Background:This study aimed to development of a protocol for effective tertiary trauma survey(TTS) to diagnose and treat missed injuries(MIs) by retrospectively analyzing the types and frequencies of injuries identified in this study.
Methods:This study was conducted on 807 trauma patients who were hospitalized at the National Trauma Center (National Medical Center, South Korea) from June 1, 2019, to June 30, 2021. Among them, 119 injury sites in 73 patients with MIs were analyzed.
Result:Fractures accounted in 98 cases(82.4%), ligament tears in 10 cases(8.4%), hemorrhage in 5 cases(4.2%), skin laceration in 2 cases(1.7%), nerve palsy in 2 cases(1.7%), contusion in 1 case(0.8%), organ injury in 1 case(0.8%). There were 34 cases of injury in upper extremities(28.6%); 27 cases in chest(22.7%); 26 cases in lower extremities(21.8%); 13 cases in facial region(10.9%); 8 cases in head(6.7%); 7 cases in abdomen(5.9%); and 4 cases in pelvis(3.4%). The diagnostic tools used to detect the MIs, 53 cases of injury(44.5%) were diagnosed by computed tomography, 23 cases(19.3%) were diagnosed by magnetic resonance imaging and X-ray respectively. Six cases(5.0%) were confirmed through physical examination.
Conclusion:This study has limitations. It was performed at a single center and the cases was small. Second, the study is retrospective in nature, and data confirmation was limited and scope of the study was limited, Therefore, the results cannot be generalized. However, TTS is still considered a useful tool for identifying injuries that were missed at the time of initial resuscitation. Furthermore, it is necessary to develop a suitable program for each trauma center that protocolized the TTS.