Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States

Jung, Kyoungwon; Matsumoto, Shokei; Smith, Alan; Hwang, Kyungjin; Lee, John Cook-Jong; Coimbra, Raúl

doi:10.1016/j.surg.2018.04.031

Cited by 8 publications

(9 citation statements)

References 23 publications

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“…Finally, another international study compared outcomes of severely injured patients between a South Korean trauma center and the NTDB, and found that the implementation of a trauma system in South Korea improved trauma mortality. 11 The trauma system in South Korea comprises trauma centers and was established nationwide in 2012. Japan does not have a trauma system with nationwide coverage or trauma centers as typically defined; instead, ECCCs play an alternative role.…”

Section: Discussionmentioning

confidence: 99%

Comparison of trauma outcomes between Japan and the USA using national trauma registries

Matsumoto

Jung

Smith

et al. 2018

Trauma Surg Acute Care Open

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BackgroundThe National Trauma Data Bank (NTDB) has served as a global benchmark for trauma care quality and outcomes. Herein, we compared patient characteristics, trauma management, and outcomes between Japanese emergency and critical care centers and US level 1 trauma centers using the Japanese Trauma Data Bank (JTDB) and NTDB.MethodsA retrospective cohort matching (1:1) study was performed. Patients treated in 2013 with an Injury Severity Score ≥9 were included. The primary outcome measure was in-hospital mortality. The secondary outcome measures included the hospital length of stay and the rate of use of radiological diagnostic modalities.ResultsA total of 14 960 pairs with well-balanced characteristics were generated from 22 535 and 112 060 eligible patients in the JTDB and NTDB, respectively. Before matching, the in-hospital mortality was higher in the JTDB than in the NTDB (7.6% vs. 6.1%; OR, 1.28; 95% CI 1.21 to 1.35). However, after matching, the in-hospital mortality was lower in the JTDB cohort (4.2% vs. 5.8%; OR, 0.72; 95% CI 0.65 to 0.80). CT scans were used in >80% of JTDB patients, which was more than 1.5 times as often as the use in the NTDB cohort. In subgroup analyses, only patients who received a blood transfusion had a poorer survival outcome in the JTDB compared with the NTDB (OR, 1.32; 95% CI 1.07 to 1.64).DiscussionWe observed marked differences in trauma care between Japan and the USA. Although the quality of the recent Japanese trauma care appears to be approaching that of the USA, it may be further improved, such as by the establishment of transfusion protocols.Level of evidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Comparison of trauma outcomes between Japan and the USA using national trauma registries

Matsumoto

Jung

Smith

et al. 2018

Trauma Surg Acute Care Open

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“…In this study, traffic accidents (62.3%) were the most common cause of injuries, followed by falls (19.7%) and occupational injuries (10.9%). In contrast, in the study of Jung et al [2], a 2-year analysis (from 2015 to 2016) showed that traffic accidents accounted for 43.3% and falls for 44.5% of patients with an ISS more than 9. In the United States, the corresponding proportions were 39.5% and 51.4%, respectively, during a similar period (from 2013 to 2014).…”

Section: Discussionmentioning

confidence: 82%

“…Furthermore, the number of trauma patients has steadily increased, and the mortality of trauma patients rose from 1.87% in 2007 to 2.71% in 2011 [3]. In 2012, the South Korean government established a master plan for regional trauma centers, which benchmarked the plans of the United States and the United Kingdom [2].…”

Section: Discussionmentioning

confidence: 99%

“…In 2010, when discussions about establishing these centers were in full swing, the proportion of pre-ventable deaths in South Korea was 35%, which was more than twice that of other advanced countries in the field of trauma [1]. Trauma centers were established in each province, so that patients could reach a trauma center anywhere in the country within an hour, and the trauma center models of advanced countries such as the United States and United Kingdom were benchmarked [2].…”

Section: Introductionmentioning

confidence: 99%

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Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

2020

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Background After the laws regulating emergency medicine were amended in 2012, regional trauma centers were established in South Korea. Plastic surgeons specialize in the simultaneous surgical care of patients with facial trauma, burns, and complicated wounds. The objective of this study was to evaluate the role of the plastic surgery department in treating severe trauma patients.Methods From January 2012 to December 2018, we enrolled 366 severe trauma patients with an Injury Severity Score (ISS) over 15 who received treatment by specialists in the plastic surgery department. Of these patients, 298 (81.4%) were male, and their mean age was 51.35 years (range, 6–91 years). The average ISS was 22.01 points (range, 16–75 points).Results The most common diagnosis was facial trauma (95.1%), and facial bone fracture (65.9%) was most common injury within this subgroup. Patients were referred to 1.8 departments on average, with the neurosurgery department accounting for a high proportion of collaborations (37.0%). The most common cause of trauma was traffic accidents (62.3%), and the average length of stay in the general ward and intensive care unit was 36.90 and 8.01 days, respectively. Most patients were discharged home (62.0%) without additional transfer or readmission.Conclusions Through this study, we scoped out the role of the specialty of plastic surgery in the multidisciplinary team at regional trauma centers. These results may have implications for trauma system planning.

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“…In recent study, an improvement in the mortality rate of severely injured patients after the establishment of the trauma center in South Korea was noted, and the mortality rate was found to be similar to that in the United States. [ 8 ] In studies related to the establishment of trauma centers, the improvements in the outcomes of severely injured patients according to the trauma centers or trauma systems have been examined. [ 9 – 12 ]…”

Section: Discussionmentioning

confidence: 99%

Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods

Jang

Park

et al. 2022

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The spleen is a commonly injured intra-abdominal organ from blunt trauma. In cases of traumatic blunt spleen injury, immediate treatment is often required. This study aimed to investigate the prognostic impact of the establishment of a trauma center on the treatment of patients with blunt trauma injury to the spleen. METHODS: We retrospectively reviewed 235 patients who visited our center from 2012 to 2019 for blunt trauma injury to the spleen. The study period was divided into two groups: January 2012 to September 2015 was the pre-center period (PCP), and September 2015 to December 2019 was the trauma center period (TCP). In each period, there were three treatment groups: Surgical group, embolization group, and conservative treatment group. The primary outcome was mortality, and the secondary outcomes were patient characteristics, such as injury severity score and abbreviated injury scale score, time from admission to intervention (both surgery and angiography embolization), and rate of spleen-preserving surgery. RESULTS: In the conservative treatment group, the Hb and hct values were relatively low in the TCP than in the PCP (p=0.007, p=0.008, respectively). The intensive care unit admission rate was relatively high in the TCP (72.9% vs. 90.6%, p=0.031). The ISS was relatively low in the TCP (18 vs. 17, p=0.001). In the surgical group, the time taken to transfer patients to the operating room after admission was greatly reduced in the TCP (151 min vs. 107 min, p=0.028). In the embolization group, the patient’s age and SBP were lower in the PCP than in the TCP (p=0.003, p=0.049, respectively); three patients had undergone embolization with CPR in the PCP, and no patient underwent CPR in the TCP. There were three deaths in PCP and none in the TCP (p=0.05). CONCLUSION: The establishment of a trauma center has led to improvements in the treatment quality and prognosis of patients with blunt trauma injury to the spleen receiving either of the three treatments.

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Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States

Cited by 8 publications

References 23 publications

Comparison of trauma outcomes between Japan and the USA using national trauma registries

Comparison of trauma outcomes between Japan and the USA using national trauma registries

Epidemiology of severe trauma patients treated by plastic surgeons: A 7-year study at a single regional trauma center in South Korea

Impact of the establishment of a trauma center on blunt traumatic spleen injury treatment: Comparison between pre-traumatic center and trauma center periods

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