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Effectiveness after Designation of a Trauma Center: Experience with Operating a Trauma Team at a Private Hospital
J Trauma Inj -0001;():-
Published online December 28, 2018
© 2018 The Korean Society of Trauma.

Kyoung Hwan Kim, M.D., Sung Ho Han, M.D., Soon-Ho Chon, M.D., Joongsuck Kim, M.D., Oh Sang Kwon, M.D., Min Koo Lee, M.D., Hohyoung Lee, M.D.

Department of Trauma Surgery, Trauma Center, Cheju Halla General Hospital, Jeju, Korea
Correspondence to: Kyoung Hwan Kim, M.D.
Department of Trauma Surgery, Trauma center, Cheju Halla General Hospital, 65 Doryeong-ro, Jeju 63127, Korea
Tel: +82-64-740-5690
Fax: +82-64-743-3110
Received November 26, 2018; Accepted December 19, 2018.
Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region.
Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups.
Results: No significant differences were found in the annual patients’ average age (54.1±20.0 vs. 52.8±18.2, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958).
Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.
Keywords : Trauma center; Injury severity score; Mortality

March 2020, 33 (1)
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