Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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A Comparison of the Effectiveness of Before and After the Trauma Team's Establishment: Treatment Outcomes and Lengths of Stay in the Emergency Department

중증외상팀의 운영 전후 손상환자의 응급실체류시간과 치료결과 비교

  • Kwon, Cheong-Hoon (Department of Emergency medicine, Kosin University College of Medicine) ;
  • Park, Chang-Min (Department of Emergency medicine, Kosin University College of Medicine) ;
  • Park, Young-Tae (Department of Emergency medicine, CHA GUMI Medical Center, CAH University)
  • 권정훈 (고신대학교 의과대학 응급의학교실) ;
  • 박창민 (고신대학교 의과대학 응급의학교실) ;
  • 박영태 (차의과학대학교 응급의학교실)
  • Received : 2011.10.26
  • Accepted : 2011.11.10
  • Published : 2011.12.31
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Abstract

Purpose: The aim of this study was to analyze the influence of a trauma team's management. Methods: A total of 181 patients with severe trauma were retrospectively divided into two groups. Of these 181 patients, 81 patients without a trauma team admitted between April and October 2008 were assigned to Group 1, and 100 patients with a Trauma team admitted between April and October 2009 were assigned to Group II. We compared general characteristics, the length of stay in the emergency department (ED) and treatment outcomes (24-h packed RBC transfusion, length of intensive care unit (ICU) stay, length of hospital stay, in-hospital mortality, 24-h mortality) between these two groups. Results: The length of stay in the ED was significantly reduced in Group II compared to Group I ($p$=0.025). No significant differences were found in mean arterial pressure, Glasgow Coma Scale, Revised Trauma Score, Injury Severity Score, in-hospital mortality and 24-h mortality between the two groups. However, Group II had a lower amount of 24-h packed RBC transfusion and a shorter length of ICU and hospital stay than Group I, although these differences were not statistically significant. Conclusion: Through the establishment of a trauma team, the length of stay in the ED can be reduced remarkably. Furthermore, the need for 24-h packed RBC transfusions and the length of stay in the ICU and hospital were found to be decreased in patients managed by a trauma team.

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References

  1. Death rates for the causes of death: Statistics Korea. Available at: http://kostat.go.kr/.
  2. Health at a glance 2009: OECD indicators. Available at: http://library.mohw.go.kr/.
  3. 2010 Social indicators in Korea: Statistics Korea. Available at: http://kostat.go.kr/.
  4. Jung KY, Kim SP, Kim SH, Kim H, Noh H, Jang HY. A study on emergency medical system performance indicators. Ministry of Health and Welfare, National Emergency Medical Center; 2008:72-4.
  5. Esposito TJ, Sanddal TL, Reynolds SA, Sanddal ND. Effect of a voluntary trauma system on preventable death and inappropriate care in a rural state. J Trauma 2003;54:663-669. https://doi.org/10.1097/01.TA.0000058124.78958.6B
  6. Kunihiro Mashiko. Trauma System in Japan: History, Present Status and Future Perspectives. J Nippon Med Sch 2005;72:194-202. https://doi.org/10.1272/jnms.72.194
  7. http://www.mw.go.kr/front/al/sal0101vw.jsp?PAR_ MENU_ID=04 & MENU_I=040102 & BOARD_ID =110 & BOARD_FLAG=01 & CONT_SEQ=211718 & page=1
  8. Schwab CW, Young G, Civil I, Ross SE, Talucci R, Rosenverg L, et al. DRG reimbursement for trauma: The demise of the trauma center (The Use of ISS grouping as an early predictor of total hospital cost). J Trauma 1998;28:939-946.
  9. Lee DK, Lee KH, Cha KH, Park KH, Choi HJ, Kim H et al. Effectiveness of Simple Trauma Team Activation Criteria on Prognosis of Severe Trauma Patients. J Korean Soc Traumatol 2009;22:71-76.
  10. Guidelines for Field Triage of Injured Patients Recommendations of the National Expert Panel on Field Triage. Division of Injury response, National Center for Injury Prevention and Control.
  11. Consultation/Verification programs for hospitals. Available at: http://www.facs.org/ trauma/.
  12. Available at: http://www.nemc.go.kr/. Assessed June 10, 2009
  13. Kim HS, Kim OJ, Choi SW, Kim EC, Park YT, Ko TI et al. The Effect of Six Sigma Activity in Major Trauma Patients on the Time Spent in the Emergency Department. J Korean Soc Traumatol 2010;23:119-127.
  14. Khetarpal S, Steinbrunn BS, McGonigal MD, Stafford R, Ney AL, Kalb DC et al. Trauma Faculty and Trauma Team Activation: Impact on Trauma System Function and Patient Outcome. J Trauma. 1999;47:576 -581. https://doi.org/10.1097/00005373-199909000-00028
  15. Lee SH, Cho SJ, Yeom SR, Ryu JH, Jung JW, Han SK et al. Effect of the Emergency Trauma Team's Management on the Treatment of Patients with Multiple Severe Trauma. J Korean Soc Traumatol 2009;22:172-178.