Correlation between the Injury Site and Trauma Mechanism in Severely Injured Patients with Blunt Trauma

Abstract

Background. In patients with severe injury, predicting the injury site without using advanced diagnostic modalities can help formulate a diagnosis and treatment plan based on the suspected injury site. Objectives. This study aimed to determine the correlation between the injury site and trauma mechanism in severely injured patients with blunt trauma. Methods. We retrospectively analyzed the clinical characteristics—including age, sex, date of emergency room (ER) visit, time of injury, trauma mechanism (car accident, motorcycle accident, bicycle accident, pedestrian accident, fall, slipping and rolling down, crush injury, assault, and others), final diagnosis, injury severity score, abbreviated injury scale (AIS) score, and injury site—of 1,245 patients in a tertiary trauma center. Results. There was a strong correlation between certain injury sites and specific trauma mechanisms. In particular, most trauma mechanisms were associated with injury to the head and neck, as well as the chest, with a combined frequency of >40.0%. Moreover, when using one-way analysis of variance and Bonferroni’s post hoc tests, there were significant differences in AIS scores 1, 3, 4, and 5 for each trauma mechanism. Conclusion. Generally, when patients with severe injury present to the ER, the injury site can be predicted upon initial assessment based on the trauma mechanism. Based on our study, the injury site predicted by a specific mechanism should be checked repeatedly and additionally through physical examination and imaging tools. This can reduce misdiagnosis and help with accurate diagnosis and treatment.

Characteristics of trauma in patients with general accidents and patients who attempted suicide - trauma mechanism, injury site, and severity: A single-center study

“…The frequency of injury mechanisms in the entire trauma group showed a similar pattern to the statistics of patients with general injury in Korea [6] and were similar to results from previous studies conducted at our hospital [5].…”

“…4 Signifcant difference was observed between AIS4 and AIS1 or AIS2 or AIS3 or AIS5 or AIS6 as a result of post hoc analysis. 5 Signifcant difference was observed between AIS5 and AIS1 or AIS2 or AIS3 or AIS4 or AIS6 as a result of post hoc analysis. 6 Signifcant difference was observed between AIS6 and AIS1 or AIS2 or AIS3 or AIS4 or AIS5 as a result of post hoc analysis.…”

“…Such missed injuries occur in approximately 38% of secondary surveys [3] and can be avoided by repeatedly evaluating the suspected damaged areas [1,4]. A previous study con rmed the correlation between injury mechanism and damaged area in patients with trauma [5]; in our hospital, we considered using this correlation for initial treatment in cases when an adjunctive secondary survey was not possible. However, because people who attempt suicide do not intentionally wear safety equipment or make gestures to protect themselves, it is presumed that the pattern of damaged areas, according to the mechanism of injury, will differ from that of patients with general injuries.…”