National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea
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 im...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLOS Global Public Health |
| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021375/?tool=EBI |
| _version_ | 1827827275349884928 |
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| author | Kyoungwon Jung Junsik Kwon Yo Huh Jonghwan Moon Kyungjin Hwang Hyun Min Cho Jae Hun Kim Chan Ik Park Jung-Ho Yun Oh Hyun Kim Kee-Jae Lee Sunworl Kim Borami Lim Yoon Kim |
| author_facet | Kyoungwon Jung Junsik Kwon Yo Huh Jonghwan Moon Kyungjin Hwang Hyun Min Cho Jae Hun Kim Chan Ik Park Jung-Ho Yun Oh Hyun Kim Kee-Jae Lee Sunworl Kim Borami Lim Yoon Kim |
| author_sort | Kyoungwon Jung |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-12T03:24:14Z |
| format | Article |
| id | doaj.art-a29f475b0a734f0aa51c33d05db10ef5 |
| institution | Directory Open Access Journal |
| issn | 2767-3375 |
| language | English |
| last_indexed | 2024-03-12T03:24:14Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLOS Global Public Health |
| spelling | doaj.art-a29f475b0a734f0aa51c33d05db10ef52023-09-03T13:44:11ZengPublic Library of Science (PLoS)PLOS Global Public Health2767-33752022-01-0121National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South KoreaKyoungwon JungJunsik KwonYo HuhJonghwan MoonKyungjin HwangHyun Min ChoJae Hun KimChan Ik ParkJung-Ho YunOh Hyun KimKee-Jae LeeSunworl KimBorami LimYoon KimAlthough 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.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021375/?tool=EBI |
| spellingShingle | Kyoungwon Jung Junsik Kwon Yo Huh Jonghwan Moon Kyungjin Hwang Hyun Min Cho Jae Hun Kim Chan Ik Park Jung-Ho Yun Oh Hyun Kim Kee-Jae Lee Sunworl Kim Borami Lim Yoon Kim 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 |
| title | National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea |
| title_full | National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea |
| title_fullStr | National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea |
| title_full_unstemmed | National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea |
| title_short | National trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care: A follow-up observational study in South Korea |
| title_sort | national trauma system establishment based on implementation of regional trauma centers improves outcomes of trauma care a follow up observational study in south korea |
| url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10021375/?tool=EBI |
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