J Korean Neurosurg Soc.  2025 Jan;68(1):25-36. 10.3340/jkns.2024.0156.

Introduction to the Korean Neurotrauma Data Bank System and Report on the Results of the Second Project

Affiliations
  • 1Department of Anesthesiology and pain medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Neurosurgery, Wonkwang University Hospital, Institute of Wonkwang Medical Science, Iksan, Korea
  • 3Korea Neuro-Trauma Data Bank Committee, Korean Neurotraumatology Society, Seoul, Korea

Abstract


Objective
: In 2006, the Korean Neurotraumatology Society (KNTS) established the 1st Korean Neurotrauma Data Bank Committee (KNTDBC) and developed the Korean Neurotrauma Data Bank System (KNTDBS). Full-scale registration of traumatic brain injury (TBI) patient data began in September 2010. Since then, KNTS has conducted two trauma-related data registration projects and is now in its 5th term of the KNTDBC. This study aimed to introduce the KNTDBS of the KNTS and report the results of the second project.
Methods
: Between January 2018 and June 2021, 1109 TBI patients were registered from 18 hospitals. The inclusion criteria were 1) patients who visited the hospital with TBI, 2) patients with severe TBI with a Glasgow coma scale (GCS) score of 8 or lower, and 3) adult patients aged 19 years or older. Exclusion criteria were 1) patients under 18 years of age, 2) patients with a GCS score of 9 or higher, and 3) patients with a history of previous craniotomy or craniectomy. Data from the second project were registered into seven major categories : patient registration, neuroimaging, neuromonitoring, hypothermia, surgical treatment, medical treatment, and patient evaluation.
Results
: The characteristics of TBI patients in this study were not significantly different from those in previous studies, including the 1st project of KNTS. The GCS had a large number of severe patients with scores of 3 and 4, which was associated with the highest proportion of patients having bilateral pupils with unrecordable responses. Most TBI patients had severe or critical injuries (score 4 or 5) concentrated in the Abbreviated incentive scale head but had minor injuries to other regions of the body. Rotterdam computed tomography scores of 5 and 6 primarily indicated acute subdural hematomas. Surgical treatment was performed in 36.2% of all TBI cases. Most hospitals used levetiracetam and valproate as prophylactic antiepileptic drugs. Neuromonitoring, hypothermia, and coma therapy were not actively performed. The overall mortality rate was 33.3%, and among 740 survivors, 3.9% underwent shunt surgery.
Conclusion
: The creation of a database for TBI patient data facilitated the collection of objective and valid information on trauma. Utilizing data from the KNTDBS will significantly aid in the treatment and prevention of TBI and contribute to the improvement of healthcare in the country.

Keyword

Korean Neurotraumatology Society; Neurotrauma Data Bank System; Traumatic brain injury; Health care

Figure

  • Fig. 1. Number of patients registered at each university hospital.

  • Fig. 2. Comparison of the first and second project of the Korean Neurotraumatology Society. TBI : traumatic brain injury, GCS : Glasgow coma scale, C-SDH : chronic subdural hematoma.

  • Fig. 3. Percentage of hematological abnormalities in the emergency room for 907 patients. CPK : creatine phosphokinase, BUN : blood urea nitrogen, CRP : C-reactive protein, PT : prothrombin time, INR : international normalized ratio, ALT : alanine transaminase, LDH : lactate dehydrogenase, AST : aspartate transaminase, WBC : white blood cell.

  • Fig. 4. Injury sites of patients with diffuse axonal injury.

  • Fig. 5. Number of patients who used AEDs. i.v. : intravenous, AED : antiepileptic drug.


Reference

References

1. Carney N, Totten AM, O’Reilly C, Ullman JS, Hawryluk GW, Bell MJ, et al. Guidelines for the management of severe traumatic brain injury, fourth edition. Neurosurgery. 80:6–15. 2017.
Article
2. Chang BS, Lowenstein DH; Quality Standards Subcommittee of the American Academy of Neurology. Practice parameter: antiepileptic drug prophylaxis in severe traumatic brain injury: report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology. 60:10–16. 2003.
Article
3. Corbett JM, Ho KM, Honeybul S. Prognostic significance of abnormal hematological parameters in severe traumatic brain injury requiring decompressive craniectomy. J Neurosurg. 132:545–551. 2019.
Article
4. Eom KS. Epidemiology and outcomes of traumatic brain injury in elderly population : a multicenter analysis using Korean Neuro-Trauma Data Bank System 2010-2014. J Korean Neurosurg Soc. 62:243–255. 2019.
Article
5. Helmy A, Kirkpatrick PJ, Seeley HM, Corteen E, Menon DK, Hutchinson PJ. Fixed, dilated pupils following traumatic brain injury: historical perspectives, causes and ophthalmological sequelae. Acta Neurochir Suppl. 114:295–299. 2012.
Article
6. Huang YH, Deng YH, Lee TC, Chen WF. Rotterdam computed tomography score as a prognosticator in head-injured patients undergoing decompressive craniectomy. Neurosurgery. 71:80–85. 2012.
Article
7. Kim HS, Lee SU, Cha JH, Heo W, Song JS, Kim SJ. Clinical analysis of results of shunt operation for hydrocephalus following traumatic brain injury. Korean J Neurotrauma. 11:58–62. 2015.
Article
8. Lee SK; Korean Trauma Data Bank Committee. Understandings and key elements of trauma data bank system. Korean J Nutr. 8:1–9. 2012.
Article
9. Maas AI, Hukkelhoven CW, Marshall LF, Steyerberg EW. Prediction of outcome in traumatic brain injury with computed tomographic characteristics: a comparison between the computed tomographic classification and combinations of computed tomographic predictors. Neurosurgery. 57:1173–1182. 2005.
Article
10. Marshall LF, Becker DP, Bowers SA, Cayard C, Eisenberg H, Gross CR, et al. The National Traumatic Coma Data Bank. Part 1: design, purpose, goals, and results. J Neurosurg. 59:276–284. 1983.
11. Nakamura N, Yamaura A, Shigemori M, Ogawa T, Tokutomi T, Ono J, et al. Final report of the Japan Neurotrauma Data Bank project 1998-2001: 1,002 cases of traumatic brain injury. Neurol Med Chir (Tokyo). 46:567–574. 2006.
Article
12. Song SY, Lee SK, Eom KS; KNTDB Investigators. Analysis of mortality and epidemiology in 2617 cases of traumatic brain injury : Korean Neuro-Trauma Data Bank System 2010-2014. J Korean Neurosurg Soc. 59:485–491. 2016.
Article
13. Wilson L, Boase K, Nelson LD, Temkin NR, Giacino JT, Markowitz AJ, et al. A manual for the glasgow outcome scale-extended interview. J Neurotrauma. 38:2435–2446. 2021.
Article
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