Preventable Trauma Death Rate after Establishing a National Trauma System in Korea

Abstract

Background This study aimed to evaluate the current overall preventable trauma death rate (PTDR) in Korea and identify factors associated with preventable trauma death (PTD). Methods The target sample size for review was designed to be 1,131 deaths in 60 emergency medical institutions nationwide. The panels for the review comprised trauma specialists working at the regional trauma centers (RTCs); a total of 10 teams were formed. The PTDR and factors associated with PTD were analyzed statistically. Results Of the target cases, 943 were able to undergo panel review and be analyzed statistically. The PTDR was 30.5% (6.1% preventable and 24.4% possibly preventable). Those treated at a RTC showed a significantly lower PTDR than did those who were not (21.9% vs. 33.9%; P = 0.002). The PTDR was higher when patients were transferred from other hospitals than when they directly visited the last hospital (58.9% vs. 28.4%; P = 0.058; borderline significant). The PTDR increased gradually as the time from accident to death increased; a time of more than one day had a PTDR 14.99 times higher than when transferred within one hour (95% confidence interval, 4.68 to 47.98). Conclusion Although the PTDR in Korea is still high compared to that in developed countries, it was lower when the time spent from the accident to the death was shorter and the final destined institution was the RTC. To reduce PTDR, it is necessary to make an effort to transfer trauma patients to RTCs directly within an appropriate time.

Distribution of Trauma Deaths in a Province of Korea: Is “Trimodal” Distribution Relevant Today?

“…[1][2][3][4][5] Although several investigations on preventable trauma deaths have been conducted since the 1990s, few studies have been conducted on the timing of deaths in Korea. [6][7][8][9][10] This could be due to the lower rate of autopsies conducted in the country. 12 However, the main reason was that no basis has been established for in-depth analysis and investigation on trauma deaths due to the lack of a trauma system.…”

“…13,14 Moreover, previous studies on preventable trauma deaths in Korea tended to focus on determining the preventability of death and calculating mortality rates. [6][7][8][9][10] These studies did not investigate in detail the timing of death, mechanism of injury, and cause of death. As a result, the trauma system in Korea has not yet reached a level that is high enough to draw corrective action plans or injury prevention programs.…”

“…Nevertheless, few studies have been conducted on this issue, and as a result, the trauma system is still not in tandem with the Korean situation, despite its highly preventable trauma death rate. [6][7][8][9][10] Gyeonggi Province is one of the representative administrative regions with the highest population density in Korea. Unsurprisingly, the largest number of trauma deaths occurred in the region.…”

Treatment Experiences of Traumatic Brain Injury Patients using Doctor-Helicopter Emergency Medical Service: Early Data in a Regional Trauma Center

“…Recently, Jung et al 9) stated that the PTDR in South Korea from January 1, 2015, to December 31, 2015 was 30.5%. Patients treated at a RTC exhibited a significantly lower PTDR than those who were not (21.9% vs. 33.9%; p =0.002).…”

Systematic Preventable Trauma Death Rate Survey to Establish the Region-based Inclusive Trauma System in a Representative Province of Korea

“…The preventable trauma death rate has been measured inconsistently using different methods in Korea, with reported rates of 50.4% in the late 1990s, 35.2% in 2009-2010, and 30.5% in 2015. [4][5][6] Gyeonggi-do, the region evaluated in our study, is about the size of the Los Angeles County in the United States. It is densely populated with approximately 13.09 million people, a quarter of the entire Korean population.…”