PARK Index for Preventable Major Trauma Death Rate

Abstract Background: Although Korea is a high-income country, its trauma system is comparable to low- and middle-income countries with high preventable trauma death rates (> 30%). Since 2012, Korea has established a national trauma system based on the implementation of regional trauma centers and improvement of the transfer system; this study aimed to evaluate its effectiveness.Methods: We compared the national preventable trauma death rates, transfer patterns, and outcomes between 2015 and 2017. The review of preventable trauma deaths was conducted by multiple panels and a severity-adjusted logistic regression model was created to identify factors influencing the preventable trauma death rate. We also compared the number of trauma patients transferred to emergency medical institutions and mortality in models adjusted with injury severity scores.Results: The preventable trauma death rate decreased from 2015 to 2017 (30.5% vs. 19.9%, p < 0.001). In the severity-adjusted model, the preventable trauma death risk had a lower odds ratio (0.68, 95% confidence interval: 0.53–0.87, p = 0.002) in 2017 than in 2015. Regional trauma centers received 1.6 times more severe cases in 2017 (according to the International Classification of Diseases Injury Severity Score [ICISS]; 23.1% vs. 36.5%). In the extended ICISS model, the overall trauma mortality decreased significantly from 2.1% (1008/47806) to 1.9% (1062/55057) (p = 0.041).Conclusions: Establishment of the national trauma system was associated with significant improvements in performance and outcomes of trauma care. This was mainly because of the implementation of regional trauma centers and because more severe patients were transferred to regional trauma centers. This study might be a good model for low- and middle-income countries, which lack a trauma system.

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Preventable trauma death rate in Daegu, South Korea

Clinical and Experimental Emergency Medicine ◽

10.15441/ceem.15.085 ◽

2015 ◽

Vol 2 (4) ◽

pp. 236-243 ◽

Cited By ~ 4

Author(s):

Sungbae Moon ◽

Suk Hee Lee ◽

Hyun Wook Ryoo ◽

Jong Kun Kim ◽

Jae Yun Ahn ◽

...

Keyword(s):

South Korea ◽

Death Rate ◽

Trauma Death

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National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea

PLOS Global Public Health ◽

10.1371/journal.pgph.0000162 ◽

2022 ◽

Vol 2 (1) ◽

pp. e0000162

Author(s):

Kyoungwon Jung ◽

Junsik Kwon ◽

Yo Huh ◽

Jonghwan Moon ◽

Kyungjin Hwang ◽

...

Keyword(s):

South Korea ◽

Death Rate ◽

Injury Severity ◽

Trauma System ◽

Trauma Centers ◽

Middle Income ◽

Death Rates ◽

Middle Income Countries ◽

National Trauma ◽

Trauma Death

Although South Korea is a high-income country, its trauma system is comparable to low- and middle-income countries with high preventable trauma death rates of more than 30%. Since 2012, South Korea has established a national trauma system based on the implementation of regional trauma centers and improvement of the transfer system; this study aimed to evaluate its effectiveness. We compared the national preventable trauma death rates, transfer patterns, and outcomes between 2015 and 2017. The review of preventable trauma deaths was conducted by multiple panels, and a severity-adjusted logistic regression model was created to identify factors influencing the preventable trauma death rate. We also compared the number of trauma patients transferred to emergency medical institutions and mortality in models adjusted with injury severity scores. The preventable trauma death rate decreased from 2015 to 2017 (30.5% vs. 19.9%, p < 0.001). In the severity-adjusted model, the preventable trauma death risk had a lower odds ratio (0.68, 95% confidence interval: 0.53–0.87, p = 0.002) in 2017 than in 2015. Regional trauma centers received 1.6 times more severe cases in 2017 (according to the International Classification of Diseases Injury Severity Score [ICISS]; 23.1% vs. 36.5%). In the extended ICISS model, the overall trauma mortality decreased significantly from 2.1% (1008/47 806) to 1.9% (1062/55 057) (p = 0.041). The establishment of the national trauma system was associated with significant improvements in the performance and outcomes of trauma care. This was mainly because of the implementation of regional trauma centers and because more severe patients were transferred to regional trauma centers. This study might be a good model for low- and middle-income countries, which lack a trauma system.

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Systematic Preventable Trauma Death Rate Survey to Establish the Region-based Inclusive Trauma System in a Representative Province of Korea

Journal of Korean Medical Science ◽

10.3346/jkms.2020.35.e417 ◽

2020 ◽

Vol 35 (50) ◽

Author(s):

Junsik Kwon ◽

Jin-Hee Lee ◽

Kyungjin Hwang ◽

Yunjung Heo ◽

Hang Joo Cho ◽

...

Keyword(s):

Death Rate ◽

Trauma System ◽

Trauma Death

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Preventable Trauma Death Rate after Establishing a National Trauma System in Korea

Journal of Korean Medical Science ◽

10.3346/jkms.2019.34.e65 ◽

2019 ◽

Vol 34 (8) ◽

Cited By ~ 5

Author(s):

Kyoungwon Jung ◽

Ikhan Kim ◽

Sue K. Park ◽

Hyunmin Cho ◽

Chan Yong Park ◽

...

Keyword(s):

Death Rate ◽

Trauma System ◽

National Trauma ◽

Trauma Death

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Methodology to reliably measure preventable trauma death rate

Trauma Surgery & Acute Care Open ◽

10.1136/tsaco-2017-000106 ◽

2017 ◽

Vol 2 (1) ◽

pp. e000106 ◽

Cited By ~ 6

Author(s):

Stacy A Drake ◽

Dwayne A Wolf ◽

Janet C Meininger ◽

Stanley G Cron ◽

Thomas Reynold ◽

...

Keyword(s):

Death Rate ◽

Trauma Death

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Ten-Year Incidence of Sport and Recreation Injuries Resulting in Major Trauma or Death in Victoria, Australia, 2005-2015

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118757502 ◽

2018 ◽

Vol 6 (3) ◽

pp. 232596711875750 ◽

Cited By ~ 4

Author(s):

Christina L. Ekegren ◽

Ben Beck ◽

Pamela M. Simpson ◽

Belinda J. Gabbe

Keyword(s):

Death Rate ◽

Major Trauma ◽

Sports Injuries ◽

Extended Period ◽

Population Level ◽

Hospital Deaths ◽

Incident Rate ◽

Sport And Recreation ◽

Motor Sports ◽

Active Recreation

Background: Sports injuries that result in major trauma or death are associated with significant health care burden and societal costs. An understanding of changes in injury trends, and their drivers, is needed to implement policy aimed at risk reduction and injury prevention. To date, population-level reporting has not been available regarding trends in serious sport and recreation injuries anywhere in Australia over such an extended period, nor have any studies of this length captured comprehensive, long-term data on all sports-related major trauma internationally. Purpose: To describe the incidence of sport and active recreation injuries resulting in major trauma or death over a 10-year period (July 2005 to June 2015) in the state of Victoria, Australia. Study Design: Descriptive epidemiological study. Methods: All sport and active recreation–related major trauma cases and deaths in Victoria, Australia, over a 10-year period were extracted from the population-level Victorian State Trauma Registry and the National Coroners Information System. Poisson regression analysis was used to examine trends in the incidence of sport and active recreation–related major trauma and death. Results: The 10-year study period entailed 2847 nonfatal major trauma cases and 614 deaths (including 96 in-hospital deaths). The highest frequencies of major trauma cases and deaths were in cycling, motor sports, and equestrian activities. The participation-adjusted major trauma and death rate was 12.2 per 100,000 participants per year over the study period. An 8% increase was noted in the rate of nonfatal major trauma (incident rate ratio [IRR], 1.08; 95% CI, 1.06-1.10; P < .001) and a 7% decrease in the death rate (IRR, 0.93; 95% CI, 0.90-0.97; P < .001). Significant increases were found in the rates of major trauma (including deaths) in equestrian activities, motor sports, and cycling. Conclusion: The death rate from sport and active recreation decreased by more than half over the course of 10 years in Victoria, while the rate of nonfatal major trauma almost doubled. This increase is largely attributable to equestrian activities, motor sports, and cycling. Study findings highlight the need to prioritize investments in the prevention of trauma in these activities.

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