Objectives Severe trauma remains a leading cause of death in the Republic of Korea. In response, regional trauma centers were established in 2012. This study evaluated the impact of direct prehospital transport to trauma centers on in-hospital mortality among patients with severe trauma using the national trauma registry. Methods: This nationwide observational study utilized data from the Korean community-based trauma registry between 2016 and 2020. Patients with an injury severity score >15 who were directly transported from the prehospital setting were included. Variables analyzed encompassed demographics, injury mechanism, transport time, hospital level, and outcomes. The primary outcome was in-hospital mortality. Both logistic regression and decision tree models were employed. Results: A total of 24,567 patients were included. Overall mortality decreased by 5.2% during the study period. Patients transported to level 1 or 2 trauma centers had a lower mortality rate (23.6%) compared to those transported to level 3 or 4 hospitals (28.0%). The proportion of direct transports to high-level centers increased from 46.7% to 64.1% between 2016 and 2020. Despite longer transport times, patients transported to high-level institutions exhibited improved survival, particularly when transport exceeded 30 minutes, suggesting that hospital selection may be more critical than minimizing transport time. Conclusion: Direct transport to high-level trauma centers improves survival among patients with severe trauma, even when transport times are prolonged. These findings support the importance of a well-organized trauma system that emphasizes hospital capability in prehospital triage decisions.
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Han Thi Vo, Tien Duc Dao, Tuyen Van Duong, Tan Thanh Nguyen, Binh Nhu Do, Tinh Xuan Do, Khue Minh Pham, Vinh Hai Vu, Linh Van Pham, Lien Thi Hong Nguyen, Lan Thi Huong Le, Hoang Cong Nguyen, Nga Hoang Dang, Trung Huu Nguyen, Anh The Nguyen, Hoan Van Nguyen, Phuoc Ba Nguyen, Hoai Thi Thanh Nguyen, Thu Thi Minh Pham, Thuy Thi Le, Thao Thi Phuong Nguyen, Cuong Quoc Tran, Kien Trung Nguyen
Osong Public Health Res Perspect 2024;15(1):33-44. Published online February 19, 2024
Objectives The prevalence of posttraumatic stress disorder (PTSD) has increased, particularly among individuals who have recovered from coronavirus disease 2019 (COVID-19) infection. Health literacy is considered a “social vaccine” that helps people respond effectively to the pandemic. We aimed to investigate the association between long COVID-19 and PTSD, and to examine the modifying role of health literacy in this association. Methods: A cross-sectional study was conducted at 18 hospitals and health centers in Vietnam from December 2021 to October 2022. We recruited 4,463 individuals who had recovered from COVID-19 infection for at least 4 weeks. Participants provided information about their sociodemographics, clinical parameters, health-related behaviors, health literacy (using the 12-item short-form health literacy scale), long COVID-19 symptoms and PTSD (Impact Event Scale-Revised score of 33 or higher). Logistic regression models were used to examine associations and interactions. Results: Out of the study sample, 55.9% had long COVID-19 symptoms, and 49.6% had PTSD. Individuals with long COVID-19 symptoms had a higher likelihood of PTSD (odds ratio [OR], 1.86; 95% confidence interval [CI], 1.63–2.12; p<0.001). Higher health literacy was associated with a lower likelihood of PTSD (OR, 0.98; 95% CI, 0.97–0.99; p=0.001). Compared to those without long COVID-19 symptoms and the lowest health literacy score, those with long COVID-19 symptoms and a 1-point health literacy increment had a 3% lower likelihood of PTSD (OR, 0.97; 95% CI, 0.96–0.99; p=0.001). Conclusion: Health literacy was found to be a protective factor against PTSD and modified the negative impact of long COVID-19 symptoms on PTSD.
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Mental health and post-traumatic stress among unprivileged people in the aftermath of COVID-19 pandemic in Southwest Bangladesh: a cross-sectional study Md. Salauddin Khan, Maliha Mahazabin, Ishita Shahid Sams, Lasker Ershad Ali, Umama Khan Cogent Mental Health.2025;[Epub] CrossRef
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The exact factors predicting outcomes following traumatic brain injury (TBI) remain elusive. In this systematic review and meta-analysis, we examined factors influencing outcomes in adult patients with TBI, from 3 months to 1 year after injury. A search of four electronic databases—PubMed, Scopus, Web of Science, and ScienceDirect—yielded 29 studies for review and 16 for meta-analysis, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. In patients with TBI of any severity, mean differences were observed in age (8.72 years; 95% confidence interval [CI], 4.77–12.66 years), lymphocyte count (−0.15 109/L; 95% CI, −0.18 to −0.11), glucose levels (1.20 mmol/L; 95% CI, 0.73–1.68), and haemoglobin levels (−0.91 g/dL; 95% CI, −1.49 to −0.33) between those with favourable and unfavourable outcomes. The prevalence rates of unfavourable outcomes were as follows: abnormal cisterns, 65.7%; intracranial pressure above 20 mmHg, 52.9%; midline shift of 5 mm or more, 63%; hypotension, 71%; hypoxia, 86.8%; blood transfusion, 70.3%; and mechanical ventilation, 90%. Several predictors were strongly associated with outcome. Specifically, age, lymphocyte count, glucose level, haemoglobin level, severity of TBI, pupillary reaction, and type of injury were identified as potential predictors of long-term outcomes.
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Ye Rim Chang, Kyoung Min Kim, Hyo Joung Kim, Dong Hun Kim, Jeonsang Kim, Dongsub Noh, Dae Sung Ma, Jeongseok Yun, Jung-Ho Yun, Seok Won Lee, Seok Ho Choi, Yoonjung Heo, Sung Wook Chang
Osong Public Health Res Perspect 2020;11(6):345-350. Published online December 22, 2020
<sec>
<title>Objectives</title>
<p>As a protective measure to slow down the transmission of coronavirus disease 2019 in Korea, social distancing was implemented from February 29<sup>th</sup>, 2020. This study aimed to evaluate the prevalence of domestic incidents and intentional injury during March 2020 when social distancing was in effect.</p></sec>
<sec>
<title>Methods</title>
<p>There were 12,638 patients who visited the Level 1 trauma center of Chungnam province with injuries from domestic incidents, familial discord, and intentional injury. The prevalence of injuries during March 2020 was compared with the average of the previous 5 years, and the average for every March between 2015 and 2019.</p></sec>
<sec>
<title>Results</title>
<p>The prevalence of domestic incidents in March 2020 was significantly higher than the 5-year average, and the average for every March from 2015 to 2019 (<italic>p</italic> < 0.001). Familial discord (<italic>p</italic> = 0.002) and intentional injury (<italic>p</italic> = 0.031) were more frequently observed in March 2020. Adolescents showed a markedly higher level of intentional injury in March 2020 than in both the 5-year average (<italic>p</italic> = 0.031), and average for every March over the previous 5 years (<italic>p</italic> = 0.037).</p></sec>
<sec>
<title>Conclusion</title>
<p>The prevalence of domestic incidents and intentional injury were significantly higher during the period of social distancing in Korea. There is a need for social consensus, better policies, and psychological support services, especially if faced with a second or third wave of coronavirus disease.</p></sec>
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<sec>
<title>Objectives</title>
<p>The aim of this study was to investigate the diagnostic value of a stress coping scale for predicting perceived psychological traumatic childbirth in mothers.</p></sec>
<sec>
<title>Methods</title>
<p>This cross-sectional study was performed on 400 new mothers (within 48 hours of childbirth). Psychological traumatic childbirth was evaluated using the 4 diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders. Coping was measured using Moss and Billings’ Stress Coping Strategies Scale.</p></sec>
<sec>
<title>Results</title>
<p>The overall mean score of stress coping was 29 ± 14.2. There were 193 (43.8%) mothers that had experienced a psychological traumatic childbirth. A stress coping score ≤ 30, with a sensitivity of 90.16 (95% CI = 85.1–94.0), and a specificity of 87.44 (95% CI = 82.1–91.6), was determined as a predictor of psychological traumatic childbirth. So that among mothers with stress coping scores ≤ 30, 87% had experienced a psychological traumatic childbirth.</p></sec>
<sec>
<title>Conclusion</title>
<p>Investigating the degree of coping with stress can be used as an accurate diagnostic tool for psychological traumatic childbirth. It is recommended that during pregnancy, problem-solving and stress management training programs be used as psychological interventions for mothers with low levels of stress control. This will ensure that they can better cope with traumatic childbirth and post-traumatic stress in the postpartum stage.</p></sec>
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