Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
권호 표지

Current State and Problem of the Transfer of Severely Injured Patients in One Regional Emergency Medical Center

일개 권역응급의료센터에서의 중증 외상환자의 전원 현황과 문제점

  • Lee, Won-Chul (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Jo, Choong-Hyun (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Jung, Kyoung-Won (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Min, Young-Gi (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Choi, Sang-Cheon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Kim, Gi-Woon (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Ahn, Jung-Hwan (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Jung, Yong-Sik (Department of Surgery, Ajou University School of Medicine) ;
  • Hwang, Sun-Ae (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Kim, Ji-Yong (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Lee, Kug-Jong (Department of Emergency Medicine, Ajou University School of Medicine) ;
  • Jung, Yoon-Seok (Department of Emergency Medicine, Ajou University School of Medicine)
  • 이원철 (아주대학교 의과대학 응급의학교실) ;
  • 조충현 (아주대학교 의과대학 응급의학교실) ;
  • 정경원 (아주대학교 의과대학 응급의학교실) ;
  • 민영기 (아주대학교 의과대학 응급의학교실) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 김기운 (아주대학교 의과대학 응급의학교실) ;
  • 안정환 (아주대학교 의과대학 응급의학교실) ;
  • 정용식 (아주대학교 의과대학 외과학교실) ;
  • 황선애 (아주대학교 의과대학 응급의학교실) ;
  • 김지영 (아주대학교 의과대학 응급의학교실) ;
  • 이국종 (아주대학교 의과대학 응급의학교실) ;
  • 정윤석 (아주대학교 의과대학 응급의학교실)
  • Received : 2010.04.23
  • Accepted : 2010.06.07
  • Published : 2010.06.30
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Abstract

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

Keywords

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