Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Clinical Analysis of Death in Trauma Patients

외상으로 인한 사망 환자의 임상적 분석

  • Kim, Whan Sik (Department of General Surgery, Yonsei University, Wonju College of Medicine) ;
  • Cho, Min Su (Department of General Surgery, Yonsei University, Wonju College of Medicine) ;
  • Bae, Keum Seok (Department of General Surgery, Yonsei University, Wonju College of Medicine) ;
  • Kang, Seong Joon (Department of General Surgery, Yonsei University, Wonju College of Medicine) ;
  • Lee, Kang Hyun (Department of Emergency Medicine, Yonsei University, Wonju College of Medicine) ;
  • Hwang, Keum (Department of Neurosurgery, Yonsei University, Wonju College of Medicine) ;
  • Oh, Jin Rok (Department of Orthopedics, Yonsei University, Wonju College of Medicine) ;
  • Park, Il Hwan (Department of Thoracic Surgery, Yonsei University, Wonju College of Medicine)
  • 김완식 (연세대학교 원주의과대학 외과학교실) ;
  • 조민수 (연세대학교 원주의과대학 외과학교실) ;
  • 배금석 (연세대학교 원주의과대학 외과학교실) ;
  • 강성준 (연세대학교 원주의과대학 외과학교실) ;
  • 이강현 (연세대학교 원주의과대학 응급의학교실) ;
  • 황금 (연세대학교 원주의과대학 신경외과학교실) ;
  • 오진록 (연세대학교 원주의과대학 정형외과학교실) ;
  • 박일환 (연세대학교 원주의과대학 흉부외과학교실)
  • Received : 2007.10.10
  • Accepted : 2007.11.17
  • Published : 2007.12.30
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Abstract

Purpose: Trauma is the 5th most common leading cause of death in Korea, but there has been no appropriate management system for patients until now. We analyzed the main causes of death in trauma patients by comparing the characteristics of those patients with the characteristics of patients who survived. We feel this analysis should have a positive effect on the development of an appropriate trauma management system in Korea. Methods: We retrospectively reviewed trauma patients who had been admitted to the Department of General Surgery from February 2002 to February 2007. We compared several expected risk factors between the mortality and the survival group. Data on the transportation, arrival time at the emergency center, amount of transfusion, initial shock index, cause of death, and initial physical condition according to RTS (Revised trauma score), ISS (Injury severity score) and TRISS (Trauma and Injury Severity Score) were collected. Patients with ISS lower than 12 were excluded. Results: Three hundred sixty-six(366) patients with multiple injuries were included. There were 40 patients in the mortality group and 326 patients in the survival group. The mean arrival time (minutes) to emergency center was longer in the mortality group (137.6 vs 93.6 p 0.04). The total amount of transfusion (ml) was larger in the mortality group (7139 vs 2470 p 0.01). The initial shock index was higher in the mortality group (1.45 vs 1.17 p<0.01). The RTS, ISS, and TRISS were not statistically different between the groups. In the multivariate analysis, mean arrival time and initial shock index were important factors for survival. Conclusion: If the mortality rate of trauma patients is to be reduced, the arrival time at the emergency center should be minimized. Improvement of the emergency medical transfer service system is very important for achieving that.

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