Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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제60권8호
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pp.390-395
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2017
Background and Objectives With increasing frequency of car accidents, patients of dizziness caused by car accidents are also increasing. Various types of dizziness or vertigo can occur from car accidents depending on different injury mechanisms. Since accurate diagnosis is important for providing proper treatments, we evaluated clinical characteristics related to vestibular function of patients with dizziness caused car accidents. Subjects and Method In this retrospective case review study that runs from January 2011 to March 2013, a total of 82 patients with dizziness following car accident were enrolled consecutively. We analyzed the final diagnosis of dizziness according to different mechanisms of injury during car accident through clinical record review. Patients who developed dizziness within one month of car accident were included, excluding those who had temporal bone fracture and previous history of dizziness. Results Of the different types observed, 36.6% was head injury, 24.4% whiplash injury, 3.7% complex injury, 2.4% others and the rest was unknown. In the final diagnosis, the different types included 36.6% benign paroxysmal positional vertigo (BPPV), 23.2% unclassifiable dizziness, 18.3% cervical vertigo, 7.3% labyrinthine concussion, 3.7% BPPV with labyrinthine concussion and the rest was others. Of the different types of dizziness symptoms, 58.5% was headache, 45.1% was audiologic symptoms, and others included earfullness, tinnitus and hearing disturbance. Tinitogram and pure tone audiogram results show that 2.9% (27 people) of patients have tinnitus and 7.3% (6 people) have hearing disturbance. Conclusion An accurate diagnosis and timely management would be very important in forming a proper approach for post traumatic vertigo patients.
Purpose: The study aimed to analyze the current status of traffic accident victims who were transported by 119 ambulances within the administrative district of Chungnam province and provide essential data for accident prevention. Methods: The pre-hospital care records of patients who called the 119 emergency service in 2019 were obtained from the Chungnam Fire Department. Data pertaining to 13,663 traffic accident victims who were transported to hospitals were analyzed. Results: Patients in those aged ≥60 years accounted for 49.8% of the total cases. In patients aged ≥80 years(n=2,154), motor cycle accidents were highest as 28.3%. In addition, cultivator (n=135) and buggy car (n=79) accident victims were the highest in aged ≥80 years as 66.7% and 67.1%, respectively. Traffic accident victims-population ratio in Chungnam was 0.65%, wherein 2.03% included population aged ≥80 years. Conclusion: It was clear that accidents varied across administrative districts depending on the age group of population distribution. Thus, safety measures for preventing motorcycle, cultivator, and buggy car accidents are necessary for areas with many older people aged ≥80 years.
This study analyzed the MMPI (Minnesota Multiphashic Personality Inventory), VAS (Visual Analogue Scale), cervical and lumbar curvature (Cervical angle, Ishihara Index, Lumbar angle, Ferguson angle) and satisfaction score of patient of traffic accident. About 59 cases of patients admitted to the Korean Medicine hospital, MMPI and pain levels (VAS) cervical and lumbar curvature (Cervical angle, Ishihara Index, lumbar angle, Ferguson angle) and satisfaction score were measured and statistically analyzed. Depending on the type of accident divided into two groups of In car TA and Out car TA. After hospitalization, patient's pain index was improved as a whole. Pain index and evaluation of the cervical and lumbar curvature, according to the accident types, the difference was not statistically significant. In the analysis of the MMPI validity scales, In car TA group was analyzed by 'V-shaped', Out car TA group was analyzed by umbrella- shaped, 'inverted V-shaped'. Clinical scales of out car TA group were analyzed by 3-1 profile compared to the In car TA group. Results of multiple regression analysis showed no association between factors and MMPI scales. In the case of a traffic accident patients, damage to the body, as well as emotional and psychological factors are thought to affect the condition or prognosis of patients. In the future, for the management and treatment of these parts will be needed to complement the academic or institutional.
This study was an attempt to encourage the development of a rehabilitation delivery system and programs as a substitute service for hospitalization on the case of car accident patients, such as hospital based home health care nursing services. Various substitute services for hospitalization are required to curtail the length of stay for inpatients who were hospitalized with car accident compensation insurance. It focused on developing an estimation an early discharge day for car accident inpatients based on detailed statements of treatment for 111 inpatients who were hospitalized at the General Hospital in 1997. This study had four specific purposes as follows. First. to find out the utilization of medical services. Second, to estimate the time of early discharge and income increasing effect based on early discharge for those patients. Third, to identify the factors affecting total medical expenditure and the length of stay for those inpatients. Forth, to figure out the need of utilizing home health care nursing service for accident patients. In order to analyze the length of stay and medical expenditure for inpatients who were hospitalized due to car accidents, the authors conducted micro- and macro-analysis of medical and medical expenditure records. Micro-analysis was done by nominal group discussion of 4 expertise with the critical criteria, such as a decrease in the amount of treatment after surgery, treatments, tests, drugs and changes in the test consistency, drug methods, vital signs, start of ROM exercise, doctor's order, patient's outside visiting ability, and stable conditions. In addition to identifying variables affecting medical expenditure, and the length of stay and income effect due to early discharge day, the data was analyzed with a multiple regression analysis and linear regression analysis model by SPSS-PC for windows and Excell program. Results of this study were as follows. First. the mean length of stay was 50.3 days. whereas the mean length of stay due to early discharge was 34.3 days at the hospital. The estimation of time of early discharge depended on the length of stay. The longer the length of stay, the longer the length of time of early discharge : for instance a length of stay under 10 days was estimated as correlating to a mean length of stay of 6.6 days and early discharge of 6.5. The mean length of stay was 217.4 days and the time of early discharge was 110.1 respectively. The mean medical expenditure per day was found to be 169.085 Won and the mean medical expenditure per day showed negative linear trends according to the length of stay at the hospital. The estimation results of the income effect due to being discharged 16 days early was around 2,244,000 won per bed. However. this sum does not represent the real benefits resulting from early discharge, but rather the income increasing amount without considering medical prime cost in the general hospital. Therefore, further analysis is required on the cost containments and benefits as turn over rate per bed as the medical prime costs. The length of stay was most significant and was positive to the total medical expenditure, as expected. Surgery and patient's residential area was also an important variable in explaining medical expenditure. The level of complications was the most significant variable in explaining the length of stay. There was a high level for need a home health care nursing service which further supports early discharge for accident patients. In addition, when the patient was discharged. they needed follow up care for complications suffered during the car accident. $86.8\%$ of discharged patients responded that they needed home health services after early discharge. From these research findings, the following suggestions have been drawn. Strategies on a health care delivery system must be developed in order to focus on the consumer's needs and being planned for 21 century health policy in Korea. Community based intermediate facilities or home health care should be developed for rehabilitation services as a substitute for hospitalization in order to shorten the length of stay would be. A hospital based home health care nursing service. it would be available immediately to utilize by patients who want rehabilitation services as a substitute for hospitalization with the cooperation of car insurance companies.
Objectives The purpose of this study is to report 24 patients who have neck pain or have been diagnosed with cervical sprain by car accidents and have been treated in the oriental medical hospital. Methods 24 children who have visited oriental medical hospital from January 2016 to September 2016 were analyzed by reviewing the patients' charts. Results In the study group, the most common chief complaint was having musculoskeletal partial pain. Among them, 18 patients had neck pain; 20 patients had C-spine sprain was diagnosed at and among 18 who had neck pain, 14 was diagnosed C-spine sprain and 4 was normal. All patients had been treated by acupuncture, herb medicine and chuna treatment (muscular manipulation) and the oriental medical treatment resulted in improvement of children patients' symptoms by car accidents. Conclusions The study result showed that the car accident could have caused cervical sprain and neck pain to children and the oriental medical treatment was effective in the children patients.
A retrospective study has been carried out for 47 cases of traffic accident victims which was entered to the Dongguk Bundang O. M. Hosp. from Jan 1, 1999 to May 4, 2000. This study was focused on finding out the distribution, pattern of the traffic accidents, clinical characteristics of the patients, motives of their choosing oriental medical treatments, the kinds of oriental medical treatment. This results were as follows : 1. The highest incidence was shown in the age of twenties to thirties as much as 59.6% and the ratio of male to female was 17:30. 2. 80.9% of all patients was injured by car accidents. 68.2% of all patients was injured as drivers and passengers and 19.2% was injured as pedestrians. The highest type in the collision between cars, was rear impact. 3. The number of patient(61.7%) via other hosp. was more than that of the first visitor(38.3%) to our hosp. 4. In admission motives, The patients who had been treated by western medical treatment, expressed the dissatisfaction of that treatment, so hoped to be treated by oriental medical styles. Also The others wanted to be treated by oriental medical methods in the reason of no deep surgical, orthopaedical lesions 5. C-spine sprain(80.9%) was the most frequent out of all patients's diagnosis and then L-spine sprain(51.1%), contusion(46.8%), etc. 6. Head Cervix(80.9%) was the commonest pain region of all patients. and then shoulder back(70.2%), lumbar region(61.7%), etc. 7. In general, the pedestrian injuries were more serious than those sustained in the car as passengers. 8. After discharge, Duration of OPD treatment was long as much as that of admission treatment. 9. At first stage of admission period, Herb medication was frequently prescribed for hwalhyultonglakgige(活血通絡之劑). but As going to end stage, was frequently used for bogi(補氣) bohyul(補血), gudam(祛痰), ansin(安神).
Objectives : The main purpose of this research is to make a survey of the effective way of the Oriental medical care and to enlarge the range of Oriental medical treatment about neck pain patients caused by traffic accident. Methods : In following research. we surveyed 197 neck pain patients of traffic accident who admitted in Daegu Hanny University Oriental Medical Hospital from May, 1, 2008 to september, 30, 2009 according to medical chart. Results : 1. In distribution of gender and age, the rate of female was 74.6%, that of male was 25.4% and the majority of the patients were thirties. In results of treatment according to gender and age, the effective rate of female was higher than the male. that of teens was highest. 2. In total results of treatment, the highest distribution was fair with 40.1%, the effective rate was 90.9%. 3. In category of traffic accident patterns, the highest distribution was car to car crash with 81.7%. The results of treatment according to the significance test were shown statistical significance. 4. In admission days, the highest distribution was 6~10 days with 41.1%. The highest effective rate was 21~25days with 100%. The results of treatment according to the significance test were shown statistical significance. Conclusions : This study suggested that Oriental medical treatments are effective in patients of neck pain caused by traffic accident. Further studies are needed for progress report that after accident patients are discharged from the Oriental Medical Hospital.
In South Korea, traffic accident patients can be treated under automobile insurance coverage. This study investigated the status of Korean medicine (KM) Automobile insurance system and usage status of main pharmacopuncture in KM clinic which reported that the largest number of automobile insurance fee claims among medical institutions. We surveyed 258 traffic accident patients who were treated at Namsangcheon KM clinic from 2014 to 2018 according to medical chart. The majority of the patients were male and thirties. In traffic accident situation, the highest distribution was car to car crash with 85.66% and 66.67% of the patients visited in the most acute phase. The most frequent treatment period was within 4 weeks and the number of treatments was 10 or less with 72.87%. In total results of treatment, the distribution was exellent with 10.08%, good with 46.90%, fair with 27.13% and poor with 15.89%, and the effective rate was 84.11%. The most frequent treatment period was within 4 weeks with 64.73% and the number of treatments was 10 or less with 72.87%. Of the 242 patients who received pharmacopunture, 91.5% were treated with HO, which was named after Honghwaja and TA, which was named after traffic accidents, and there were significant differences in the number of treatments and symptom improvement between the two groups. In this study, we confirmed the status of automobile insurance treatment and usage of main pharmacopuncture of single KM clinic with symptom improvement. This study can be regarded as one of the basis of KM treatment for the rapidly growing automobile insurance market.
Objectives : This study aims to evaluate current clinical evidence of acupuncture treatment for rehabilitation in patients with traffic accident in South Korea. Methods : Seven Korean databases were searched for prospective clinical trials for acupuncture on rehabilitation in patients with traffic accident from their inception to June, 2009. Only studies conducted in Korean language were searched. Risk of bias in included randomized controlled trials were assessed by Cochrane Handbook procedure. Results : Fifteen clinical trials were included among 31 studies searched. Eight were observational studies, five were non-randomizedcontrolled trials, and two were randomized controlled trials. In all of included studies, acupuncture were conducted with other concomitant treatment. Included studies dealt with such conditions as neck pain, low back pain tinnitus after traffic accident, post-traumatic stress, oculomotor nerve palsy, diplopia and insomnia. All of included studies reported favorable effects of acupuncture group compared to baseline or control group. All of included studies lacked the occurrence of adverse events. High risk of bias were observed in two randomized controlled trials. Conclusions : There is no evidence that acupuncture is effective for rehabilitation of traffic accident. All of included studies lacked appropriate methodological qualities and internal validity. Future welldesigned clinical trials that evaluate the effects and safety of acupuncture treatment for rehabilitation in patients with traffic accident is needed.
본 연구는 일개 시지역에 소재한 병원급 의료기관 2개에서 2009년 한 해 동안 교통사고로 입원진료를 받은 후 퇴원한 자동차보험 환자 중 1,583명을 대상으로 진료현황과 진료내역별 진료비, 진료비 비율의 특성을 분석하였다. 분석결과 자동차보험 입원환자는 남자가 많았고, 연령은 성인기 연령층이 많았으며, 재원일수는 4~7일이 가장 많았다. 진료현황과 진료내역별 진료비, 그리고 총진료비 중 진료내역별 진료비가 차지하는 비율은 성별, 연령, 재원일수에 따라 각각 통계적으로 유의한 차이를 보였다. 특히 진료내역별 진료비는 주로 여성의 진료비가 높았고, 60대 이상의 고연령층과 재원일수가 길수록 각 진료내역별 진료비가 높았다. 따라서 각 의료기관은 연령층에 따른 효율적 진료방안을 마련하여 재원일수의 단축을 위해 노력하고, 특히 고연령층에 대한 진료패턴 파악과 신체적 정신적 상태, 중증도 등을 고려한 적정진료를 제공함으로써 진료의 효율성을 제고해야 할 것이다.
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