J Korean Med Sci.
2019 Mar;34(8):e65. 10.3346/jkms.2019.34.e65.
Preventable Trauma Death Rate after Establishing a National Trauma System in Korea
- Affiliations
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- 1Department of Surgery, Ajou University Hospital, Ajou University School of Medicine, Suwon, Korea.
- 2Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea. yoonkim@snu.ac.kr
- 3Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.
- 4Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Korea.
- 5Cancer Research Institute, Seoul National University, Seoul, Korea.
- 6Department of Trauma Surgery, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea.
- 7Department of Trauma Surgery, Wonkwang University Hospital, Iksan, Korea.
- 8Department of Neurosurgery, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Korea.
- 9Department of Emergency Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
- 10Department of Emergency Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea.
- 11Department of Information and Statistics, Korea National Open University, Seoul, Korea.
- 12Department of Emergency Medicine, Seoul National University Hospital, Seoul, Korea.
- 13National Emergency Medical Center, National Medical Center, Seoul, Korea.
- KMID: 2441908
- DOI: http://doi.org/10.3346/jkms.2019.34.e65
Abstract
- BACKGROUND
This study aimed to evaluate the current overall preventable trauma death rate (PTDR) in Korea and identify factors associated with preventable trauma death (PTD).
METHODS
The target sample size for review was designed to be 1,131 deaths in 60 emergency medical institutions nationwide. The panels for the review comprised trauma specialists working at the regional trauma centers (RTCs); a total of 10 teams were formed. The PTDR and factors associated with PTD were analyzed statistically.
RESULTS
Of the target cases, 943 were able to undergo panel review and be analyzed statistically. The PTDR was 30.5% (6.1% preventable and 24.4% possibly preventable). Those treated at a RTC showed a significantly lower PTDR than did those who were not (21.9% vs. 33.9%; P = 0.002). The PTDR was higher when patients were transferred from other hospitals than when they directly visited the last hospital (58.9% vs. 28.4%; P = 0.058; borderline significant). The PTDR increased gradually as the time from accident to death increased; a time of more than one day had a PTDR 14.99 times higher than when transferred within one hour (95% confidence interval, 4.68 to 47.98).
CONCLUSION
Although the PTDR in Korea is still high compared to that in developed countries, it was lower when the time spent from the accident to the death was shorter and the final destined institution was the RTC. To reduce PTDR, it is necessary to make an effort to transfer trauma patients to RTCs directly within an appropriate time.
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