Journal of Trauma and Injury

The Korean Society of Traumatology (대한외상학회)
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The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center

외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험

  • Kim, Hyung Won (Division of Critical Care and Trauma Surgery, Department of Surgery, Trauma Training Center, Yonsei University College of Medicine) ;
  • Hong, Tae Hwa (Division of Critical Care and Trauma Surgery, Department of Surgery, Trauma Training Center, Yonsei University College of Medicine) ;
  • Lee, Seung Hwan (Division of Critical Care and Trauma Surgery, Department of Surgery, Trauma Training Center, Yonsei University College of Medicine) ;
  • Jung, Myung Jae (Division of Critical Care and Trauma Surgery, Department of Surgery, Trauma Training Center, Yonsei University College of Medicine) ;
  • Lee, Jae Gil (Division of Critical Care and Trauma Surgery, Department of Surgery, Trauma Training Center, Yonsei University College of Medicine)
  • 김형원 (연세대학교 의과대학 세브란스병원 중환자외상외과, 외상전문의수련센터) ;
  • 홍태화 (연세대학교 의과대학 세브란스병원 중환자외상외과, 외상전문의수련센터) ;
  • 이승환 (연세대학교 의과대학 세브란스병원 중환자외상외과, 외상전문의수련센터) ;
  • 정명재 (연세대학교 의과대학 세브란스병원 중환자외상외과, 외상전문의수련센터) ;
  • 이재길 (연세대학교 의과대학 세브란스병원 중환자외상외과, 외상전문의수련센터)
  • Received : 2014.11.09
  • Accepted : 2015.12.10
  • Published : 2015.12.31
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Abstract

Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

Keywords

References

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