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Changes in Preventable Death Rates and Traumatic Care Systems in Korea

Other Title
한국의 예방 가능 외상 사망률과 외상 처치 체계의 변화
Authors
김, 현; 정, 구영; 김, 선표; 김, 선휴; 노, 현; 장, 혜영; 윤, 한덕; 허, 윤정; 류, 현호; 정, 태오; 황, 용; 주, 정민; 주, 명돈; 한, 상균; 조, 광원; 최, 기훈; 박, 준민; 정, 현민; 이, 수복; 경, 연영; 유, 지영; 전, 우찬; 안, 지윤; 이, 장영; 지, 호진; 이, 태헌; 김, 오현; 차, 용성; 차, 경철; 이, 강현; 황, 성오
Citation
Taehan Ŭnggup Ŭihakhoe chi, 23(2):189-197, 2012
Journal Title
Taehan Ŭnggup Ŭihakhoe chi; Journal of the Korean Society of Emergency Medicine; 대한응급의학회지
ISSN
1226-4334
Abstract
Purpose: This study was performed in order to determine the changes over time in preventable and potentially preventable traumatic death rates, and to assess the factors that affected the deaths of trauma patients which occurred in Korean pre-hospital and hospital settings.



Methods: All trauma deaths occurring either in the emergency department (ED) or after admission at twenty Korean hospitals between August 2009 and July 2010 were retrospectively analyzed. The deaths were initially reviewed by a team of multidisciplinary specialists and classified into nonpreventable, potentially preventable, and preventable deaths. Only preventable and potentially preventable deaths were the subject of our analysis. Structured data extraction included patient demographics, vital signs, injury severity, probability of survival, preventability of mortality, reported errors in the evaluation and management of the patient, and classification of error types (system, judgment, knowledge).



Results: During the study period, 446 trauma victims died in the ED or within 7 days after admission. The mean age was 52 years, 74.1% were men and the mean time from injury to death was 35.6 hours. The most common cause of death was head injury (44.7%) followed by hemorrhage 30.8%) and multi-organ failure (8.0%). The rates of preventable/ potentially preventable deaths were 35.2% overall and 29.8% when limited to patients surviving to admission. Of all death classifications, 31.2% were potentially preventable and 4.0% were preventable. Errors leading to preventable death occurred in the emergency department 51.2%), pre-hospital setting (30.3%) and during inter-hospital transfer (60.8%). Most errors were related to clinical management (48.4%) and structural problems in the emergency medical system (36.5%).



Conclusion: The preventable death rates for Korean trauma victims were higher than those found in other developed countries, possibly due to poorly established emergency medical systems for trauma victims in pre-hospital and hospital settings. A system wide approach based on the emergency medical system and well-developed in-hospital trauma teams should be adopted in order to improve the quality of care of trauma victims in Korea.
Keywords
InjuriesEmergency medical servicesDeath
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Medical Humanities & Social Medicine
AJOU Authors
허, 윤정
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