admitted with trauma, of whom 1,149 underwent trauma surgery (including laparotomy, thoracotomy, pelvic packing, neck surgery, and peripheral vascular surgery). A total of 1,787 trauma surgeries were performed, and the mean time to surgery for hypotensive patients with hemorrhagic shock from arrival was approximately 50 minutes. Damage control surgery including laparotomy, thoracotomy, and pelvic packing accounted for 12% of cases. It was determined that the mortality rate (excluding death on arrival) was less than 5%, and the length of hospital stay decreased over the study period. Conclusion Clinical performance, particularly in trauma surgery, conducted by dedicated trauma surgeons, has led to favorable clinical outcomes at a regional trauma center in South Korea.

Purpose: Treatment at a dedicated trauma center significantly reduces the mortality rate after trauma. High-quality trauma care requires well-established systems. Moreover, the presence of an on-site trauma surgeon during resuscitation improves outcomes. Although the trauma system history, including trauma centers in South Korea, is relatively short, it has developed rapidly, and trauma surgeons’ roles have also been established. This study aimed to show clinical performance, particularly in trauma surgery, and the outcomes of a regional trauma center serving as a Level 1 trauma center in South Korea. Methods: Using the Korean Trauma Data Bank, data collected at Ajou University Hospital Trauma Center between January 2020 and December 2022 was retrospectively analyzed. Patients’ demographic characteristics, mechanisms of injuries, trauma surgery types, and outcomes were evaluated. Results: There were 9,205 patients admitted with trauma, of whom 1,149 underwent trauma surgery (including laparotomy, thoracotomy, pelvic packing, neck surgery, and peripheral vascular surgery). A total of 1,787 trauma surgeries were performed, and the mean time to surgery for hypotensive patients with hemorrhagic shock from arrival was approximately 50 minutes. Damage control surgery including laparotomy, thoracotomy, and pelvic packing accounted for 12% of cases. It was determined that the mortality rate (excluding death on arrival) was less than 5%, and the length of hospital stay decreased over the study period. Conclusion Clinical performance, particularly in trauma surgery, conducted by dedicated trauma surgeons, has led to favorable clinical outcomes at a regional trauma center in South Korea.