Impact of Qualified Trauma Center Implementation on Mortality From Severe Trauma in Korea: A Retrospective Cohort Study.

IF 2.3 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Junsik Kwon, Myeonggyun Lee, Seoyoung Song, Sora Kim, Jonghwan Moon, Yo Huh, Kyoungwon Jung
{"title":"Impact of Qualified Trauma Center Implementation on Mortality From Severe Trauma in Korea: A Retrospective Cohort Study.","authors":"Junsik Kwon, Myeonggyun Lee, Seoyoung Song, Sora Kim, Jonghwan Moon, Yo Huh, Kyoungwon Jung","doi":"10.3346/jkms.2025.40.e196","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The Korean government and experts initiated a national trauma system development project in 2012. Its first major initiative was establishing and operating regional trauma centers across the country. We assessed whether the severity-adjusted mortality rates were lower in trauma centers compared with non-trauma centers and the specific benefits of trauma centers for patients with trauma.</p><p><strong>Methods: </strong>This retrospective cohort study analyzed the data of patients with trauma registered in the National Emergency Department Information System from 2015 to 2019. Additionally, we used the Korean Trauma Data Bank and trauma center status data provided by the Ministry of Health and Welfare. We focused on patients with survival probabilities of < 0.5 according to the International Classification of Diseases Injury Severity Score, 9th Edition. The severity-adjusted mortality rates between the trauma centers and non-trauma centers were compared.</p><p><strong>Results: </strong>The 7 qualified trauma centers had notably more younger patients with penetrating injuries than the non-trauma centers. Patients admitted to the trauma centers had more critical vital signs and a higher incidence of reduced consciousness than those admitted to the non-trauma centers. After adjusting for severity, the in-hospital mortality rates were significantly lower in the trauma centers than in the non-trauma centers (16.9% vs. 18.2%; relative risk, 0.933; 95% confidence interval, 0.874-0.997). Patients in shock conditions had significantly lower mortality rates when treated in trauma centers. The disparity in cumulative mortality rates between the trauma centers and non-trauma centers was most pronounced 2 days post-admission.</p><p><strong>Conclusion: </strong>This study confirmed that the national project for establishing regional trauma centers effectively reduced mortality rates among severely injured patients.</p><p><strong>Trial registration: </strong>Clinical Research Information Service Identifier: KCT0009684.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 32","pages":"e196"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12360909/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Korean Medical Science","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3346/jkms.2025.40.e196","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: The Korean government and experts initiated a national trauma system development project in 2012. Its first major initiative was establishing and operating regional trauma centers across the country. We assessed whether the severity-adjusted mortality rates were lower in trauma centers compared with non-trauma centers and the specific benefits of trauma centers for patients with trauma.

Methods: This retrospective cohort study analyzed the data of patients with trauma registered in the National Emergency Department Information System from 2015 to 2019. Additionally, we used the Korean Trauma Data Bank and trauma center status data provided by the Ministry of Health and Welfare. We focused on patients with survival probabilities of < 0.5 according to the International Classification of Diseases Injury Severity Score, 9th Edition. The severity-adjusted mortality rates between the trauma centers and non-trauma centers were compared.

Results: The 7 qualified trauma centers had notably more younger patients with penetrating injuries than the non-trauma centers. Patients admitted to the trauma centers had more critical vital signs and a higher incidence of reduced consciousness than those admitted to the non-trauma centers. After adjusting for severity, the in-hospital mortality rates were significantly lower in the trauma centers than in the non-trauma centers (16.9% vs. 18.2%; relative risk, 0.933; 95% confidence interval, 0.874-0.997). Patients in shock conditions had significantly lower mortality rates when treated in trauma centers. The disparity in cumulative mortality rates between the trauma centers and non-trauma centers was most pronounced 2 days post-admission.

Conclusion: This study confirmed that the national project for establishing regional trauma centers effectively reduced mortality rates among severely injured patients.

Trial registration: Clinical Research Information Service Identifier: KCT0009684.

Abstract Image

Abstract Image

Abstract Image

韩国合格的创伤中心对严重创伤死亡率的影响:一项回顾性队列研究。
背景:韩国政府和专家于2012年启动了国家创伤系统开发项目。它的第一个主要举措是在全国范围内建立和运营区域创伤中心。我们评估了创伤中心的严重校正死亡率是否比非创伤中心低,以及创伤中心对创伤患者的具体益处。方法:本回顾性队列研究分析2015 - 2019年在国家急诊科信息系统登记的创伤患者资料。此外,我们使用韩国创伤数据库和卫生福利部提供的创伤中心状况数据。根据《国际疾病分类损伤严重程度评分》第9版,我们关注的是生存概率< 0.5的患者。比较创伤中心与非创伤中心的严重校正死亡率。结果:7家符合条件的创伤中心较非创伤中心有更多的年轻穿透性损伤患者。创伤中心的患者比非创伤中心的患者有更多的关键生命体征和更高的意识下降发生率。在调整严重程度后,创伤中心的住院死亡率显著低于非创伤中心(16.9%比18.2%;相对危险度为0.933;95%可信区间为0.874-0.997)。在创伤中心接受治疗的休克患者死亡率显著降低。住院后2天,创伤中心和非创伤中心的累积死亡率差异最为明显。结论:本研究证实了国家建立区域创伤中心的项目有效地降低了重伤员的死亡率。试验注册:临床研究信息服务标识:KCT0009684。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Korean Medical Science
Journal of Korean Medical Science 医学-医学:内科
CiteScore
7.80
自引率
8.90%
发文量
320
审稿时长
3-6 weeks
期刊介绍: The Journal of Korean Medical Science (JKMS) is an international, peer-reviewed Open Access journal of medicine published weekly in English. The Journal’s publisher is the Korean Academy of Medical Sciences (KAMS), Korean Medical Association (KMA). JKMS aims to publish evidence-based, scientific research articles from various disciplines of the medical sciences. The Journal welcomes articles of general interest to medical researchers especially when they contain original information. Articles on the clinical evaluation of drugs and other therapies, epidemiologic studies of the general population, studies on pathogenic organisms and toxic materials, and the toxicities and adverse effects of therapeutics are welcome.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信