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

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

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

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

BACKGROUND: The triage-revised trauma score(t-RTS) is used for triage in trauma patients in many countries. Recently, the triage score was developed as a new triage method for trauma patients in Korea. The objective of this study was to assess the accuracy of triage for the t-RTS and the triage score. METHODS: The medical records of 1575 consecutive trauma patients visiting the Emergency Center, Masan Samsung Hospital, from March to August 1999 were retrospectively analyzed. The triage score and the t-RTS were taken from the charts completed by the emrgency room doctors and nurses. The accuracies of the two triage methods were compared by using the undertriage and the overtriage rates, receiver operating characteristic(ROC) curve analysis, and a correlation analysis with many physiologic, anatomical, biochemical, and mixed scores(Glasgow coma scale, injury severity score, TRISS, APACHE II and III scores, operation, survival, etc.). RESULTS: The undertriage rates for the triage score and the t-RTS were 22.8% and 38.2%, r e s p e c t i v e l y ( pscore and the t-RTS were 0.871+/-0.033 and 0.800+/-0.039, respectively(95% confidence interval, p<0.001). In general, the correlations of the two triage methods with many physiologic, anatomical, biochemical, and mixed scores were moderately high, but there were no statistical differences between the correlation coefficients of the two triage methods for those scores. CONCLUSION: The triage score was equal or superior to the t-RTS for triage in trauma patients. The former was simpler and could be used easily by emergency medical personnel. Therefore, the authors conclude that the triage score can be used instead of the t-RTS for triage in trauma patients.
APACHE ; Coma ; Emergencies ; Humans ; Injury Severity Score ; Korea ; Medical Records ; Retrospective Studies ; ROC Curve ; Triage*

PURPOSE: This study was conducted in order to evaluate the epidemiological characteristics of children with fall-down injuries according to age groups and to analyze the major trauma groups that were treated at the emergency room (ER). METHODS: Among 1,222 children under age 6 who were treated at the ER from January 2008 to December 2009, a retrospective study was conducted through examination of medical records. The children were classified by age into 3 groups: infant, toddler, and pre-schooler. In each group, the differences between the causative factors that led to the fall-down injuries were analyzed. Also, ISS (Injury Severity Score) score above 4 was classified as major trauma, and an ISS score 0-1 was classified as a minor trauma. The relationship between major trauma and age group was also analyzed. RESULTS: Through an analysis of child fall-down injuries, men (56.6%), toddler (47.3%), head-related symptoms (72.9%), furniture-related traumas (80.2%), and falls from less than a 1-m height (69.9%) were found to be common factors. Furthermore, in radiological studies, fractures and brain hemorrhages accounted for 16.9% of major traumas, and simple skull fractures were the most common (21.4%). Distributed according to age group, the factors relevant to fall injuries were fall height and head-related symptoms for infants, accident site, fall height and head-related symptoms for toddlers, and accident site for pre-schoolers (p<0.05). Also, head-related symptoms and fall height were independent factors of major trauma in all age groups. However, major traumas (17.3%) were related to dumped trauma, fall height and accident site (p<0.05). CONCLUSION: This study was mainly about head-related injuries, and toddler were most common victims. The relevant factors for the major trauma were falling height for infants, accident site and falling height for toddlers, and accident site, falling height for pre-schoolers.
Child ; Emergencies ; Humans ; Infant ; Injury Severity Score ; Intracranial Hemorrhages ; Male ; Medical Records ; Retrospective Studies ; Skull Fractures

PURPOSE: This study examined the factors affecting the precaution and request of medical direction for prehospital emergency treatment of major trauma patients by 119 rescue services. METHODS: Medical records and prehospital run reports of major trauma patients with an Injury Severity Score (ISS) above 15 were reviewed. In total, 123 patients who were transferred by 119 rescue services to the Emergency Department of one hospital from December 1, 2010 to February 28, 2013 were enrolled. A total of 123 patients with major trauma satisfied the ISS criterion. Excluding 26 patients with missing data, 97 patients were included in this study. Out of these 97 patients, 72 patients were male and the mean age was 46+/-16.1 years. The statistical methods used in the analysis were the Receiver-Operating Characteristic curve and Fisher's exact test. RESULTS: Between the hospital precaution group and non-precaution group, the only significant difference was in the RTS score (p=0.007). In total, 52 patients (39 male patients; mean age 49.52+/-16.14 years) with major trauma were transferred during the medical direction period. Between groups that requested medical direction and groups that did not, the only significant difference was the time interval from the call to hospital arrival (p=0.032). CONCLUSION: Within the variables we examined, transport of major trauma patients, in addition to low incidence of precaution and request for medical direction by 119 rescue services, only a few were considered.
Emergencies* ; Emergency Medical Services ; Emergency Treatment* ; Humans ; Incidence ; Injury Severity Score ; Male ; Medical Records ; Methods