• Journal of Chest Surgery
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• v.33 no.11
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• pp.869-875
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• 2000

배경: 뇌혈관계 합병증은 관상동백우회술 후 발생하는 사망률 중 10% 이상을 차지하는 치명적인 질환이다. 최근들어 고령 환자, 고혈압, 당뇨병 등이 병발하고 고 위험군에 대한 수술이 증가하면서 뇌혈관계 합병증은 오히려 증가하고 있다. 본 연구는 관상동맥우회술을 받은 환자의 의무기록을 조사하여 관상동맥우회술 후 발생되는 뇌혈관계 질환의 위험 인자를 밝히고자 한다. 대상 및 방법: 1991년 3월부터 1999년 7월 사이에 관상동맥우회술을 받은 185명을 조사하여, 뇌혈관계 합병증의 위험 인자들을 통계적으로 검증하였다. 결과: 뇌혈관계 합병증의 유병율은 7.57%(14명)였으며 이중 5예는 사망하였다. 동 기간 중 전체 사망은 11예이므로 사망자의 45.5%가 뇌혈관계 합병증으로 사망한 것이다. 통계적의의가 있는 뇌혈관계 합병증 위험 인자로는 수술 후 부정맥(p=0.0064), 기왕의 뇌혈관계 병력(p=0.0090), 체외순환시간(p=0.0181), 대동맥의 동맥경화(p=0.03575) 및 당뇨병(p=0.0452) 등이었다. 경동맥협착이 동반되어 경동맥 혈관내막 절제술(carotid endarterectomy)을 동시에 시술한 경우는 2예였으나, 뇌혈관계 합병증은 발생하지 않았다. 75세 이상의 고령환자는 3명이었으며 모두 뇌혈관계 합병증은 발생하지 않았다. 결론: 관상동맥우회술 후 발생하는 뇌혈관계 질환과 통계적으로 유의한 위험요인은 수술 후 부정맥, 뇌혈관이상의 기왕력, 체외순환시간, 대동맥궁의 동맥경화, 당뇨 등이었다.

• Journal of Digital Convergence
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• v.16 no.10
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• pp.343-350
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• 2018

The purpose of this study was to identify the effect of nutrition related factors on mortality risk among community-residing older adults in Korea. We analyzed data from 8,532 older adults who took part in the 2008 living profiles of older people survey and 2011 death mortality data. According to Cox regression analysis, male (Hazard Ratio [HR], 2.03; 95% Confidence Interval [CI], 1.74~2.37), diabetes mellitus (HR, 1.35; 95% CI, 1.12~1.64), underweighted (HR, 2.68; 95% CI, 2.16~3.31), dysphagia (HR, 1.23; 95% CI, 1.02~1.47), chewing ability (HR, 1.33; 95% CI, 1.11~1.59), and undernutrition (HR, 1.47; 95% CI, 1.23~1.75) significantly affected mortality risk. Systematic nutrition support programs should be developed to decrease the mortality among Korean older adults.

• Journal of the Korean Society for Railway
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• v.6 no.4
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• pp.11-18
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• 2003

우리는 복잡한 현상을 하나의 수치로 표현하는 각종 지표(index)를 생활에서 많이 접하고 있다. 종합주가 지수, 불쾌지수, 소비자 물가지수, 년간 교통사고 건수, 인구 10만명당 교통사고 사망자수 등도 일종의 지표라 할 수 있다. 철도에서도 위험을 평가하는 지표로는 "년간 사고건수", "열차운행 100만-km당 사고건수"와 같이 발생빈도에 초점을 둔 경우와 "년간 사망자수", 혹은 "피해액", "운행지장"과 같이 사고피해에 초점을 둔 경우가 있다. (중략)

• 대한방사선방어학회:학술대회논문집
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• 2009.11a
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• pp.38-39
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• 2009

• Journal of Chest Surgery
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• v.39 no.2 s.259
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• pp.127-133
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• 2006

Background: In the studies of the distribution of time to death in trauma patients, the early deaths within several hours after injury were a large component of total trauma deaths. Due to the development of trauma system, overall mortality of trauma was decreased, but trauma is still the major cause of deaths. Material and Method: From January 1994 to December 2003, trauma patients who had been admitted and had expired at tertiary hospital were enrolled. There was a total of 400 cases, a retrospective study was done to determine the distribution of trauma mortality according to the part of the body that were severely injured part and compared the difference between early deaths within 6 hours and late deaths after 6 hours. We also analysed the risk factors of early deaths due to trauma. Result: In severe injury to the head and abdomen, the distribution of mortality was bimodal. But, in severe chest injuries, the distribution was log-shape and most early deaths were almost of trauma related. The average of GCS were 5.86$\pm$4.15 for the early deaths and 8.24$\pm$5.02 for the late deaths (p < 0.05). The AIS of thorax were 2.66$\pm$1.87 for the early deaths and 1.55$\pm$1.76 for late deaths. The risk factors for early mortality were non-EMS transportation (odds ratio 3.474), high AIS (odds ratio 1.491) and GCS (odds ratio 0.859). Conclusion: In trauma patients, the causes of early mortality were severe brain injury and massive hemorrhage. Also severe chest injuries were the major cause of the early deaths in truama. Early diagnosis of chest injury can frequently be missed in the acute trauma setting. Therefore, high index of suspicion, a careful examination, and aggressive surgical treatment are important in multiple trauma patients.

• Tuberculosis and Respiratory Diseases
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• v.44 no.1
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• pp.25-43
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• 1997

Introduction : The outcome and incidence of acute respiratory distress syndrome (ARDS) could be variable related to the varied definitions used for ARDS by researchers. The purpose of the national survey was to define the risk factors of ARDS and investigate the prognostic indicies related to mortality of ARDS in Korea according to the definition of ARDS determined by the American-European Concensus Conference on 1992 year. Methods : A Multicenter registry of 48 University or University-affliated hospital and 18 general hospital s equipped with more than 400 patient's beds conducted over 13 months of patients with acute respiratory distress syndrome using the same registry protocol. Results : 1. In the 12 months of the registry, 167 patients were enrolled at the 24 hospitals. 2. The mean age was 56.5 years (${\pm}17.2$ years) and there was a 1.9:1 ratio of males to females. 3. Sepsis was the most common risk factors (78.1%), followed by aspiration (16.6%), trauma (11.6%), and shock (8.5%). 4 The overall mortality rate was 71.9%. The mean duration was 11 days (${\pm}13.1$ days) from the diagnosis of ARDS to the death. Respiratory insufficiency appeared to be a major cause in 43.7% of the deaths followed by sepsis (36.1%), heart failure (7.6%) and hepatic failure (6.7%). 5. There were no significant differences in mortality based on sex or age. No significant difference in mortality in infectious versus noninfectious causes of ARDS was found. 6. There were significant differences in the pulse rate, platelet numbers, serum albumin and glucose levels, the amounts of 24 hour urine, arterial pH, $Pa0_2$, $PaCO_2$, $Sa0_2$, alveolar-arterial oxygen differences, $PaO_2/FIO_2$, and PEEP/$FI0_2$ between the survivors and the deaths on study days 1 through 6 of the first week after enrollment. 7. The survivors had significantly less organ failure and lower APACHE III scores at the time of diagnosis of ARDS (P<0.05). 8. The numbers of organ failure (odd ratio 1.95, 95% confidence intervals:1.05-3.61, P=0.03) and the score of APACHE III (odd ratio 1.59, 95% confidence interval:1.01-2.50, P=0.04) appeared to be independent risk factors of the mortality in the patients with ARDS. Conclusions : The mortality was 71.9% of total 167 patients in this investigation using the definition of American-European Consensus Conference on 1992 year, and the respiratory insufficiency was the leading cause of the death. In addition, the numbers of organ failure and the score of APACHE III at the time of diagnosis of ARDS appeared to be independent risk factors of the mortality in the patients with ARDS.

• Life and Agrochemicals
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• v.26 no.7 s.210
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• pp.27-29
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• 2005

• Clinical and Experimental Pediatrics
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• v.50 no.5
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• pp.443-448
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• 2007

Purpose : To evaluate the potential prognostic value of the antithrombin-III (AT-III) level in the children with acute lung injury (ALI), we analyzed several early predictive factors of death including AT-III level at the onset of ALI and compared the relative risk of them for mortality. Methods : Over a 18-month period, a total of 198 children were admitted to our pediatric intensive care unit and 21 mechanically ventilated patients met ALI criteria, as defined by American-European consensus conference, i.e., bilateral pulmonary infiltrates and $PaO_2/FiO_2$ lower than 300 without left atrial hypertension. Demographic variables, hemodynamic and respiratory parameters, underlying diseases, as well as Pediatric Risk of Mortality-III (PRISM-III) scores and Lung Injury Score (LIS) at admission were collected. AT-III levels were measured within 3 hours after admission. These variables were compared between survivors and non-survivors and entered into a multiple logistic regression analysis to evaluate their independent prognostic roles. Results : The overall mortality rate was 38.1% (8/21). Non-survivors showed lower age, lower lung compliance, higher PEEP, higher oxygenation index (OI), lower arterial pH, lower $PaO_2/FiO_2$, higher PRISM-III score and LIS, and lower AT-III level. PRISM-III score, LIS, OI and decreased AT-III level (less than 70%) were independently associated with a risk of death and the odds ratio of decreased AT-III level for mortality is 2.75 (95% confidence interval; 1.28-4.12) Conclusion : These results suggest that the decreased level of AT-III is an important prognostic factor in children with ALI and the replacement of AT-III may be considered as an early therapeutic trial.

• Proceedings of the Safety Management and Science Conference
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• 2013.11a
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• pp.9-23
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• 2013

건설공사는 인력의존도가 가장 높으며 타 산업에 대비하여 자동화가 매우 낮고 외기에 노출된 작업 환경으로 추락 등의 중대재해 위험이 가장 높은 산업이다. e-나라지표에 의하면 2006년부터 2012년까지 전체 산업의 약 21.9%를 차지하는 건설 근로자가 생산 활동에 종사하고 있으며, 이직 및 인력의 이동이 매우 잦은 특성을 갖고 있다. 2006년~2012년까지의 재해발생 통계에 따르면 전체적으로 타 산업은 매년 다소간의 증감은 있으나 재해가 감소하는 추세이지만, 건설공사의 경우는 지속적으로 증가하고 있다. 특히, 사고성 사망재해의 경우는 7년간 전체 산업에서 발생하는 사고성 사망재해의 평균 40.9%를 건설업이 차지하고 있어 가장 높아 매우 심각한 수준이다. 또한 건설현장과 건설회사의 안전보건경영의 운영방법 및 제도가 매우 단순하고 정성적인 수준으로 타 산업에 비하여 안전경영의 정량화에 대한 노력이 매우 미약하다. 과거 재해사례 및 통계를 분석하여 앞으로의 재해 위험 요소를 제거하거나 안전한 상태로 형성하여야 하나, 발표되는 재해사례나 통계를 구호 또는 슬로건으로 전파, 교육하는 수준에 머물고 있다. 본 연구에서는 아파트공사를 대상으로 2006년~2011년의 과거 재해통계(8,687건)를 분석하여 데이터베이스화하고, 실제 공사한 아파트공사 샘플현장의 자료(89,375명)를 데이터베이스화하여 현 실정에 부합한 정량적 직종별 위험도를 산정하는 연구를 진행하였다. 따라서 아파트공사의 직종별 위험도를 정량적인 데이터로 산출하고, 과학적인 방법으로 현장 위험수준을 실시간 모니터링 함으로써 건설현장의 주된 생산력인 근로자의 생명과 건강을 보호할 수 있는 효과적인 재해예방이 이루어 질 것으로 기대된다.

• Journal of Chest Surgery
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• v.42 no.6
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• pp.725-731
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• 2009

Background: Lobectomy and more extended anatomic resection are regarded as standard treatment for stage Ia non-small cell lung cancer, but approximately 15~40% of patients suffer from treatment failures such as cancer recurrence or death. The authors analyzed types and causes of treatment failures in surgically treated cases of stage Ia non small cell lung cancer. Material and Method: We retrospectively reviewed the medical records of 156 patients who had undergone complete resection for stage Ia NSCLC between Jan 1992 and Aug 2005. Patients were divided into two different treatment failure groups: cancer-related deaths and non-cancer-related deaths. Risk factors were analyzed in each group by the Kaplan-Meyer survival method and the Cox proportional hazard model. Result: Among the 156 patients, 93 were males; the mean age was 61. The median follow-up period was 33.8 months. The 5 year survival rate was 87.6%. Microscopic lympho-vascular permeation was reported in 10 patients. Recurrence was reported in 19 patients and 12 patients died due to recurrent lung cancer. Noncancer related deaths occurred in 16 patients. Risk factors for cancer recurrence and cancer related death were microscopic lympho-vascular permeation (HR=6.81, p=0.007, HR=7.81, p<0.001); for non-cancer related death, risk factors were pneumonectomy (HR=25.92, p=0.001) and postoperative cardiopulmonary complications (HR=29.67, p=0.002). Conclusion: After complete resection of stage Ia non small cell lung cancer patients, mortality includes not only cancer related deaths but also cancer unrelated deaths. Adjuvant chemotherapy is advised for patients who show microscopic lympho-vascular permeation, which is a risk factor for recurrence and for cancer related death. Patients who had pneumonectomy or who suffered from cardiac or respiratory complications need meticulous care in order to reduce comorbidity-induced death.