RÉSUMÉ
PURPOSE: This study was performed to investigate the preventable death rate (PDR) in Daegu, South Korea, and to assess both its affecting- and preventable-factors to improve the treatment of regional trauma patients. METHODS: All cases of traumatic death that occurred between January 2012 and December 2012 in five hospitals in Daegu were analyzed retrospectively by a panel review. Cases were classified into preventable (P) and non-preventable deaths (NP). We determined the affecting factors of trauma deaths and preventable factors during trauma care. RESULTS: The PDR was 25.2%. Significant differences by mode of arrival, day of injury, cause of death, and time of emergency department (ED) arrival were observed between P and NP groups. According to the logistic regression analysis, preventability was associated with patients transferred from other hospitals, ED arrival at night and dawn, and non-head injuries. A total of 145 preventable factors were discovered in 59 preventable trauma deaths. When we categorized by location, the ED was the most common, with 71 cases, followed by 57 prehospital preventable factors. When we classified the preventable factors by process, 76.8% were process-related and 23.4% were structure-related. CONCLUSION: Our study is valuable to build an adequate trauma system in Daegu as it provides the baseline quality control data. Efforts to mediate the preventable factors were revealed in this study, and continuous reviews to calculate and track the PDR are needed to evaluate the local trauma system and establish a system specific to Daegu.
Sujet(s)
Humains , Cause de décès , Service hospitalier d'urgences , Corée , Modèles logistiques , Mortalité , Évaluation des résultats et des processus en soins de santé , Contrôle de qualité , Études rétrospectivesRÉSUMÉ
PURPOSE: The goal of wound managements are to prevent further tissue injury during dressing changes, and absorb the excessive exudates, provide moist condition, reduce the infection. But the usual dressing methods have several limitations to serve the information about wound surface environment. Moist, pressure, temperature, pH are the important factors that give us the information about the healing process phase, speed of healing, & the risk of infection. METHODS: We made full thickness wounds & burn on porcine model, then assessed the surface temperature intermittently until repithelialization were completed, and size measurement were done with Image Pro Plus 6.0. RESULTS: In wound areas, the surface temperature was lowest at post operation #1 day, then slightly increased till POD #21 days, and again down slope curvature. In burn area, the surface temperature was highest at POD #1 day, then slightly decreased till POD # 21 days, and more fall curvature. Modern sensing technology along with wireless radio frequency communication technology is posed to make significant advances in wound management. Our result will be a basic data for the future researches about the surface temperature monitor to detect the early infection and the intervention to modulate the surface temperature to increase the rate of epithelialization. CONCLUSION: The result of the correlation between the surface temperature and area reduction have weak or moderate negative Pearson correlation coefficient.