The Prognostic Significance of Injury Severity Score and Height of Fall in Free Fall Patients

PURPOSE: In this study, the prognostic significance of the Injury Severity Score (ISS) and the height of fall in free-fall patients were investigated. METHODS: The medical records of 179 victims of falls from a height who were brought alive to the Emergency Department of Gyeongsang National University Hospital between January 2003 and December 2007 were analyzed. The age, the sex of the patients, the rate of admission, the hospital stay, the site of injury, the severity of injury, the rate of surgery, the site of the fall and the presence of alcohol intoxication were evaluated by using a retrospective review of the medical records. Injury severity was measured by using the ISS. Patients were categorized into four subgroups according to the height from where they had fallen. The data were statistically analyzed with using SPSS ver. 10.0. RESULTS: The admission rates for the subgroups with falls of less than 3 stories were significantly lower than those for the subgroups with higher heights of falls (70.7% vs. 100%, p<0.05). These two subgroups showed statistically significant differences in mean hospital stay (17.11+/-24.88 vs. 56.73+/-49.21, p<0.05), rate of operation (30.6% vs. 53.8%, p<0.05), and mean ISS (6.86+/-4.97 vs. 13.96+/-9.14, p<0.05). In the correlation analysis, the ISS and the mean hospital stay showed the highest correlation with correlation coefficient of 0.666. CONCLUSION: In this retrospective analysis of 179 free-fall patients, we evaluated the prognostic factors affecting the outcomes for the free-fall patients. The patients who had fallen from heights of 3 stories or higher showed statistically significant higher rates of admission, longer durations of hospital stay, higher ISSs, and higher operation rates. The most accurate factor in predicting the length of hospital stay was the ISS.

The Clinical Outcomes of Kyphoplasty for the Treatment of Malignant Vertebral Compression Fractures / 대한통증학회지

BACKGROUND: Kyphoplasty is a minimally invasive procedure that can stabilize osteoporotic and neoplastic vertebral fractures. We retrospectively evaluated the clinical outcomes of kyphoplasty for the treatment of vertebral compression fractures in cancer patients. METHODS: We reviewed the clinical data of 27 cancer patients who were treated with kyphoplasty (55 vertebral bodies) between May 2003 and Feb 2008. The clinical parameters, using a visual analog 10 point scale (VAS) and the mobility scores, as well as consumption of analgesic, were evaluated preoperatively and at 1 week after kyphoplasty. RESULTS: A total 55 cases of thoracic and lumbar kyphoplasties were performed without complications. The mean age of the patients was 66 years. All the patients experienced a significant improvement in their subjective pain and mobility immediately after the procedures. The pain scores (VAS), mobility scores and other functional evaluations using the Oswestry disability score and the SF-36 showed significant differences between the pre- and postoperational conditions. CONCLUSIONS: Kyphoplasty is an effective, minimally invasive procedure that can relieve the pain of patients with vertebral compression fractures and these fractures are the result of metastasis.

A Case of Pancreatic Abscess Due to Salmonella Typhi / 대한내과학회지

Salmonella infection occurs in 5 different clinical forms; gasteroenteritis, enteric fever, bacteremia, chronic carried state and localization at one or more sites. Extraintestinal pyogenic infections caused by salmonella species include soft tissue abscesses, bone and joint infections, cholecystitis, liver abscess and splenic abscess etc. Pancreatic abscess due to Salmonella typhi is a very rare extraintestinal manifestation of salmonellosis. Infection pathways may be considered as reflux of infected bile through the pancreatic duct, hematogenous spread from a distant site or lymphatic spread from the intestinal tract. Treatment of pancreatic abscess needs surgical intervention and antibiotics therapy. We have experienced a case of a 40-years-old female with pancreatic abscess due to Salmonella typhi. She was treated with ultrasonography-guided catheter drainage and intravenous ceftriaxone for 18 days. After 14 days, the sonographic examination revealed the abscess cavity in pancreas almost disappeared. We report this case with review of literatures.