Sung Wook Song

Objective: Traumatic brain injury (TBI) often occurs alongside injuries to other body regions, worsening patient outcomes. This study evaluates the impact of concomitant injuries on clinical outcomes in patients with isolated versus non-isolated TBI.Methods: This retrospective cross-sectional analysis was conducted using data from the Emergency Department-based Injury In-depth Surveillance (EDIIS) for 180,058 TBI patients admitted to 23 tertiary hospitals from January 1, 2020, to December 31, 2022. Patients were categorized into isolated TBI group (iTBI; n=127,673) and non-isolated TBI group (niTBI; n=52,385) based on injury diagnostic codes. Clinical outcomes—24-hour and 30-day mortality, hospital admission, and interhospital transfer—were compared. Multivariate logistic regression analyses adjusted for potential confounders were performed.Results: The niTBI patients exhibited significantly higher 24-hour mortality (1.5% vs. 0.4%), 30-day mortality (2.6% vs. 1.0%), hospital admissions (24.5% vs. 8.4%), and interhospital transfers (3.6% vs. 1.1%) than iTBI patients (all P<0.001). Concomitant injuries increased the adjusted odds of 24-hour mortality (adjusted odds ratio [aOR], 1.456; 95% confidence interval [CI], 1.286–1.648) and 30-day mortality (aOR, 1.111; 95% CI, 1.022–1.208). Thoracic injuries were the most significant predictor of adverse outcomes in niTBI patients, increasing the odds of 24-hour mortality by nearly sixfold (aOR, 5.958; 95% CI 5.057–7.019).Conclusions: Concomitant injuries significantly worsen clinical outcomes in TBI patients, with thoracic injuries being the most critical predictor of mortality. These findings highlight the importance of comprehensive trauma assessments and targeted prevention strategies to improve survival rates and optimize resource allocation for patients with multiple injuries.

Yoo JR, et al. Yonsei Med J. 2025 Feb;66:e34. https://doi.org/10.3349/ymj.2024.0376

Objective: This study aimed to investigate the characteristics and epidemiological trends of pediatric injuries among patients visiting emergency departments on Jeju Island, Korea.Methods: Using a community-level serial cross-sectional analysis, we targeted pediatric patients 18 years or younger who visited emergency departments for injuries over a 10-year period. A comprehensive examination of injury characteristics and epidemiological trends was performed using the data sourced from the Jeju Injury Surveillance System. This included an evaluation of the annual incidence and overall trends in pediatric injury cases.Results: The study found toddlers (42.5% of cases) to be the most frequently injured age group. Male patients were more prone to injuries, with a male to female ratio of 1.7:1. Injuries among visitors accounted for 17.3% of cases, with a seasonal spike in summer, evenings, and weekends. Most incidents occurred at home, were predominantly accidental in nature, with adolescents more likely to require emergency medical system services. The common mechanisms of injuries were blunt force (49.2%), slips/falls (22.0%), and motor vehicle collisions (13.2%), leading to bruises, cuts, and sprains. Over the decade, a general increase in pediatric injuries was observed. Accidental injuries initially surged but later stabilized; however, self-harm/suicide and assault/violence injuries showed a concerning upward trend. Age-specific analysis revealed increasing trends in infants and adolescents.Conclusion: The results of the present study underscore the crucial need for targeted injury prevention and resource allocation strategies, particularly for high-risk groups and time of injury, to effectively mitigate pediatric trauma on Jeju Island.

Su Jong Lee, So Young Lee, Jun Hwan Choi, Mina Seok, Sung Wook Song, Hyun Jung Lee. KJSM 2024;42:12-22. https://doi.org/10.5763/kjsm.2024.42.1.12

The aim of this study was to investigate the prevalence of shoulder pain and analyze its association with socio-demographic factors, agricultural work-related conditions, and biomechanical factors among farmers on Jeju Island. We utilized initial survey data from the Safety for Agricultural Injury of Farmers’ cohort study involving adult farmers on Jeju Island. The presence and characteristics of shoulder pain, socio-demographics, agricultural work-related conditions, and biomechanical factors were assessed using semi-structured questionnaires. A total of 1206 participants were analyzed for prevalence and associated risk factors using frequency and multivariate logistic regression analyses. The overall prevalence of shoulder pain was 17%. Multivariate logistic regression analysis, adjusted for significant socio-demographic and agricultural work-related condition variables, revealed that stress level, type of farming, and experiencing an agricultural injury within the preceding year were significantly associated with shoulder pain (stress level: “occasional,” adjusted odds ratio [aOR], 1.581; 95% confidence interval [CI], 1.079–2.318; “frequent,” aOR, 1.964; 95% CI, 1.205–3.200; and “extreme,” aOR, 2.999; 95% CI, 1.480–6.074 vs “rarely”; type of farming: “orchard,” aOR, 0.82; 95% CI, 0.597–1.124; “livestock,” aOR, 0.225; 95% CI, 0.079–0.641 vs “field”; and experienced an agricultural injury within the past year: “yes,” aOR, 2.078; 95% CI, 1.269–3.405). In addition, 3 biomechanical factors significantly contributed to shoulder pain: activities requiring significant power such as shoveling, pickaxing, and hammering; repetitive use of a particular body part; and constant elevation of the arm above the head. The findings highlight the importance of postural education, injury prevention, and psychological support in managing shoulder pain among farmers.

Kim DR, et al. Korean J Radiol. 2024 Aug;25(8):706-714. https://doi.org/10.3348/kjr.2023.0960

Objectives: This study was conducted to identify the association between short sleep duration and depressive symptoms among elderly farmers.Methods: This study analyzed the Safety for Agricultural Injuries of Farmers cohort data collected from September 2015 to June 2018. The data were based on an agricultural survey of the health and behaviors of adult farmers on Jeju Island in South Korea. Depressive symptoms were defined as a score of 8 or higher according to the short form of the geriatric depression scale. Short sleep duration was defined as less than 6 hours of average daily sleep duration.Results: The analysis included 507 participants, aged over 60 years. Of these, 87 (17.2%) demonstrated depressive symptoms. The prevalence of depressive symptoms differed significantly between farmers with <6 h (25.8%) and those with ≥6 h (13.5%) of sleep (p=0.001). Multivariable analyses confirmed that short sleep duration was significantly associated with depressive symptoms (odds ratio=1.876, 95% confidence interval=1.129–3.118).Conclusions: Our findings suggest that short sleep duration increases the risk of depressive symptoms among elderly farmers. Adequate daily sleep duration may prevent depressive symptoms in the population.

Objective Agriculture is a hazardous industry. However, previous studies have focused on injuries to agricultural workers without comparison with injuries to nonagricultural workers. Therefore, we compared the clinical characteristics and outcomes of injuries reported at an emergency department (ED) between agricultural workers and nonagricultural workers.Methods We established a prospective ED-based agricultural injury surveillance system at a tertiary university hospital. Adult patients visiting the ED for an injury were divided into farmer and non-farmer groups depending on their engagement with agriculture. Using an adjusted multivariate analysis and propensity score matching (age, sex, inhabitant, and insurance type), we compared the clinical characteristics and outcomes of injuries between the farmer and non-farmer groups.Results In total, 38,556 injured adult patients (37,746 in the non-farmer group and 810 in the farmer group) were available for the unmatched sample analysis. The 1,620 matched subjects were equally classified after one-to-one nearest-neighbor propensity score matching. A multivariate logistic regression analysis of the unmatched sample revealed higher adjusted odds ratios (ORs) for intensive care unit admission (adjusted OR, 1.752; P=0.003) and overall surgery (adjusted OR, 1.870; P<0.001) in the farmer group. In contrast, univariate logistic regression analyses of the propensity score–matched sample found a higher OR in the farmer group only for overall surgery (OR, 1.786; P<0.001).Conclusion Injuries of agricultural workers had higher odds only of requiring surgery; differences in injury-related mortality between groups were not statistically significant in either the matched or unmatched sample analyses.

The demand for total knee arthroplasty (TKA) is rapidly increasing worldwide. The most common indication for TKA is osteoarthritis (OA); however, some patients with rheumatoid arthritis (RA) also undergo TKA. This study aimed to investigate the effects of RA on TKA. Our findings revealed that patients with RA underwent TKA at a younger age than did patients with OA. However, contrary to the findings of pre-21st century studies, the average age of TKA among patients with RA was not significantly different from that of patients with OA. Additionally, patients with RA had a 1.5-fold higher risk of undergoing TKA. Although not statistically significant, patients with RA had a higher revision TKA rate, a shorter time until revision TKA, and underwent more revision TKAs due to infections than did patients with OA. An analysis of factors that affect revision TKA revealed that the risk of revision increased if the erythrocyte sedimentation rate and C-reactive protein levels were increased at the time of TKA. This study showed that patients with RA have a slightly higher risk of undergoing TKA than did patients with OA. Furthermore, the presence of inflammation at the time of TKA increases the risk of revision; therefore, inflammation should be adequately controlled before performing TKA.