An analysis of missed injuries in patients with severe trauma
Purpose To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys. Methods We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1...
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| Format: | Article |
| Language: | English |
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Korean Society of Traumatology
2022-12-01
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| Series: | Journal of Trauma and Injury |
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| Online Access: | http://jtraumainj.org/upload/pdf/jti-2022-0017.pdf |
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| _version_ | 1841527085986742272 |
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| author | EunGyu Ju Sun Young Baek Sung Soo Hong Younghwan Kim Seok Hwa Youn |
| author_facet | EunGyu Ju Sun Young Baek Sung Soo Hong Younghwan Kim Seok Hwa Youn |
| author_sort | EunGyu Ju |
| collection | DOAJ |
| description | Purpose To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys. Methods We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1, 2019 to June 30, 2021. Results In trauma patients with an Injury Severity Score ≥16 accounted for 27.5% in the non-missed injury group (non-MIG), but this rate was considerably higher at 71.2% in MIG. The mean hospitalization longer in MIG (50.90±39.56) than in non-MIG (24.74±26.11). The proportion of patients with missed injuries detected through tertiary trauma survey (TTS) was 28 patients (23.5%) within 24 hours, 90 patients (75.6%) after 24 hours to before discharge. The majority of missed injuries were fractures (82.4%) and ligament tears (8.4%), which required consultation with the orthopedic department. The final diagnoses of missed injuries were confirmed by computed tomography (44.5%), magnetic resonance imaging (19.3%), X-ray (19.3%), bone scan (11.8%), and physical examination (5.0%). Conclusions TTS is considered a useful process for detecting missed injuries that were not identified at the time of initial resuscitation in the primary and secondary surveys. In the future, to detect missed injuries quickly, it is necessary to develop a suitable TTS program for each trauma center. In addition, further research is needed to verify the effectiveness of the protocolized TTS and survey chart to improve the effectiveness of TTS. |
| format | Article |
| id | doaj-art-396f64376e094d80a4fb76c80c54c8c3 |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-396f64376e094d80a4fb76c80c54c8c32025-01-16T04:54:53ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832022-12-0135424825410.20408/jti.2022.00171212An analysis of missed injuries in patients with severe traumaEunGyu Ju0Sun Young Baek1Sung Soo Hong2Younghwan Kim3Seok Hwa Youn4 National Trauma Center, National Medical Center, Seoul, Korea Department of Surgery, National Trauma Center, National Medical Center, Seoul, Korea Department of Surgery, National Trauma Center, National Medical Center, Seoul, Korea Department of Surgery, National Trauma Center, National Medical Center, Seoul, Korea Department of Surgery, National Trauma Center, National Medical Center, Seoul, KoreaPurpose To analyze the data of trauma patients with undetected injuries at the time of initial resuscitation during the primary and secondary surveys. Methods We retrospectively reviewed the medical records of 807 patients who were hospitalized at the National Trauma Center, Seoul, Korea from June 1, 2019 to June 30, 2021. Results In trauma patients with an Injury Severity Score ≥16 accounted for 27.5% in the non-missed injury group (non-MIG), but this rate was considerably higher at 71.2% in MIG. The mean hospitalization longer in MIG (50.90±39.56) than in non-MIG (24.74±26.11). The proportion of patients with missed injuries detected through tertiary trauma survey (TTS) was 28 patients (23.5%) within 24 hours, 90 patients (75.6%) after 24 hours to before discharge. The majority of missed injuries were fractures (82.4%) and ligament tears (8.4%), which required consultation with the orthopedic department. The final diagnoses of missed injuries were confirmed by computed tomography (44.5%), magnetic resonance imaging (19.3%), X-ray (19.3%), bone scan (11.8%), and physical examination (5.0%). Conclusions TTS is considered a useful process for detecting missed injuries that were not identified at the time of initial resuscitation in the primary and secondary surveys. In the future, to detect missed injuries quickly, it is necessary to develop a suitable TTS program for each trauma center. In addition, further research is needed to verify the effectiveness of the protocolized TTS and survey chart to improve the effectiveness of TTS.http://jtraumainj.org/upload/pdf/jti-2022-0017.pdfwounds and injuriesinjury severity scorecritical caremissed diagnosis |
| spellingShingle | EunGyu Ju Sun Young Baek Sung Soo Hong Younghwan Kim Seok Hwa Youn An analysis of missed injuries in patients with severe trauma Journal of Trauma and Injury wounds and injuries injury severity score critical care missed diagnosis |
| title | An analysis of missed injuries in patients with severe trauma |
| title_full | An analysis of missed injuries in patients with severe trauma |
| title_fullStr | An analysis of missed injuries in patients with severe trauma |
| title_full_unstemmed | An analysis of missed injuries in patients with severe trauma |
| title_short | An analysis of missed injuries in patients with severe trauma |
| title_sort | analysis of missed injuries in patients with severe trauma |
| topic | wounds and injuries injury severity score critical care missed diagnosis |
| url | http://jtraumainj.org/upload/pdf/jti-2022-0017.pdf |
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