Introduction to the Korean Neurotrauma Data Bank System and Report on the Results of the Second Project

Abstract

Objective: In 2006, the Korean Neurotraumatology Society (KNTS) established the 1st Korean Neurotrauma Data Bank Committee (KNTDBC) and developed the Korean Neurotrauma Data Bank System (KNTDBS). Full-scale registration of traumatic brain injury (TBI) patient data began in September 2010. Since then, KNTS has conducted two trauma-related data registration projects and is now in its 5th term of the KNTDBC. This study aimed to introduce the KNTDBS of the KNTS and report the results of the second project.

Methods: Between January 2018 and June 2021, 1109 TBI patients were registered from 18 hospitals. The inclusion criteria were 1) patients who visited the hospital with TBI, 2) patients with severe TBI with a Glasgow coma scale (GCS) score of 8 or lower, and 3) adult patients aged 19 years or older. Exclusion criteria were 1) patients under 18 years of age, 2) patients with a GCS score of 9 or higher, and 3) patients with a history of previous craniotomy or craniectomy. Data from the second project were registered into seven major categories : patient registration, neuroimaging, neuromonitoring, hypothermia, surgical treatment, medical treatment, and patient evaluation.

Results: The characteristics of TBI patients in this study were not significantly different from those in previous studies, including the 1st project of KNTS. The GCS had a large number of severe patients with scores of 3 and 4, which was associated with the highest proportion of patients having bilateral pupils with unrecordable responses. Most TBI patients had severe or critical injuries (score 4 or 5) concentrated in the Abbreviated incentive scale head but had minor injuries to other regions of the body. Rotterdam computed tomography scores of 5 and 6 primarily indicated acute subdural hematomas. Surgical treatment was performed in 36.2% of all TBI cases. Most hospitals used levetiracetam and valproate as prophylactic antiepileptic drugs. Neuromonitoring, hypothermia, and coma therapy were not actively performed. The overall mortality rate was 33.3%, and among 740 survivors, 3.9% underwent shunt surgery.

Conclusion: The creation of a database for TBI patient data facilitated the collection of objective and valid information on trauma. Utilizing data from the KNTDBS will significantly aid in the treatment and prevention of TBI and contribute to the improvement of healthcare in the country.

Keywords: Health care; Korean Neurotraumatology Society; Neurotrauma Data Bank System; Traumatic brain injury.

Fig. 1.

Number of patients registered at each university hospital.

Fig. 2.

Comparison of the first and second project of the Korean Neurotraumatology Society. TBI : traumatic brain injury, GCS : Glasgow coma scale, C-SDH : chronic subdural hematoma.

Fig. 3.

Percentage of hematological abnormalities in the emergency room for 907 patients. CPK : creatine phosphokinase, BUN : blood urea nitrogen, CRP : C-reactive protein, PT : prothrombin time, INR : international normalized ratio, ALT : alanine transaminase, LDH : lactate dehydrogenase, AST : aspartate transaminase, WBC : white blood cell.

Fig. 4.

Injury sites of patients with diffuse axonal injury.

Fig. 5.

Number of patients who used AEDs. i.v. : intravenous, AED : antiepileptic drug.