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

• Published in: Journal of Korean medical science Vol. 35; no. 50; pp. e417 - 13
• Main Authors: Kwon, Junsik, Lee, Jin-Hee, Hwang, Kyungjin, Heo, Yunjung, Cho, Hang Joo, Lee, John Cook-Jong, Jung, Kyoungwon
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Academy of Medical Sciences 28.12.2020; 대한의학회
• Subjects: Original; 의학일반; Trauma Center; Trauma System; Injuries and Wounds; Preventable Death Rate; Province; Korea
• ISSN: 1011-8934; 1598-6357; 1598-6357
• DOI: 10.3346/jkms.2020.35.e417

Trauma mortality review is the first step in assessing the quality of the trauma treatment system and provides an important basis for establishing a regional inclusive trauma system. This study aimed to obtain a reliable measure of the preventable trauma death rate in a single province in Korea. From January to December 2017, a total of 500 sample cases of trauma-related deaths from 64 hospitals in Gyeonggi Province were included. All cases were evaluated for preventability and opportunities for improvement using a multidisciplinary panel review approach. Overall, 337 cases were included in the calculation for the preventable trauma death rate. The preventable trauma death rate was estimated at 17.0%. The odds ratio was 3.97 folds higher for those who arrived within "1-3 hours" than those who arrived within "1 hour." When the final treatment institution was not a regional trauma center, the odds ratio was 2.39 folds higher than that of a regional trauma center. The most significant stage of preventable trauma death was the hospital stage, during which 86.7% of the cases occurred, of which only 10.3% occurred in the regional trauma center, whereas preventable trauma death was more of a problem at emergency medical institutions. The preventable trauma death rate was slightly lower in this study than in previous studies, although several problems were noted during inter-hospital transfer; in the hospital stage, more problems were noted at emergency medical care facilities than at regional trauma centers. Further, several opportunities for improvements were discovered regarding bleeding control.