가천대학교 길병원 권역외상센터 3개년 내원 환자 및 치료 경험 분석(2011~2013) Three-year Analysis of Patients and Treatment Experiences in the Regional Trauma Center of Gachon University Gil Hospital between 2011 and 2013원문보기
Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiti...
Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.
Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.
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제안 방법
The ISS used in this study was calculated by summing the squares of the Abbreviated Injury Scale (AIS) score, with a range between 1 and 6, that was obtained from 3 regions with the most severe injuries among 6 anatomical regions including the head and neck, facial, thoracic, abdominal, limbs and pelvic, and external regions according to the patients’final diagnosis.
대상 데이터
A total of 138 patients were directly admitted to the trauma ICU (TICU) and 137 patients were admitted to the TICU after undergoing emergency surgeries. The patients stayed in the TICU for a total of 3981 days, the number of per-patient days in the TICU was 14.
Visiting route, mode of transportation, mechanism of injury, ISS, mortality rate in hospital, the ratio of ICU admission, number of surgeries performed, departments who collaborated, and treatment outcome were investigated for those 367 patients. Severe trauma was defined as an ISS >15.
참고문헌 (14)
Sturm JA, Pape HC, Dienstknecht T. Trauma care in Germany: an inclusive system. Clin orthop Res 2013; 471: 2912-23.
Cales RH, Ehrlich F, Sacra J, Cross R, Jr., Ervin ME. Trauma care system guidelines: improving quality through the systems approach. Annals of emergency medicine 1987; 16: 464.
Murray CJ, Lopez AD, Jamison DT. The global burden of disease in 1990: summary results, sensitivity analysis and future directions. Bulletin of the World Health Organization 1994; 72: 495-509.
Kim T, Jung K, Kwon J, Kim J, Baek Sj, Song Sy, et al. Experience with the Treatment of Patients with Major Trauma at the Department of Trauma Surgery in One Regional Emergency Medical Center for One Year. J Korean Soc Traumatol 2011; 24: 37-44.
Lee WC, Jo CH, Jung KW, Min YG, Choi SC, Kim GW, et al. Current State and Problem of the Transfer of Severely Injured Patients in One Regional Emergency Medical Center. J Korean Soc Traumatol 2010; 23: 6-15.
Frink M, Zeckey C, Mommsen P, Haasper C, Krettek C, Hildebrand F. Polytrauma management - a single centre experience. Injury 2009; 40 Suppl 4: S5-11.
Kam C, Lai C, Lam S, So F, Lau C, Cheung K. What are the ten new commandments in severe polytrauma management? World J Emerg Med 2010; 1: 85-92.
Sampalis JS, Denis R, Frechette P, Brown R, Fleiszer D, Mulder D. Direct transport to tertiary trauma centers versus transfer from lower level facilities: impact on mortality and morbidity among patients with major trauma. J Trauma 1997; 43: 288-95; discussion 95-6.
Han SS, Jung K, Kwon J, Kim J, Choi SC, Lee KJ. Problems with Transferring Major Trauma Patients to Emergency Medical Center of a University Hospital from Another Medical Center. J Korean Soc Traumatol 2011; 24: 118-24.
Merli GJ. Medical consultation in the patient with multiple trauma. The Medical clinics of North America 1993; 77: 493-507.
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