Trauma Volume and Performance of a regional Trauma Center in Korea: Initial 5-year analysis

Abstract

Purpose: We aimed to evaluate the trauma volume and performance indicators during the first 5-year period of operation in a single regional trauma center. methods: We analyzed prospectively collected data from the Korean Trauma Data Bank for a single regional trauma center between January 2014 and December 2018. More than 250 variables were analyzed. We calculated the predicted survival rates using the trauma and injury severity score (TRISS) method. results: In total, there were 16,103 trauma admissions during the first 5 years; trauma activation was performed in 5,105 of these cases. Over 70% of the patients were men, and most of the admitted patients were within the age groups of 55-59 years for men and 75-79 years for women. Analyses were performed considering two patient groups: the total patient group and the group of those with severe trauma (injury severity score [ISS] >15). The median ISS, revised trauma score, and TRISS of the two groups were 5 (interquartile range [IQR] 4-10), 22 (IQR 17-27), and 7.6±0.99 and 6.74±1.9, 0.95±0.13, 0.81±2.67, respectively. Of the total patient group, 801 patients (5%) died in the hospital, whereas of the group of patients with ISS >15, 526 (19.5%) died. The direct transportation of patients to the regional trauma center increased year by year. The emergency room stay time and time to entering the operating room showed a decrease until 2017; however, these parameters increased again in 2018. Conclusions: The trauma volume in the regional trauma center is appropriate, and some improvements could be observed after its establishment. However, performance indicators reveal the prematurity of the trauma center and its potential for further improvements. Moreover, the development of a national trauma system, beyond regional trauma centers, is required.

Artificial intelligence to predict in-hospital mortality using novel anatomical injury score

“…Numerous variables, including the demographics, pre-hospital and in-hospital information, time factors, clinical characteristics, vital signs, trauma scores, and final outcome information, were recorded. Therefore, the quantity and quality of the KTDB data were satisfactory 25 .…”

An Evaluation of the Effect of Performance Improvement and Patient Safety Program Implemented in a New Regional Trauma Center of Korea

“…Fortunately, several recent reports, including this one, have demonstrated that several Korean regional trauma centers have been successfully established and have contributed to the improvement of local trauma performance. 3 5 Nevertheless, differences exist in the quality and extent of trauma care at the 15 regional trauma centers that have officially been operating. According to Jung et al, 5 initial trauma centers have reported good outcomes, but trauma centers that have just commenced operating or have yet to open face difficulties in securing manpower and establishing relevant systems.…”

“…There have been recent reports on outcomes resulting from performance improvements in trauma care in institutions that opened earlier and have been operating trauma centers for more than 5 years. 3 4 The most recently published national survey revealed that regional trauma centers had lower PTDRs. 5 Based on these results, it is projected that national trauma outcomes can be improved if the operation of these trauma centers is further established and a system promoting the concentration of severe trauma patients in regional trauma centers is supported.…”

Understanding Regional Trauma Centers and managing a trauma care system in South Korea: a systematic review

“…A higher prevalence of trauma has been reported in younger people, affecting twice as many men as women [ 2 3 4 ]. The preventable trauma death rate in South Korea is reportedly higher than that in other developed countries, despite declining from 40.5% in 1997 to 39.6% in 2003, 35.3% in 2009, and 30.5% in 2015 [ 5 6 7 ]. Trauma can be prevented through proactive interventions addressing environmental, equipment, behavioral, and individual risk factors in the public domain [ 8 ].…”