J Korean Med Sci.  2025 Aug;40(32):e196. 10.3346/jkms.2025.40.e196.

Impact of Qualified Trauma Center Implementation on Mortality From Severe Trauma in Korea: A Retrospective Cohort Study

• Kwon J
• Lee M
• Song S
• Kim S
• Moon J
• Huh Y
• Jung K

• KMID: 2571211
• DOI: http://doi.org/10.3346/jkms.2025.40.e196

Abstract

Background
The Korean government and experts initiated a national trauma system development project in 2012. Its first major initiative was establishing and operating regional trauma centers across the country. We assessed whether the severity-adjusted mortality rates were lower in trauma centers compared with non-trauma centers and the specific benefits of trauma centers for patients with trauma.
Methods
This retrospective cohort study analyzed the data of patients with trauma registered in the National Emergency Department Information System from 2015 to 2019. Additionally, we used the Korean Trauma Data Bank and trauma center status data provided by the Ministry of Health and Welfare. We focused on patients with survival probabilities of < 0.5 according to the International Classification of Diseases Injury Severity Score, 9th Edition. The severity-adjusted mortality rates between the trauma centers and non-trauma centers were compared.
Results
The 7 qualified trauma centers had notably more younger patients with penetrating injuries than the non-trauma centers. Patients admitted to the trauma centers had more critical vital signs and a higher incidence of reduced consciousness than those admitted to the non-trauma centers. After adjusting for severity, the in-hospital mortality rates were significantly lower in the trauma centers than in the non-trauma centers (16.9% vs. 18.2%; relative risk, 0.933; 95% confidence interval, 0.874–0.997). Patients in shock conditions had significantly lower mortality rates when treated in trauma centers. The disparity in cumulative mortality rates between the trauma centers and non-trauma centers was most pronounced 2 days post-admission.
Conclusion
This study confirmed that the national project for establishing regional trauma centers effectively reduced mortality rates among severely injured patients.

Keyword

Wounds and Injuries; Mortality; Korea; Trauma Centers