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Comparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States

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dc.contributor.authorJung, K-
dc.contributor.authorMatsumoto, S-
dc.contributor.authorSmith, A-
dc.contributor.authorHwang, K-
dc.contributor.authorLee, JC-
dc.contributor.authorCoimbra, R-
dc.date.accessioned2019-11-13T04:27:49Z-
dc.date.available2019-11-13T04:27:49Z-
dc.date.issued2018-
dc.identifier.issn0039-6060-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/17621-
dc.description.abstractBACKGROUND: The South Korean government recently developed a master plan for establishing a national trauma system based on the implementation of regional trauma centers. We aimed to compare outcomes between severely injured patients treated at a recently established South Korean trauma center and matched patients treated in American level-1 trauma centers.
METHODS: Two cohorts were selected from an institutional trauma database at Ajou University Medical Center (AUMC) and the American National Trauma Data Bank. Adult patients with an Injury Severity Score of >/=9 were included. Patients were matched based on covariates that affect mortality, using 1:1 propensity score matching. We compared outcomes between the two datasets and performed survival analyses.
RESULTS: We created 1,451 and 2,103 matched pairs for the pre-trauma center and post-trauma center periods, respectively. The in-hospital mortality rate was higher in the institutional trauma database pre-trauma center period compared with the American National Trauma Data Bank (11.6% versus 8.1%, P<.001). However, the mortality rate decreased in the institutional trauma database post-trauma center period and was similar to that in the American National Trauma Data Bank (6.9% versus 6.8%, P=.903). Being treated at Ajou University Medical Center Trauma Center was significantly associated with higher mortality during the pre-trauma center period (OR: 1.842, 95% CI: 1.336-2.540: P<.001), although no significant association was observed during the post-trauma center period (OR: 1.102, 95% CI: 0.827-1.468: P=.509).
CONCLUSION: The mortality rate improved after a trauma center was established in a South Korean hospital and is similar to that from matched cases treated at American level-1 trauma centers. Thus, creating trauma centers and a regional trauma system may improve outcomes in major trauma cases.
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dc.language.isoen-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHDatabases, Factual-
dc.subject.MESHFemale-
dc.subject.MESHHospital Mortality-
dc.subject.MESHHospitalization-
dc.subject.MESHHumans-
dc.subject.MESHInjury Severity Score-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHPropensity Score-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRetrospective Studies-
dc.subject.MESHSurvival Analysis-
dc.subject.MESHSurvival Rate-
dc.subject.MESHTrauma Centers-
dc.subject.MESHTreatment Outcome-
dc.subject.MESHUnited States-
dc.subject.MESHWounds and Injuries-
dc.titleComparison of outcomes in severely injured patients between a South Korean trauma center and matched patients treated in the United States-
dc.typeArticle-
dc.identifier.pmid29884477-
dc.contributor.affiliatedAuthor정, 경원-
dc.contributor.affiliatedAuthor이, 국종-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.surg.2018.04.031-
dc.citation.titleSurgery-
dc.citation.volume164-
dc.citation.number3-
dc.citation.date2018-
dc.citation.startPage482-
dc.citation.endPage488-
dc.identifier.bibliographicCitationSurgery, 164(3). : 482-488, 2018-
dc.embargo.liftdate9999-12-31-
dc.embargo.terms9999-12-31-
dc.identifier.eissn1532-7361-
dc.relation.journalidJ000396060-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Surgery
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