Age group analysis of patients with dog bite injuries who visited a single regional emergency medical center and factors affecting wound infections

( Dong Ho Kang ),( Jea Yeon Choi ),( Woo Sung Choi ),( Jae Ho Jang ),( Jin-seong Cho ),( Sung Youl Hyun ) 대한외상학회 2022 大韓外傷學會誌 Vol.35 No.2

Purpose: The aim of this study was to analyze by age group the characteristics of patients with dog bite injuries, as well as determine which factors were associated with wound infections in those patients. Methods: We reviewed patients with dog bite injuries who presented to Gachon University Gil Medical Center in Incheon, Korea from January 1, 2014 to December 31, 2018. They were classified by age group: children (0-18 years), adults (19-59 years), or elderly (≥60 years). Event profiles, wound characteristics, and infections were compared across these age groups. Multivariable logistic regression was used to identify factors associated with wound infections. Results: Of the total 972 dog bite injuries, 272 (28.0%) were in children, 606 (62.3%) were in adults, and 94 (9.7%) were in the elderly. The median age was 30 years (interquartile range, 16-48 years) and the majority of patients (60.5%) were female. The most common place of injury was at home (73.8%) and indoors (77.0%). In children, the head and neck were the most frequent sites of injury (43%), while the most frequent site in adults and the elderly (50.8% and 59.6%, respectively) was the upper extremity. The odds ratio (OR) for wound infection was 3.997 (95% confidence interval [CI], 1.279-12.491; P=0.017) for head and neck injuries and 3.881 (95% CI, 1.488-10.122; P=0.006) for lower extremity injuries. The OR for wound infection was 4.769 (95% CI, 2.167-10.494; P<0.001) for significant injuries. Elderly patients had a higher risk for wound infection than other age groups (OR, 2.586; 95% CI, 1.221-5.475; P=0.013). Conclusions: When analyzing patients with dog bite injuries, differences across age groups were found, with the elderly at the highest risk for significant injury and wound infection. It is recommended that age-specific approaches and strategies be used to prevent dog bite wound infections.

Characteristics of injuries associated with electric personal mobility devices: a nationwide cross-sectional study in South Korea

( Maro Kim ),( Dongbum Suh ),( Jin Hee Lee ),( Hyuksool Kwon ),( Yujin Choi ),( Joo Jeong ),( Sola Kim ),( Soyun Hwang ),( Joong Wan Park ),( You Hwan Jo ) 대한외상학회 2022 大韓外傷學會誌 Vol.35 No.1

Purpose: The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR, 3.88; 95% confidence interval, 1.33-11.36) and operating an ePMD while intoxicated (AOR, 2.78; 95% confidence interval, 1.52-5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

Transforming Growth Factor-β1에 대한 항체 및 유전자 치료가 피부 반흔 형성에 미치는 영향

김준형,한기환,안종덕,이인규,김은주,황미열,박관규 대한병리학회 2001 Journal of Pathology and Translational Medicine Vol.35 No.4

Analysis of causes of injuries among children in Daegu, Korea

Geol Ha,전만중,사공준 대한소아청소년과학회 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.11

Purpose: The purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers. Methods: We reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009. Results: Among the pediatric patients who visited the ECC, 1,526(27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547[35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges,except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventyone injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries. Conclusion: The cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries.

Pediatric Injuries in Kids Cafés and Risk Factors for Significant Injuries: a 6-Year Cross-Sectional Study Using a Multicenter Injury Registry in Korea

Ik Chang Choi,박중완,Jae Yun Jung,김도균,곽영호,서동범,이세욱 대한의학회 2020 Journal of Korean medical science Vol.35 No.6

Background: A kids café is a popular indoor playground in Korea that combines a playground for young children and a café for their caregivers. There have been no national reports about kids café-related injuries in Korea. This study investigated kids café-related injuries in Korea registered in a multicenter injury surveillance database and analyzed the risk factors for significant kids café-related injuries. Methods: A multicenter cross-sectional study was performed using the Emergency Department-based Injury In-depth Surveillance registry in Korea between 2011 and 2016. Significant injury was defined as an injury requiring hospitalization or surgery. A multivariable logistic regression model was used to obtain the adjusted odds ratios (aORs) for factors associated with significant kids café-related injuries. Results: Among 1,537,617 injured patients, we extracted 891 patients who were injured in kids cafés. Of these, 46 (5.2%) were admitted, and 39 (4.4%) underwent surgery. The most common injured anatomical site, injury type, and mechanism were lower extremity (28.2%), superficial injury (27.2%), and slip (27.1%), respectively. Among injury-inducing factors, significant injuries were most commonly caused by a trampoline (28.1%), and rock climbing equipment was the only risk factor in a kids café that led to significant injury after adjusting for age, sex, injury mechanism, and injured anatomical sites (aOR, 14.94; 95% confidence interval, 1.51–147.72). Conclusion: The rock climbing equipment in a kids café can cause serious injury to children. Establishing safety regulations for rock climbing equipment in kids cafés may have the greatest impact in reducing significant injuries requiring hospitalization or surgery.

압축천연가스 버스의 폭발로 인한 다량의 손상

장석희 ( Seok Hee Jang ),강보승 ( Bo Seung Kang ),최혁중 ( Hyuk Joong Choi ),강형구 ( Hyung Goo Kang ),임태호 ( Tae Ho Lim ) 대한외상학회 2011 大韓外傷學會誌 Vol.24 No.2

Purpose: During August 2010, a natural gas fuel cylinder on a bus exploded in downtown Seoul, injuring 20 citizens. This kind of blast injury has never been reported in Korea before. Thus, the goal of this study was to review the clinical features of these victims to help physicians manage similar cases and to understand the risk factors associated with blast injuries in everyday life, Methods: Twenty (20) victims who visited nearby emergency departments, and 3 peoples left hospital without care. Seventeen (17) victims were included in this study, and the following factors were investigated: age, sex, type of hospital, diagnosis of injury, injury mechanism, position of victim (in-bus/ out of bus), classification of injury severity with START (simple triage and rapid treatment), and classification of injury according to the mechanism of the blast injury. Results: The victims included 8 males (47%), 9 females (53%). The mean age was 37.5±12. Thirteen (13) victims were transferred to two tertiary hospitals, and 4 were transferred to two secondary hospitals. The types of injury were 3 fractures, 2 ligaments injuries, 6 contusions, 4 abrasions, and 3 open wounds (one of them was combined fracture). According to START classification, 17 victims were 1 immediate, 11 minor, 5 delayed, and no death. Classifications according to the mechanism of the blast injury were 1 primary injury, 6 secondary injuries (2 of them combined other mechanism), 3 tertiary injuries and 9 quaternary injuries. Conclusion: Trauma care physicians should be familiar with not only the specific types of injuries from blast accidents, but also the potential accidents that may occur in public facilities.

우리나라 주택 내에서 발생하는 비의도적 손상의 양상

이은정,이진석,김윤,박건희,은상준,서수경,김용익,Lee, Eun-Jung,Lee, Jin-Seok,Kim, Yoon,Park, Kun-Hee,Eun, Sang-Jun,Suh, Soo-Kyung,Kim, Yong-Ik 대한예방의학회 2010 예방의학회지 Vol.43 No.1

Objectives: To investigate the patterns of unintentional home injuries in Korea. Methods: The study population was 12,382,088 people who utilized National Health Insurance services due to injuries (main diagnosis codes S00 to T28) during 2006. Stratified samples(n=459,501) were randomly selected by sex, age group and severity of injury. A questionnaire was developed based on the International Classification of External Causes of Injury and 18,000 cases surveyed by telephone were analyzed after being projected into population proportionately according to the response rates of their strata. Domestic injury cases were finally included. Results: Domestic injuries (n=3,804) comprised 21.1% of total daily life injuries during 2006. Women were vulnerable to home injuries, with the elderly and those of lower income (medical-aid users) tending to suffer more severe injuries. Injury occurred most often due to a slipping fall (33.9%), overexertion (15.3%), falling (9.5%) and stumbling (9.4%), with severe injury most often resulting from slipping falls, falls and stumbles. Increasing age correlated with domestic injury-related disability. Conclusions: The present findings provide basic information for development of home injury prevention strategies, with focus on the elderly.

Analysis of causes of injuries among children in Daegu, Korea

Ha, Geol,Jeon, Man-Joong,SaKong, Joon The Korean Pediatric Society 2010 Clinical and Experimental Pediatrics (CEP) Vol.53 No.11

Purpose: The purpose of this study was to determine the mechanisms and exact causes of injuries to children by analyzing the medical records of children who visited emergency medical centers. Methods: We reviewed the medical records of 7,114 pediatric patients (aged below 15 years) who visited the emergency care center (ECC) of a Yeungnam university hospital in Daegu between January 2007 and December 2009. Results: Among the pediatric patients who visited the ECC, 1,526 (27.2%) were admitted for injuries (boys, 979 [64.2%] and girls, 547 [35.8%]); the boy-to-girl ratio in this study population was 1.8:1. The proportion of boys was higher than that of girls over all age ranges, except for children aged less than 1 year. The highest incidence of injury due to slipping (20.5%) was noted in the 1-year-old group, and nearly half the total number of cases (49.3%) involved children who were under 4 years of age. Of the sites of injury, 999 involved the head and face (73.7%) and 134 involved the hand and wrist (9.9%). Seventy-one injuries (5.7%) occurred on the bed, 70 (5.6%) at the door, and 67 (5.3%) on the stairs. Of the approximately 250 types of injuries classified by cause, 17 accounted for 50.4% of all the injuries. Conclusion: The cause of injury could be attributed to approximately 20 causes in more than half the cases of pediatric injuries. A classification of the types of injuries and the development of appropriate preventive strategies can help avoid such injuries.

Management of Traumatic Pancreatic Injuries: Evaluation of 7 Years of Ex-perience at a Single Regional Trauma Center

( Min A Lee ),( Seung Hwan Lee ),( Kang Kook Choi ),( Youngeun Park ),( Gil Jae Lee ),( Byungchul Yu ) 대한외상학회 2021 大韓外傷學會誌 Vol.34 No.3

Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients’ demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas- specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient’s hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

Nonfatal injuries in Korean children and adolescents, 2007–2018

Yeon Gyu Min,Hong Yoo Rha,Kong Seom Gim 대한소아청소년과학회 2022 Clinical and Experimental Pediatrics (CEP) Vol.65 No.4

Background: Injury is the leading cause of death or disability in children and adolescents. Rates of deaths from injuries have recently declined, but studies of the occurrence of nonfatal injuries are lacking.Purpose: This study aimed to investigate nonfatal injuries in children and adolescents younger than 20 years based on data from the Korean National Health and Nutrition Survey, 2007–2018.Methods: A questionnaire survey was conducted to determine whether children and adolescents had experienced an injury requiring a hospital visit in the previous year. We investigated each injury’s risk factors and characteristics.Results: Of a total of 21,598 children and adolescents, 1,748 (weighted percentage, 8.1%) experienced one or more injuries in the previous year. There was no yearly difference in the proportion of injuries experienced. Among the male subjects, 10.0% had an injury experience; among the female participants, 6.1% had an injury experience (P<0.001). The highest rate was 9.0% in children aged 1–4 years. In multivariate logistic regression analysis, male sex; having an urban residence; having restricted activity due to visual, hearing, or developmental impairment; and attention deficit/hyperactivity disorder were significant risk factors for injury experience. The characteristics of up to 3 injuries per patient were investigated, and 1,951 injuries were analyzed. Falls and slips accounted for 34.9%, collisions for 34.1%, and motor vehicle accidents for 11.3% of the total injuries. Ninety-six percent of injuries were unintentional, 20% caused school absences, and 10% required hospitalization.Conclusion: Among Korean children and adolescents, 8.1% experienced injuries at least once a year with no significant differences in incidence over the past 12 years. Greater attention and effort to prevent injuries are needed.