• 제목/요약/키워드: external causes of injuries

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ICECI (International Classification of External Causes of Injuries)를 이용한 중증 소아외상의 분류 (ICECI Based External Causes Analysis of Severe Pediatric Injury)

  • 안기옥;김재은;장혜영;정구영
    • Journal of Trauma and Injury
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    • 제19권1호
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    • pp.1-7
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    • 2006
  • Purpose: Injury is a leading cause of morbidity and mortality for children. As an injury prevention measure, the differences in external causes of severe pediatric injuries based on ICECI were analyzed according to age groups. Methods: A retrospective study was performed for pediatric patients under 15 years of age, who had been admitted to the emergency department with severe injuries from January 1998 to December 2004. The external causes of injury were investigated according to the ICECI: intent, mechanisms, places of occurrence, objects/substances producing injury, and related activities. The patients were divided into four groups based on age: infant (<0 year), toddler (1~4 years), preschool age (5~8 years), and school age (9~15 years). Results: The injury mechanisms, the places of occurrence and the related objects/substances vary with the age groups. The most common subtype of traffic accidents was pedestrian injury in pre-school age group. Falls most frequently occurred in the toddler group. But falls from a height of less than l meter height (6 patients) occurred only in the infant group. The most common place of occurrence in the infant group was the home, and that of other groups was the road. The related objects/substances for falls, for example, household furnitures and playground equipment depended on the age group. Conclusion: The age-group specific characteristics of severe pediatric injury were analyzed successfully through the ICECI. Therefore, when establishing a plan for the prevention of pediatric injury, consideration must be given to the differences in the external causes of injuries according to age group.

우리나라 대표적(代表的) 표본인구(標本人口)의 연간(年間) 손상(損傷) 및 중독발생율(中毒發生率)과 역학적(疫學的) 특성(特性) (National Survey of Injury and Poisoning on a Representative Sample Population of Koreans)

  • 김정순;김성수;장성칠
    • Journal of Preventive Medicine and Public Health
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    • 제27권3호
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    • pp.447-463
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    • 1994
  • Despite the public health importance of injury and poisoning in terms of its high mortality and incidence, epidemiologic information to be utilized are scarce in Korea. This study was carried out in 1990 on a representative sample population (about 55,000 persons) along with the 6th National Tuberculosis Prevalence Survey in order to estimate the magnitude of injury and poisoning occurrence and to identify its epidemiologic characteristics which can be aided for establishing preventive strategy. Pre-tested and structured Questionnaire was used by trained interviewer to collect data including general information of the person, various information on the injury and poisoning during the past one year such as time and place of its occurrence, its nature and external causes, type of medical institute attended, duration of treatment and outcome of the accident occured. In analysis of the data collected incidence rates per 1000 persons by sex, age group and its nature as well as external causes, and relative frequencies were calculated. The result obtained are as followings; 1. The incidence rate per 1000 was 30 for both sexes, 39 for male and 22 for female, male being 1.8 times more frequent than female. Age adjusted incidences were not much different from the crude rates. Age group specific rate curve showed bimodal shape in both sexes, small peaks in preschool children and higher peaks in older ages. The incidence rate per 1000 people by area was highest in Jeon-bug province (57/1000) and the lowest in Daegu city(11/1000). 2. The place where the injuries occured were road in 46%, within the boundary of house in 25%, and working place in 12% The injuries and poisoning had occured more frequently during the months from March to August of the year than other months. 3. The relatively frequent injuries by its nature were contusion with intact skin surface (19%), fracture of upper limb (13%), open wound of head, neck and trunk (12%) and fracture of lower limb (11%) among males; contusion with intact skin surface (28%), sprains and strains of joints and adjacent muscle (14%), fracture of upper limb (10%) and fracture of lower limb (9%) among females. Higher incidence rate among males than females were fracture of skull (4.5 times), open wound and fractures of limbs ($2{\sim}3$ times). Age specific rate of injuries and poisoning by its nature showed increasing pattern by age in fractures of upper and lower limbs and sprains & strains of joints whereas the age group of 30's showed highest incidence in open wounds of upper limb. Fractures of radius and ulna in upper limb, fractures of tibia & fibula and ankle in lower limb were most frequent among fractures of upper and lower limbs. The frequent injuries among sprains and strains of joints and adjacent muscles were that of ankle, foot and back, and among open wound were that of head and fingers. 4. Relative frequency of injuries and poisoning by external causes showed following order : other accidents (25%), accidental falls (23%), motor vehicle accident (22%) and other road vehicle accident (14%) among males and accidental falls (37%), motor vehicle accident (24%) and other accident (18%) among females. The external causes revealing higher incidences among males than females, were other road vehicle accident (4.8 times), vehicle accident not elsewhere classifiable (4.4 times), accidental poisoning (4.4 times), accidents due to natural and environmental factors (2.8 times), and sucide & self-inflicted injuries (2.8 times). Age specific incidence by external causes for frequent injuries showed that incidence of other accident steadily increased from 10's till age 50's; motor vehicle traffic accident increased from age 20's and dropped after age 60's; on the other hand accidental fall increased strikingly by age. The most frequent external causes among motor vehicle traffic accidents was motor vehicle traffic accident involving collision with pedstrain (69%), pedal cycle accident (30%) and other road vehicle accident (71%) among other road vehicle accidents; falls on same level from slipping, tripping or standing (44%) and other falls from one level to another among accidental falls; accidents caused by machinary (32%) for male and striking against or struck accidentally by objects or person for female among other accidents. 5. Seventy nine percent of the injuries and poisonings were treated in general hospital or hospital/clinic. The duration of treatment ranged from a few days to 123 weeks; the majority(52%) took under 2 weeks, 36% for $3{\sim}8$ weeks and 4% over 21 weeks. 6. The accident resulted in full recovery of normal healthy state in 62%, residual functional defects in 21% and on process of treatment in 16%.

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손상 및 외상 사망 환자의 재원일수 특성에 관한 융합 연구 -퇴원손상심층조사자료를 중심으로 (A Convergence Study on the Characteristics of Length of Hospital Stays of Injured and Traumatic Death Patients - Based on the Korea National Hospital Discharge Injury Survey Data)

  • 송유림;이무식;김두리;김광환
    • 한국융합학회논문지
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    • 제8권5호
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    • pp.87-96
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    • 2017
  • 이 연구는 퇴원손상심층조사 자료를 이용해 손상 및 외상 사망환자의 재원일수 특성을 분석하여 손상 및 외상으로 인한 사망 예방을 위한 기초 자료 제공을 목적으로 시행되었다. 조사대상은 퇴원손상심층조사 자료에서 2014년 1월 1일부터 12월 31일까지 퇴원한 환자 중, 치료결과가 '사망'이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 233명이었다. 연구결과, 여자의 재원일수가 남자보다 길었다. 주진단은 기타 내부 인공삽입장치, 삽입물 및 이식편의 합병증(T85)에서 재원일수가 가장 길었다. 이상의 연구결과로 볼 때 손상으로 인한 사망 재원일수 영향 요인을 파악하여 이들을 집중적으로 관리하기 위한 정책개발이 필요한 것으로 판단된다.

Medical Care Expenditure in Suicides From Non-illness-related Causes

  • Sohn, Jungwoo;Cho, Jaelim;Moon, Ki Tae;Suh, Mina;Ha, Kyoung Hwa;Kim, Changsoo;Shin, Dong Chun;Jung, Sang Hyuk
    • Journal of Preventive Medicine and Public Health
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    • 제47권6호
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    • pp.327-335
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    • 2014
  • Objectives: Several epidemiological studies on medical care utilization prior to suicide have considered the motivation of suicide, but focused on the influence of physical illnesses. Medical care expenditure in suicide completers with non-illness-related causes has not been investigated. Methods: Suicides motivated by non-illness-related factors were identified using the investigator's note from the National Police Agency, which was then linked to the Health Insurance Review and Assessment data. We investigated the medical care expenditures of cases one year prior to committing suicide and conducted a case-control study using conditional logistic regression analysis after adjusting for age, gender, area of residence, and socioeconomic status. Results: Among the 4515 suicides motivated by non-illness-related causes, medical care expenditures increased in only the last 3 months prior to suicide in the adolescent group. In the younger group, the proportion of total medical expenditure for external injuries was higher than that in the older groups. Conditional logistic regression analysis showed significant associations with being a suicide completer and having a rural residence, low socioeconomic status, and high medical care expenditure. After stratification into the four age groups, a significant positive association with medical care expenditures and being a suicide completer was found in the adolescent and young adult groups, but no significant results were found in the elderly groups for both men and women. Conclusions: Younger adults who committed suicide motivated by non-illness-related causes had a higher proportion of external injuries and more medical care expenditures than their controls did. This reinforces the notion that suicide prevention strategies for young people with suicidal risk factors are needed.

안면부 골절과 전산화 단층 촬영으로 진단된 두부 손상의 연관성 (The Relationship between Facial Fractures and Radiologically-proven Cranial Injuries)

  • 송진우;조익준;한상국;정연권
    • Journal of Trauma and Injury
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    • 제22권1호
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    • pp.18-23
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    • 2009
  • Purpose: In this study, we retrospectively investigated the medical records of patients with facial fractures and suspected cranial injuries in order to determine if there was any relationship between various facial fracture patterns and cranial injuries. Methods: Medical records were reviewed to identify patients diagnosed with facial fractures who underwent cranial computed tomography (CT) scans. Records were reviewed for gender, age, injury mechanism, facial fracture pattern, and presence or absence of cranial injuries. Facial fracture patterns were classified as isolated fractures (tripod, zygomatic arch, maxilla, orbit, and mandible), combined fractures, or total fractures. Cranial injuries included skull fractures, traumatic subarachnoid hemorrhages, subdural hemorrhages, epidural hemorrhages, and contusional hemorrhages. All cranial injuries were established by using cranial CT scans, and these kinds of cranial injuries were defined radiologically-proven cranial injuries (RPCIs). We evaluated the relationship between each pattern of facial fractures and the incidence of RPCIs. Results: Of 132 eligible patients with facial fractures who underwent cranial CT scans, a total of 27 (20.5%) patients had RPCIs associated with facial fractures. Falls and slips were the most common causes of the fractures (31.8%), followed by assaults and motor vehicle accidents (MVAs). One hundred one (76.5%) patients had isolated facial fractures, and 31 (23.5%) patients had combined facial fractures. Fractures were found most commonly in the orbital and maxillary bones. Patients with isolated maxillary fractures had a lower incidence of RPCIs than those with total mandibular fractures. RPCIs frequently accompanied combined facial fractures. Conclusion: Combined facial fractures had a significant positive correlation with RPCIs. This means that facial fractures caused by stronger or multidirectional external force are likely to be accompanied by cranial injuries.

성인에서 AUDIT와 손상의 연관성 (Drinking Pattern and Nonfatal Injuries of Adults in Korea)

  • 유인숙;최은미;권호장;이상규
    • 한국산학기술학회논문지
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    • 제13권4호
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    • pp.1690-1698
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    • 2012
  • 음주는 손상의 가장 위험 요인으로 정확한 평가를 위하여 세계보건기구에서 개발한 Alcohol Use Disorders Identification Test (만성음주행태측정 이하 AUDIT)와 같은 도구를 이용하여 성인에서의 음주행태와 손상 발생률 및 손상 세부 특성과의 연관성을 평가하고자 실시 하였다. 본 연구는 2009년도 국민건강영양조사를 이용하였으며 성인 만 19세 이상 성인 중 7,893명이 참여하여 손상에 응답한 7,511명, 그 중 음주행태조사 참여는 6,6362명 설문에 무응답 104명을 제외 최종 6,258명 연구 대상으로 분석하였다. AUDIT범주에 따른 손상 발생률 및 세부특성 즉 신체부위, 유형, 기전별 손상 발생율의 비교위험도를 T-test, ANOVA, Logistic regression 이용하여 산출하였다. 통계분석은 SPSS 19.0 통계프로그램을 사용하였다. 분석결과 체전손상에서 남자가 손상의 발생이 유의하게 높았다. 음주 관련 손상의 경우에서 남자가 여자에 비해 손상의 발생 위험이 8.3배 높았다. 교육은 고등학교 졸업자가 AUDIT이 가장 높은 비율을 보여 유의하였으며, 결혼한 사람과 월소득이 201-300만원인 사람들이 AUDIT가 가장 높게 나타났으며 유의하였다. 문제음주자와 알코올의존자에서 의미있게 증가된 신체부위의 손상은 두 경부에서 0.0371로 유의하게 나타났고 AUDIT와 손상외인 기전에서는 운수사고, 미끄러짐, 기타, 부딪힘, 추락의 순으로 나타났으며, 손상의 유형 분류상 기타(열상, 좌상, 중독, 관통상 등)에서 유의하였다. 음주로 인한 손상 및 손상외인의 기전은 매우 중요하며, 상담자를 통한 동기유발 조정이 이루어 지게 되면 음주횟수를 줄여 음주로 인한 손상을 완화시킬 수 있는 장치가 필요하다.

전치부 외상성 손상시 치아고정술 후의 예후에 관한 연구 (A STUDY ON THE PROGNOSIS AFTER STABILIZATION OF THE TRAUMATIZED ANTERIOR TEETH)

  • 김미영;이의웅
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제12권1호
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    • pp.62-71
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    • 1990
  • This study was to evaluate the nature of traumatic injuries on anterior teeth of 530 patients and the prognosis of stabilized cases of 102 patients, including possible 18-follow up cases among them, treated at Dental Hospital, Yonsei Medical Center from Mar. 1983 to Feb. 1988. The obtained results were as follows. 1. The peak of monthly distribution of trauma to the anteriors was June and was the lowest in November. The ratio of male to female was 2.6 : 1. The most common incidence of the trauma to the anteriors was seen in the 3rd decades. The most chiefly involved teeth were central incisors in both upper and lower jaws. The causes of trauma were as followed in descending order by first blows, traffic accidents, falls, slip downs, and sports. The types of traumatic injuries of anterior teeth consisted of periodontal tissue injuries(55.9%), the injuries to the hard dental tissues and pulp(31.3%), and alveolar bone injuries(12.8%). 2. 35.1% stabilized anteriors were treated with root canal therapy. The success rate of stabilization was 95.3%, and 92.3% in replantation of avulsed teeth. 3. External root resorption, internal root resorption with calcification of pulp chamber or root canal, ankylosis of root, and other periapical pathosis were seen in follow-up radiographic findings. 4. Success rate of stabilization of the traumatized anteriors after 3 years showed 71.4% average.

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어린이(0-12세) 손상환자의 재원일수에 미치는 요인분석: 퇴원손상심층자료를 중심으로 (Analysis of Factors Affecting the Length of Stay in Children(Aged 0 to 12) with Injuries: Centering Around the Data from the Korea National Hospital Discharge In-Depth Injury Surveys)

  • 이채경
    • 문화기술의 융합
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    • 제9권3호
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    • pp.137-143
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    • 2023
  • 이 연구는 어린이(0-12세)손상 환자의 특성에 따른 재원일수의 관계를 규명하여, 어린이손상 환자 재원일수에 미치는 요인을 분석하고자 시행하였다. 조사대상은 퇴원손상심층조사 자료에서 2016년 1월1일부터 2020년 12월31일 까지 퇴원한 환자 중 0-12세 이하이며, 주진단이 손상 및 사고의 외인(S00-T98)인 환자 7,804명이었다. 분석은 빈도 분석 및 독립표본 t-검정, ANOVA 검정을 실시하였다. 재원일수에 영향을 미치는 요인을 알아보고자 회귀분석을 시행하였다. 연구대상자의 평균재원일수는 5.5일 이었다. 학령기(7-12세)기 아동이 학령전기(0-6세)보다 재원일수가 길었으며, 진료비 지불방법이 의료급여 및 기타보험 환자가 재원일수가 길었다. 의료기관 소재지가 수도권보다 비수도권(전라도, 경상도)일 때, 병상규모가 100-299병상인 경우 재원일수가 길었다. 내원경로는 외래인 경우 재원일수가 짧았고, 손상기전이 운수사고, 화상인 경우 재원일수가 길었다. 부진단이 있고, 주수술을 시행한 경우 재원일수가 길었으며, 퇴원후 방향이 사망인 경우 재원일수가 길게 나타났다. 이 연구는 전국 단위 자료인 퇴원손상심층조사 자료를 이용하여 우리나라 어린이 손상환자의 재원일수의 특성 및 결정요인을 파악하였다는 점에서 의의를 갖는다. 또한, 안전교육 및 예방 활동만으로도 발생을 줄일 수 있는 어린이 손상의 관련 요인 대한 적극적인 치료와 다양한 예방정책 마련을 위한 기초 자료를 제공했다는 점에서 의의가 있다.

우리나라 생활안전영역의 비의도적 손상 발생률 및 발생 양상 (The Incidence and Patterns of Unintentional Injuries in Daily Life in Korea: A Nationwide Study)

  • 박건희;은상준;이은정;이채은;박두용;한경훈;김윤;이진석
    • Journal of Preventive Medicine and Public Health
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    • 제41권4호
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    • pp.265-271
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    • 2008
  • Objectives: This study was conducted to estimate the cumulative incidence rate (CIR) of unintentional injuries in Korean daily life and to describe the pattern of unintentional injuries. Methods: The study population was the people who used the National Health Insurance because of injuries (ICD code: S00$\sim$T98) during 2006. The stratified sample according to gender, age and the severity of injury (NISS, New Injury Severity Score) was randomly selected. The questions on the questionnaire were developed as a reference for an international classification tool (ICECI, International Classification of External Causes of Injury). The questions included the locations of injury, the mechanisms of injury and the results of injury. Moreover, we used age, gender, region and income variables for analysis. Results: The CIR of unintentional injuries that occurred in daily life for 1 year per 100,000 persons was 17,606, and the CIR of severe injuries was 286. Many injuries were occurred at home (29.6%), public places (19.0%), school (13.7%) and near home (12.0%). The major mechanisms of injuries were slipping (48.8%), contact (14.0%), physical over-exertion (13.8%), and fall (6.6%). Infants and old aged people were vulnerable to injuries, and those who lived rural area and who were in a low income level were vulnerable too. Conclusions: We signified the risk groups and risk settings of unintentional injuries in Korean daily life. These results could contribute to establishing strategies for injury prevention and implementing these strategies.

역도(力道)선수에서 견관절 질환 (The Weight Lifters' Shoulder)

  • 전인호;경희수
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.73-80
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    • 2002
  • Purpose: Weight lifting is a good training to control body weight, to correct body shape and to relieve stress. How-ever if the training is continued by inadequate training method and technique, the risks of the shoulder injuries are relatively high. Main Subject: The rotator cuff injury is the most common disorder to wright lifters and often results from the train- ing program of upright row, military press and pectoral deck. The chances of subacromial impingement in these postures are high because the shoulder rotates under the acromion at 90 abduction state. Shoulder instability in weight lifters can develop due to various causes. aepeated microtrauma and excessive abduction and external rotation may result in laxity of the anterior capsular structure, ligament and muscles. Behind the neck and bench press are high risk training postures. Other than those injuries, idiopathic osteolysis of distal clavicle, acromioclavicular separation, pectoralis major muscle rupture, and triceps muscle rupture nay develop. Conclusion: The best treatment option of the shoulder injury to weight lifters is to eliminate the possible risk elements for the weight lifters in training program and to provide proper and prompt treatment as soon as possible.