• Title/Summary/Keyword: 입원환자 관리

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Temporal Variations of Cerebrovascular Diseases in a University Hospital (일개 대학병원을 대상으로 한 뇌혈관질환의 시간적 변동양상)

  • Lee, Mi-Yon;Lee, Sang-Bock;Lee, Jun-Hang;Lee, Sam-Yul;Lee, Tae-Soo;Jin, Gye-Hwan
    • Journal of the Korean Society of Radiology
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    • v.1 no.1
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    • pp.17-23
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    • 2007
  • Background: Cerebrovascular diseases are known to show different patterns of incidence among regions and races. Therefore, it is very important to determine the incidence pattern of a specific area in order to diagnose, treat and prevent cerebrovascular diseases. The objective of the present study is to analyze quantitatively the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases by season, by gender and by age. Methods: The subjects of this study were 1603 patients hospitalized for hemorrhagic or ischemic cerebrovascular diseases at the Department of Neurosurgery or the Department of Neurology of a University Hospital. Statistical analysis of data used Excel 2003 of Microsoft, and t-test was conducted using ORIGIN 6.0 of MICROCAL. Results: In the subjects, the incidence ratios of hemorrhagic and ischemic cerebrovascular diseases for four years, the period of this research, were 38.55% and 61.45%, respectively. The mean and standard deviation of age when hemorrhagic cerebrovascular diseases occurred were 58.20 and 12.60, respectively, and the percentages of subjects in their 40s, 50s, 60s and 70s were all around 20%. On the contrary, the mean and standard deviation of age when ischemic cerebrovascular diseases occurred were 65.01 and 13.59, respectively. The average age of patients with ischemic cerebrovascular diseases was older than that of patients with hemorrhagic brain diseases, and the percentages of those in their 60s, 70s and 80s were 15.53%, 37.06% and 27.72%, respectively. The season when hemorrhagic cerebrovascular diseases appeared most frequently was winter, which was followed by summer, spring and autumn. The season when hemorrhagic cerebrovascular diseases appeared most frequently was spring, which was followed by summer, winter and autumn. Conclusions: In this study, the incidence rates of hemorrhagic and ischemic cerebrovascular diseases were 38.55% and 61.45%, showing the rising percentage of ischemic cerebrovascular diseases. For making adequate prevention and disease control plans, it is considered necessary to make a long-term epidemiological investigation of cerebrovascular diseases.

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A Classification Method of Delirium Patients Using Local Covering-Based Rule Acquisition Approach with Rough Lower Approximation (러프 하한 근사를 갖는 로컬 커버링 기반 규칙 획득 기법을 이용한 섬망 환자의 분류 방법)

  • Son, Chang Sik;Kang, Won Seok;Lee, Jong Ha;Moon, Kyoung Ja
    • KIPS Transactions on Software and Data Engineering
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    • v.9 no.4
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    • pp.137-144
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    • 2020
  • Delirium is among the most common mental disorders encountered in patients with a temporary cognitive impairment such as consciousness disorder, attention disorder, and poor speech, particularly among those who are older. Delirium is distressing for patients and families, can interfere with the management of symptoms such as pain, and is associated with increased elderly mortality. The purpose of this paper is to generate useful clinical knowledge that can be used to distinguish the outcomes of patients with delirium in long-term care facilities. For this purpose, we extracted the clinical classification knowledge associated with delirium using a local covering rule acquisition approach with the rough lower approximation region. The clinical applicability of the proposed method was verified using data collected from a prospective cohort study. From the results of this study, we found six useful clinical pieces of evidence that the duration of delirium could more than 12 days. Also, we confirmed eight factors such as BMI, Charlson Comorbidity Index, hospitalization path, nutrition deficiency, infection, sleep disturbance, bed scores, and diaper use are important in distinguishing the outcomes of delirium patients. The classification performance of the proposed method was verified by comparison with three benchmarking models, ANN, SVM with RBF kernel, and Random Forest, using a statistical five-fold cross-validation method. The proposed method showed an improved average performance of 0.6% and 2.7% in both accuracy and AUC criteria when compared with the SVM model with the highest classification performance of the three models respectively.

Influences of Nutritional Status and Depression on Satisfaction with Life in Middle-Aged Long-Term Care Patients (중년기 장기요양 환자의 영양 상태, 우울이 삶의 만족도에 미치는 영향)

  • Oh, Cheong-Uk;Park, Yoon-Jin
    • Journal of Digital Convergence
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    • v.15 no.1
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    • pp.363-372
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    • 2017
  • This study aimed to identify influences which nutritional status and depression have on satisfaction with life on middle-aged long-term care patients. This study is a descriptive study conducted with 120 patients aged 40-65 from February 1st to March 31th, 2015 in hospital. Data were analyzed using t-test, ANOVA, Scheff's test, Pearson's correlation coefficients, multiple regression. The average of nutrition status, depression, satisfaction of life was $15.85{\pm}3.85$, $24.70{\pm}15.85$, $3.54{\pm}1.22$ each. The findings show nutritional status(r=.281, p<.005) have correlation(+) with satisfaction of life, otherwise, nutritional status(r=.439, p<.001) and satisfaction of life(r=-.-574, p<.001) have correlation(-) with depression both. Influencing factors on satisfaction of life were subjective health(${\beta}=.387$, p=.000) and depression(${\beta}=.251$, p=.010), explained 36.0% of the variance. Therefore, management program for improving satisfaction of life is needed on middle-aged long term care patients.

Correlation Analysis of between Patient and Equipment Factors and Radiation Dose in Chest Low Dose and Abdominal Non-contrast CT (흉부 저선량 및 복부 비조영 CT 검사에서 환자 및 장비 인자와 선량과의 상관관계 분석)

  • Shim, Jina;Lee, Youngjin
    • Journal of the Korean Society of Radiology
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    • v.15 no.2
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    • pp.117-123
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    • 2021
  • This paper is to establish a basis for a dose reduction strategy by confirming correlations with the factors that may affect the radiation dose based on the dose records in low-dose chest CT and abdominal non-contrast CT. In order to find out the causes of unnecessary exposure, the correlation between seven factors (age, gender, height, weight, BMI, patient status [inpatient and outpatient], and use of dose modulation) and CT dose were identified. Logistic regression was used as the statistical analysis for correlation verification. In the low dose chest CT, as the higher values of height and BMI and dose modulation off were associated with lowering the risk exceeding Diagnostic Reference Levels(DRL) (odds ration<1, p<0.05). However, as woman compared to man and the higher values of weight were associated with highering the risk exceeding DRL (odds ration>1, p<0.05). In the abdomen CT, as dose modulation off were associated with lowering the risk exceeding DRL (odds ration<1, p<0.05). Therefore It is necessary to conduct research on the relationship between various factors affecting radiation exposure and patient radiation dose for reducing the dose.

Effect of Diet and Exercise Recommendations Provided by Medical Staff to Patients, and Exercise Self Efficacy with Coronary Artery Disease on Adherence to Regular Exercise (관상동맥질환자에게 제공한 의료인의 식이 및 운동권고, 운동자기효능감이 규칙적인 운동이행에 미치는 영향)

  • Mi-Soo Kweon;Suk-Jeong Lee;Du-Ri Kim
    • Journal of Industrial Convergence
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    • v.22 no.3
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    • pp.91-100
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    • 2024
  • Coronary artery disease(CAD) is associated with a high risk of recurrence and an increased mortality rate upon recurrence. Consequently, there is a need for continuous health behavior recommendations from medical staff. Therefore, a study was conducted on 219 patients hospitalized for coronary angiography. The study aimed to investigate the influence of medical staff recommendations on exercise adherence among CAD patients. In conclusion, regular exercise(RE) recommendation(OR 3.52, p=.036) and dietary advice from medical staff(OR 6.48, p=.022), having high exercise self-efficacy(OR 1.36, p=.001) positively affected RE adherence. Therefore, medical staff should strengthen personalized recommendations for RE and healthy diets, as well as develop exercise self-efficacy enhancement programs to encourage patient participation. Future research is recommended to explore the impact of the degree and method of medical staff recommendations on self-management practices among CAD patients.

Spontaneous Pneumomediastinum: Clinical Investigation (자연성 종격동 기종의 임상적 고찰)

  • Park Jae Hong;Chei Chang Seck;Hwang Sang Won;Kim Han Yong;Yoo Byung Ha;Kim Dae Hwan
    • Journal of Chest Surgery
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    • v.39 no.3 s.260
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    • pp.220-225
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    • 2006
  • Background: Spontaneous pneumomediastinum is an uncommon, benign, self-limited disorders that usually occurs in young adults without any apparent precipitating factors or disease. The purpose of this study was to review our experience in dealing with this entity and describe a reasonable course of assessment and management. Material and Method: A retrospective case series was conducted to identify adults patients with SPM who were diagnosed and treated in a single institution between 2001 and 2005. Result: Fifteen patients were identified who included 14 men and 1 women with a mean age of 26 years. Presenting symptoms were chest pain in 12 patients ($80\%$), dyspnea in 5 patients ($33\%$), and throat discomfort in 4 patients ($26\%$). Two cases were associated with use of inhalational drugs and 3 cases were associated with exercise. The predisposing factors were asthma, excessive exercise, and vomiting in spontaneous pneumomediastinum. The physical findings were subcutaneous emphysema in 10 patients ($77\%$). Chest radiography and computerized tomography were the diagnostic methods in all cases with CT scan revealing six cases with associated pulmonary abnormalities. Esophagogram and flexible bronchoscopy were selectively used. Fifteen patients ($100\%$) were admitted to the hospital. Their mean hospital stay was 3 days. All patients were conservatively treated. In a follow-up of 3 years no complications or recurrences were observed. Conclusion: Most simple spontaneous pneumomediastinum cases were benign diseases and most of them ($77\%$) had shown typical chest pain, dyspnea and subcutaneous emphysema. Inhalational drug use was not a major cause of SPM; however, increased use of bronchoinhalers was a suspicious cause of SPM.

Life Style and Eating Behavior of Stroke Patients in Daegu and Gyeongbuk Province, Korea (대구.경북지역 뇌졸중 환자의 생활습관 및 식행동 특성)

  • Sung, Su-Jung;Jung, Doo-Gyo;Lee, Won-Kee;Kim, Yoo-Jung;Lee, Hye-Sung
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.38 no.3
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    • pp.319-332
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    • 2009
  • The present study was performed to analyze the life style and eating behavior of stroke patients and to find the risk factors related to stroke incidence in Daegu and Gyeongbuk Province, Korea. The case subjects (n=100) were selected from newly diagnosed stroke patients at Kyungpook National University Hospital. The control subjects (n=150) were selected from community inhabitants who did not have stroke history and were sex and age-matched with the case subjects. The survey was conducted by individual interviews using questionnaires on the general characteristics, life-style, eating behavior, food intake frequency and food preference. The high body mass index, preexisting diseases such as diabetes and hypertension, stroke family history, smoking, overeating habit and high preference for sweet, greasy and meat foods appeared to be the risk factors for stroke incidence. On the other hand, the results suggest that life style of regular exercise and nonsmoking, food habits of green tea drinking and enough chewing, preference for Korean meal type, high intake frequency for legumes, vegetables, mushrooms, seaweeds, fishes and shell fishes, soy milk and green tea might be the protective factors for the stroke. Therefore, maintenance of healthy weight, the prevention and management of the deteriorative chronic diseases, change of life style and improvement of eating behaviors are considered to be important for stroke prevention.

A Study on Using of Materials and Compliance of Diet Therapy by Distribution of Body Weight in Diabetic Patients (당뇨병 환자의 체중분포별 식사요법 실행 및 자료의 활용 실태)

  • 한지숙;정지혜
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.33 no.3
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    • pp.533-541
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    • 2004
  • The purpose of this study was to investigate using of diet therapy materials and the compliance of diet therapy by distribution of body weight in diabetic patients. The percentage of diabetic patients who was distributed by BMI was 18.5% in under weight group, 51.5% in normal weight group, 16.9% in over weight group and 13.1% in obesity group. Of 130 diabetic patients, 62.3% experienced weight loss after the diagnosis. 35.4% of the diabetic patients had ever been in the hospital. 38.5% of the diabetic patients had prevalence of the complications. Knowledge for diet therapy showed low score in over weight and obesity group, specially in the items on the amount of food that I have to consume or the method selecting foods using the food exchange list. Diet therapy practice was also lower in obesity group than the other groups. Most of diabetic patients thought the diet therapy was important and got diet therapy materials through dietitian or doctor. But using of diet therapy materials was 50.0% in under weight group, 41.8% in normal weight group. 22.7% in over weight group and 35.3% in obesity group. Food exchange list was diet therapy item considered as the most difficult for diabetic patients to understand. Diet therapy items considered as the most necessary by diabetic patients were to be attended to choose foods and how to make out menu. This study showed that the diabetic patients were different in using of diet therapy materials or diet therapy practice by distribution of body weight. Therefore it is suggested that the program composed of necessary contents by body weight distribution of diabetic patients need to be developed.

Clinical aspects of an outbreak of Serratia marcescens infections in neonates (신생아 중환자실에서 Serratia marcescens에 의한 집단 감염 발생에 대한 고찰)

  • Sung, Min-Jung;Chang, Chul-Hun;Yoon, Yeon-Kyong;Park, Su-Eun
    • Clinical and Experimental Pediatrics
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    • v.49 no.5
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    • pp.500-506
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    • 2006
  • Purpose : We evaluated an outbreak of Serratia marcescens infections in 24 neonates in a neonatal intensive care unit(NICU). Methods : From January to August, 2004 a nosocomial outbreak of S. marcescens occurred in our NICU. We describe the clinical characteristics of the outbreak and analyse the risk factors for infections with S. marcescens. After the outbreak stopped, 7 isolates from blood were typed using rapid amplified polymorphic DNA analysis(RAPD). Results : S. marcescens was isolated from 24 neonates, 19 infected and 5 colonized. Seven out of nineteen neonates had bacteremia, 4 had ventilator associated pneumonia, 4 had purulent conjunctivitis, 2 had UTI, 1 had meningitis and 1 had a wound infection. Three neonates died due to S. marcescens infection, 2 of 3 had ventilator associated pneumonia, 1 had meningitis complicated with abscess. The mortality rate of S. marcescens infection was 15.8%. Factors associated with S. marcescens infections were previous antibiotic therapy, indwelling catheter and use of ventilators. The isolated strains were resistant to most antibiotics, but frequently sensitive to imipenem, bactrim and amikacin. RAPD typing results show that at least 3 epidemic strains were related with this outbreak. But one genotype was predominant type in this outbreak. The control measures were instituted and the outbreak stopped within 2 months. Conclusion : S. marcescens can cause rapidly spreading outbreaks associated with fatal infections in neonates. If S. marcescens is isolated from clinical specimens, meticulous infection control measures and epidemiologic investigations should be done at an early stage of the outbreak.

Clinical Presentation of the Patients with Non-traumatic Chest Pain in Emergency Department (응급의료센터에 내원한 비외상성 흉통환자의 임상 양상)

  • Chung, Jun-Young;Lee, Sam-Beom;Do, Byung-Soo;Park, Jong-Seon;Shin, Dong-Gu;Kim, Young-Jo
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.283-295
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    • 1999
  • Background: Patients with acute non-traumatic chest pain are among the most challenging patients for care by emergency physicians, so the correct diagnosis and triage of patients with chest pain in the emergency department(ED) becomes important. To avoid discharging patients with acute myocardial infarction(AMI) without medical care, most emergency physicians attempt to admit almost all patients with acute chest pain and order many laboratory tests for the patients. But in practice, many patients with non-cardiac pain can be discharged with simple tests and treatment. These patients occupy expensive intensive care beds, substantially increasing financial cost and time of stay at ED for the diagnosis and treatment of myocardial ischemia and AMI. Despite vigorous efforts to identify patients with ischemic heart disease, approximately 2% to 5% of patients presented to the ED with AMI and chest pain are inadvertently discharged. If the cause for the chest pain is known, rapid and accurate diagnosis can be implemented, preventing wastes in time and money and inadvertent discharge. Methods and Results: The medical records of 488 patients from Jan. 1 to Dec. 31, 1997 were reviewed. There were 320(angina pectoris 140, AMI 128) cases of cardiac diseases, and 168(atypical chest pain 56, pneumothorax 47) cases of non-cardiac diseases. The number of associated symptoms were $1.1{\pm}0.9$ in non-cardiac diseases, $1.4{\pm}1.1$ in cardiac diseases and $1.7{\pm}1.1$ in AMI(p<0.05). In laboratory finding the sensitivity of electrocardiography(EKG) was 96.1%, while the sensitivity of myoglobin test ranked 45.1%. Admission rate was 71.6% in for cardiac diseases and 50.6% for non-cardiac diseases(p<0.01). Mortality rate was 8.8% in all cases, 13.8% in cardiac diseases, 0.6% in non-cardiac diseases, and 28.1% especially in AMI. Conclusion: In conclusion, all emergency physicians should have thorough knowledge of the clinical characteristics of the diseases which cause non-traumatic chest pain, because a patient with any of these life-threatening diseases would require immediate treatment. Detailed history on the patient should be taken and physical examination performed. Then, the most simple diagnostic approach should be used to make an early diagnosis and to provide treatment.

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