Wounds and Injuries/*mortality

No abstract available.
*Hospital Mortality ; Humans ; Wounds and Injuries/*mortality

A series of 70 lumboperitoneal shunt performed at Yonsei university Severance hospital was reviewed. The clinical indications for this procdures were communicating hydrocephalus, CSF fistulas, benign intracranial hypertension and bulging craniectomy site. There were several complications such as shunt migration, obstruction, infection and nonfunctioning. Wound dehiscence, epidural hematoma and ingumal hernia were also observed after shunting. This procedure is completely extracranial and diminished intracranial complications, thereby significantly reducing morbidity and mortality. Good results were reported due to easy insertion, short operation time and reduced complications. This report documented the efficacy of lumbopertoneal shunt and literatures were reviewed.
Fistula ; Hematoma ; Hernia ; Hydrocephalus ; Mortality ; Pseudotumor Cerebri ; Wounds and Injuries

The management of malignant left colon obstruction remains a difficult problem. Conventional surgical treatment is muti-staged and each stage carries its own morbidity and mortality. The purpose of this study is to identify the feasibility and safety of one stage operation in patients presenting with acute obstruction of the left colon. From January 1991 to June 1996, 29 patients received one stage resection for acutely obstructed carcinoma of the left colon at Soonchunhyang University Chunan Hospital. Subtotal colectomies were performed in 9 patients(31.0%), left hemicolectomies in 6(20.7%), low anterior resection in 6(20.7%), sigmoid colectomy in 4(13.8%), anterior resection in 4 patients(13.8%). Subtotal colectomy was performed in patients with massively distended colon of dubious viability and to contain ischemic lesions at proximal colon. Total operative mortality was 6.9%: 5% in the immediate resection with anastomosis group, 11.1% in subtotal colectomy group. Complications included wound infection(4), fecal incontinence(2), intestinal obstruction(2), anastomotic leakage(1), upper G-I bleeding(1), postoperative bleeding(1), pulmonary complication(1). Our results suggest that resection and primary anastomosis can be performed with acceptable morbidity and mortality in patients with acute malignant obstruction of the left colon.
Chungcheongnam-do ; Colectomy ; Colon* ; Colon, Sigmoid ; Humans ; Mortality ; Wounds and Injuries

PURPOSE: Though the nonoperative management of liver injury (NOMLI) has frequently been employed for traumatic liver injuries, the indications for NOMLI for grade IV liver injuries are still controversial. To determine the usefulness of the NOMLI in grade IV liver injuries, the clinical features of an operative management (n=26) and a NOMLI group (n=20) were compared. METHODS: For the 10 years up until Feb. 2004, 46 grade IV liver injury cases, according to the AAST liver injury scale, at the Kyung Pook National University Hospital, were selected for this study. The clinical features, grade of liver injury and outcomes of treatments were reviewed retrospectively. RESULTS: Of the 46 cases 40 (87%) and 6 (13%) were male and female, respectively. The mean ages of the male and female cases were 37.6 (15.2 and 34.5 (16.7 years, respectively. The causes of liver trauma were vehicle accident (71.7%, 33/46), industry accident (26.1%, 12/46) and violence (2.2%, 1/46). The accompanying abdominal injury was not present in the NOMLI group compared to 30.8% (8/26) in the operative management group. NOMLI was more than 2 times more frequently indicated after Feb. 1999. The mortality in operative management group was 11.5% (3/26) compared with none in the NOMLI group. 20% (4/20) of NOMLI group failed due to delayed bleeding and eventually had to undergo operations and the 80% (16/20) of NOMLI group was successful. The morbidity in successful NOMLI group was bile collection (6.25%, 1/16) and empyema (6.25%, 1/16). CONCLUSION: Nonoperative management for grade IV liver injury in hemodynamically stable patients without accompanying abdominal injury was successful. However, continuous monitoring and immediate operative management should be prepared for the delayed bleeding.
Abdominal Injuries ; Bile ; Empyema ; Female ; Hemorrhage ; Humans ; Liver* ; Male ; Mortality ; Retrospective Studies ; Violence ; Wounds and Injuries

OBJECTIVETo analyze and summarize the secular trend and influencing factors of road traffic injuries(RTI) in China, so as to provide evidence for the management of traffic safety.

METHODSIndexes as fatalities per 10,000 vehicles, fatalities per 100,000 population, fatalities per 10,000 kilometers, motorization(number of vehicles per 1000 population) and mortal coefficient were used. Clustering analysis and ranking correlation were used to analyze the relative factors.

RESULTSThe number of casualties of RTI had doubled every decade before the year of 2000. One hundred thousand people were killed in RTI every year since 2000. Facts as: Gross National Product(GNP) of China exceeded 1000 USD in 2002, number of motor vehicles reached 1.3 million in 2005, had both influenced the rates of road traffic fatality, mileage fatality and mortal coefficient which causing them to drop since 2002. In China, RTI happened in the underdeveloped districts in the western part of the country including Tibet, Ningxia, Xinjiang, Qinghai, and in some coastal areas as Zhejiang and Guangdong provinces. Men seemed to be more at risk than women in RTI, and accounted for three-quarters of the victims. Majority of fatalities happened in 21-50 year olds and the fatalities among those over 65 year olds had risen every year. The vulnerable populations in road-user category were pedestrians, passengers, motorcyclists and bicyclists. Under most situations, drivers were responsible for RTI and over half of them were professionals. Bad behaviors were the major causes of RTI, including exceeding the speed limit, handle misfeasance, breaking traffic rules and regulation, having taken alcohol or driving with fatigue etc. Exceeding the speed limit was the most risky factor which causing 75% of the RTI and the traffic deaths increased between 2002 to 2004. A positive correlation was discovered between population fatality rate and the factors as the number of vehicles, volume of road haulage, volume of passengers and the degree of highway etc. with correlation coefficients as r1 = 0.986, r2 = 0.986, r3 = 0.987, r4 = 0.985, P = 0.001, respectively.

CONCLUSIONSince 1951, the population fatality rate of RTI had been going up continuously until it began to fall in 2003.

Accidents, Traffic ; mortality ; statistics & numerical data ; China ; epidemiology ; Female ; Humans ; Male ; Wounds and Injuries ; mortality

In Korea, injury is the third most common cause of death after cancer and cerebrovascular disease, but it is the major cause of death for the working age population under 40 years old. Also, the preventable trauma death rate in Korea is still higher than in developed countries. This fact has raised awareness of the need to establish a trauma system. For this reason, support services for the establishment of regional level 1 trauma centers was launched in 2012 by the Ministry of Health and Welfare. The purpose of this service is to designate 17 regional level 1 trauma centers distributed evenly across the country and to provide adequate care for seriously injured patients 24 hours a day, 7 days a week. As a result, the preventable trauma death rate is expected to fall to the level of the developed countries by 2020. As of November 2016, 16 regional level 1 trauma centers have been selected and 9 of them have officially opened. If the project is completed as planned, the quality of all phases of trauma care (prehospital, transport, and hospital) will be high, and the lives of seriously injured patients can more often be saved and their disabilities minimized.
Cause of Death ; Cerebrovascular Disorders ; Developed Countries ; Humans ; Korea ; Mortality ; Transportation ; Trauma Centers* ; Wounds and Injuries

Intraoperative aneurysmal rupture can be defined as aneurysmal rupture that takes place during any procedure from the induction of anesthesia to the closing of the wound and may result in a disastrous surgical outcome if not managed properly. The author experienced 11 cases of intraoperative aneurysmal rupture among 134 cases of aneurysm surgeries over the past 7 years at Yong-San hospital. The intraoperative rupture rate was 8% and there was statistically significant higher incidence of rupture in the early operated group. Rupture occurred during dissection in 5 cases and during the clipping procedure in 6. The early and late mortality was 27%, which included one case that could also be attributed to the direct effect of subarachnoid hemorrhage.
Anesthesia ; Aneurysm* ; Incidence ; Intracranial Aneurysm ; Mortality ; Rupture* ; Subarachnoid Hemorrhage ; Wounds and Injuries

BACKGROUND: Stainless steel wiring remains the most popular technique for primary sternal closure. Recently, a multifilament cable wiring system (Pioneer Surgical Technology Inc., Marquette, MI, USA) was introduced for sternal closure and has gained wide acceptance due to its superior resistance to tension. We aimed to compare conventional steel wiring to multifilament cable fixation for sternal closure in patients undergoing major cardiac surgery. METHODS: Data were collected retrospectively on 1,354 patients who underwent sternal closure after major cardiac surgery, using either the multifilament cable wiring system or conventional steel wires between January 2009 and October 2010. The surgical outcomes of these two groups of patients were compared using propensity score matching based on 18 baseline patient characteristics. RESULTS: Propensity score matching yielded 392 pairs of patients in the two groups whose baseline profiles showed no significant differences. No significant differences between the two groups were observed in the rates of early mortality (2.0% vs. 1.3%, p=0.578), major wound complications requiring reconstruction (1.3% vs. 1.3%, p>0.99), minor wound complications (3.6% vs. 2.0%, p=0.279), or mediastinitis (0.8% vs. 1.0%, p=1.00). Patients in the multifilament cable group had fewer sternal bleeding events than those in the conventional wire group, but this tendency was not statistically significant (4.3% vs. 7.4%, p=0.068). CONCLUSION: The surgical outcomes of sternal closure using multifilament cable wires were comparable to those observed when conventional steel wires were used. Therefore, the multifilament cable wiring system may be considered a viable option for sternal closure in patients undergoing major cardiac surgery.
Hemorrhage ; Humans ; Mediastinitis ; Mortality ; Propensity Score ; Retrospective Studies ; Stainless Steel ; Steel ; Thoracic Surgery* ; Wounds and Injuries

In recent years, improved antibiotic care and physiologic fluid replacement in cases involving burn wounds have led to a decrease in the rate of fatalaties caused by wound sepsis and shock. There has, however, been an upsurge and relative increase in the frequency (15 -25%) and mortality rate (50 -89 %) of pulmonary complications. Since pulmonary lesions may result from direct injury to the respiratory tract caused by smoke inhalation, from circulatory, metabolic or infectious complications in cases involving cutaneous burns, or may develop during the therapeutic management of these lesions, a wide spectrum of pulmonary abnormalities can occur during the post-burn period. There is considerable overlap between their radiographic appearances, which are often nonspecific. Since the successful management of these patients is based on the early recognition and vig-orous treatment of lesions, familiarity with all facets of these complications, based on a pathophysiology of the injury and on the knowledge of the clinical setting, enables radiologists to make more specific diagnoses.
Burns* ; Diagnosis ; Humans ; Inhalation ; Mortality ; Recognition (Psychology) ; Respiratory System ; Sepsis ; Shock ; Smoke ; Wounds and Injuries