• Title/Summary/Keyword: 중증도 분류

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A CAOPI System Based on APACHE II for Predicting the Degree of Severity of Emergency Patients (응급환자의 중증도 예측을 위한 APACHE II 기반 CAOPI 시스템)

  • Lee, Young-Ho;Kang, Un-Gu;Jung, Eun-Young;Yoon, Eun-Sil;Park, Dong-Kyun
    • Journal of the Korea Society of Computer and Information
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    • v.16 no.1
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    • pp.175-182
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    • 2011
  • This study proposes CAOPI(Computer Aided Organ Prediction Index) system based on APACHE II(Acute Physiology And Chronic Health Evaluation) for classifying disease severity and predicting the conditions of patients' major organs. The existing ICU disease severity evaluation is mostly about calculating risk scores using patients' data at certain points, which has limitations on making precise treatments. CAOPI system is designed to provide personalized treatments by classifying accurate severity degrees of emergency patients, predicting patients' mortality rate and scoring the conditions of certain organs.

Relation Among Parameters Determining the Severity of Bronchial Asthma (기관지천식 환자의 증상의 중증도를 나타내는 지표들간의 연관성)

  • Lee, Sook-Young;Kim, Seung-June;Kim, Seuk-Chan;Kwon, Soon-Suk;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.585-593
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    • 2000
  • Background : International consensus guidelines have recently been developed to improve the assessment and management of asthma. One of the major recommendation of these guidelines is that asthma severity should be assessed through the recognition of key symptoms, such as nocturnal waking, medication requirements, and objective measurements of lung function. Differential classification of asthma severity would lead to major differences in both long term pharmacological management and the treatment of severe exacerbation. Methods : This study examined the relationship between the symptom score and measurements of $FEV_1$ and PEF when expressed as a percentage of predicted values in asthmatics (n=107). Results : The correlation of $FEV_1$ % with PEFR% was highly significant (r=0.83, p<0.01). However, there was agreement in terms of the classification of asthma severity in 76.6% of the paired measurements of $FEV_1$ % and PEFR%. Agreement in the classification of asthma severity was also found in 57.1% of the paired analysis of $FEV_1$ % and symptom score. 39% of the patients classified as having moderate asthma on the basis of $FEV_1$ % recording would be considered to have severe asthma if symptom score alone were used. Low baseline $FEV_1$ and high bronchial responsiveness were associated with a low degree of perception of airway obstruction. Conclusion : The relationships between the symptom score, PEFR and $FEV_1$ were generally poor. When assessing asthma severity, age, duration, $PC_{20}$, and baseline $FEV_1$ should be considered.

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Effects of a Web-Based Korean Triage and Acuity Scale Learning Program on Triage Self-Efficacy and Triage Performance Ability for Nurses in Emergency Department (웹기반 한국형 중증도 분류 체계 학습프로그램이 응급실간호사의 중증도 분류에 대한 자기효능감 및 수행능력에 미치는 효과)

  • Kim, Hyo-Jin;Kang, Hee-Young
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.171-180
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    • 2019
  • Purpose: The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses. Methods: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions. Results: The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group. Conclusion: The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

Thinking Strategies of Triage Nurses' Decision Making in the Emergency Department: Think Aloud Study (응급실 중증도 분류 간호사의 의사결정과정에 나타난 사고전략: 소리내어 생각하기)

  • Moon, Sun Hee;Park, Yeon Hwan
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.15-26
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    • 2016
  • Purpose: The aim of this study was to identify thinking strategies in the complicated decision-making process based on real patient-based data of triage nurses in the emergency department (ED). Methods: This study used the 'think aloud' method to collect data from 8 triage nurses from one general hospital ED in South Korea. The data were analyzed with protocol analysis using thinking strategies. Results: The triage process was divided into three stages. The first stage consisted of 8 thinking strategies, including searching for information. They used intuition based on directly observed concepts for identifying a crisis. The second stage consisted of 17 thinking strategies related to the decision-making process. They assessed patients and generated a hypothesis to try to understand their health problems through analytic thinking. The third stage consisted of 10 thinking strategies, including qualifying. They considered the situation of the ED and properly triaged the patients. During the triage process, they frequently used judging the value and searching for information on 17 thinking strategies. Conclusions: Triage nurses demonstrated various connected thinking strategies for each stage. Based on our results, further studies should be done to develop a triage education program.

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Comparison between Korean Triage and Acuity Scale and Injury Severity Scoring System in Emergency Trauma Patients (외상환자의 한국형 중증도 분류와 손상중증도 점수체계의 비교)

  • Choi, YoonHee;Kim, BoHwa;Shin, JiEun;Jang, MyungJin;Lee, EunJa
    • Journal of East-West Nursing Research
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    • v.28 no.1
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    • pp.10-20
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    • 2022
  • Purpose: We compared the Korean Triage and Acuity Scale (KTAS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) determined the validity of KTAS for classifying trauma patients. Methods: A retrospective chart review of 10,865 trauma patients (aged ≥15 years) who visited a single regional trauma and emergency medical center from January 1, 2016, to December 31, 2020, was conducted. Data were collected from the Korean Trauma Data Bank. Based on KTAS classification, the rates of intensive care unit admission, surgery and intervention, transfusion, emergency room (ER) and hospital mortality, and ER stay time were investigated. Data were analyzed using Chi-square test, Pearson's correlation coefficient, receiver operating characteristic curve, and area under the ROC curve. Results: In the KTAS, severe trauma patients (ISS ≥16) were classified as Level 1 (79.6%), 2 (44.8%), 3 (15.5%), 4 (4.0%) and 5 (7.6%). The following were the predictive powers of KTAS, ISS, and RTS for different parameters: surgery and intervention rate, KTAS (.71), ISS (.70), and RTS (.63); transfusion rate within 4h, KTAS (.82), ISS (.82), and RTS (.74); ER stay time within 90 min, KTAS (.72), ISS (.62), and RTS (.56); and ER mortality, KTAS (.84), ISS (.72), and RTS (.88). These findings were statistically significant (p<.001). The sensitivity and specificity of KTAS for trauma patients were .88 (.87~.90), and .38 (.37~.39), respectively. Conclusion: KTAS is a useful classification system that can predict the clinical outcomes of patients with trauma, and effectively triage acutely ill trauma patients, thus provide appropriate treatment.

Convergence Study in Development of Severity Adjustment Method for Death with Acute Myocardial Infarction Patients using Machine Learning (머신러닝을 이용한 급성심근경색증 환자의 퇴원 시 사망 중증도 보정 방법 개발에 대한 융복합 연구)

  • Baek, Seol-Kyung;Park, Hye-Jin;Kang, Sung-Hong;Choi, Joon-Young;Park, Jong-Ho
    • Journal of Digital Convergence
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    • v.17 no.2
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    • pp.217-230
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    • 2019
  • This study was conducted to develop a customized severity-adjustment method and to evaluate their validity for acute myocardial infarction(AMI) patients to complement the limitations of the existing severity-adjustment method for comorbidities. For this purpose, the subjects of KCD-7 code I20.0 ~ I20.9, which is the main diagnosis of acute myocardial infarction were extracted using the Korean National Hospital Discharge In-depth Injury survey data from 2006 to 2015. Three tools were used for severity-adjustment method of comorbidities : CCI (charlson comorbidity index), ECI (Elixhauser comorbidity index) and the newly proposed CCS (Clinical Classification Software). The results showed that CCS was the best tool for the severity correction, and that support vector machine model was the most predictable. Therefore, we propose the use of the customized method of severity correction and machine learning techniques from this study for the future research on severity adjustment such as assessment of results of medical service.

Analysis of the Korean Triage and Acuity Scale by type of ambulance (한국형 중증도 분류도구를 이용한 구급차별 중증도 분석)

  • Park, Joung-Je
    • The Korean Journal of Emergency Medical Services
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    • v.25 no.3
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    • pp.71-80
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    • 2021
  • Purpose: The purpose of this study is to investigate the characteristics and appropriateness of the Korean-type severity classification by ambulance based on the medical records of 43,561 emergency patients who were brought to the emergency medical center via ambulance between January 1, 2015 and December 31, 2017. Methods: This study analyzed the classification characteristics of the Korean severity classification tool by applying them to emergency patients who visited the emergency medical center. Results: As a result of the study first, among the categories of home hospitals according to the results of visits, "other," "low consciousness," and "dyspnea" in the order of 129 ambulances were statistically significantly higher. In the order of "low consciousness" and "trauma," the "trauma" category was 5.3% higher than that of 129 ambulances. Conclusion: Among the classification items, "others," "low consciousness," and "dyspnea" were significantly higher in the group of patients who boarded 129 ambulances, and "others," "low consciousness," and "traumatic" were significantly higher in the 119 ambulances.

The Study of Communication Supporting System Interface for Person with Speech Disorder (중증 언어장애인을 위한 의사소통 시스템 인터페이스에 관한 연구)

  • Joo, Min-Young;Hong, Seung-Wook;Park, Jeong-Hwa;Park, Su-Hyun
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2007.06a
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    • pp.289-292
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    • 2007
  • 우리가 다른 이들과 만나 대화하는 것은 극히 평범한 일이다. 하지만 대화뿐만이 아니라 의사소통마저도 힘들어하는 이들이 있다. 이들은 언어 장애를 가진 이들이다. 언어 장애에는 태어나면서부터 장애를 가지는 선천적 장애와 사고와 질병으로 인한 후천적 장애가 있다. 그 중 후천적 장애는 언어장애와 더불어 신체적 장애를 가진 이들이 있다. 이들을 본 논문에서는 중증 언어 장애인이라고 분류하였다. 중증 언어 장애인의 장애정도를 크게 글자 표현이 불가능한 상태로부터 4가지 단계로 나뉠 수 있다. 글자 표현이 불가능하지만 개체 선택이 가능한 1단계, 손 혹은 발을 이용하여 가부 결정만 가능한 2단계, 지체를 이용하여 표현이 불가능한 3단계, 그리고 마지막 4단계가 3단계의 표현마저도 불가능하여 의사소통이 전혀 불가능한 상태이다. 사고로 인한 후천적 장애인 경우 위의 4가지 단계중 하나의 단계에서 머물러 있지만, 루게릭병과 같은 병은 위의 4가지 단계를 몇 년에 걸쳐서 진행되기 때문에 일반적인 장비로써는 이 들과의 의사소통이 불가능하다. 본 논문에서는 위의 1,2,3단계의 중증 언어 장애인을 대상으로 그들이 의사소통을 정확하고 신속하게 전달하기 위해서 어떠한 인터페이스를 사용하는 것이 효과적인 방법에 대해 논해보고, 향후 발전될 방향에 대해서 그 방향을 제시하였다.

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The Influence of Atopic Findings on Severity of Pneumonia in Children with 2009 Pandemic Influenza A (H1N1) Infection (2009 신종 인플루엔자 A (H1N1) 폐렴 환아에서 아토피 소견이 폐렴의 중증도에 미치는 영향)

  • Kim, Jong Hee;Kim, Hyun Jeong;Kang, Im Ju
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.182-192
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    • 2011
  • Purpose : Atopic findings may be associated with severity of pneumonia in 2009 pandemic influenza A (H1N1) infection, which could suggest a possible association between atopic findings and the severity of viral infections. Thus, we studied association between atopic findings and severity of disease in children with H1N1 influenza infection. Methods : A retrospective study was performed in 74 children admitted in a single tertiary institute and confirmed as H1N1 patients by reverse transcriptase (RT) - polymerase chain reaction (PCR). They were divided into 2 groups according to the severity of pneumonia. We evaluated whether the atopic finding is risk factor between the two groups. Results : Children with severe pneumonia had higher percentages of serum eosinophilia (88% vs 40%, P <0.001), asthma (65% vs 35%, P =0.011), allergic rhinitis (71% vs 40%, P =0.009), and IgE level (P =0.007). We found positive correlations between aeroallergen sensitizations and severity of pneumonia (82% vs 53%, P =0.007). Conclusion : Among patients with H1N1 pneumonia, asthma and atopic findings are risk factors for severity of pneumonia.

Triage Nurses' Work Experiences in Emergency Department: A Qualitative Research (응급실 중증도 분류 간호사의 업무 경험: 질적 연구)

  • Park, Yu Jin;Kong, Eun-Hi;Park, Young A
    • Journal of muscle and joint health
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    • v.25 no.3
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    • pp.176-186
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    • 2018
  • Purpose: The purpose of the study was to describe work experiences of triage nurses working at emergency departments in Korea. Methods: A qualitative descriptive research method was used. Twenty-one nurses of emergency department participated in the first interview and 16 of them participated in the second interview. Data were collected through in-depth interviews and field notes. Qualitative content analysis was utilized to analyze the data. Results: Forty-eight codes, 12 categories, and six themes emerged from the data analysis: caring on the frontline, burden as an initial evaluator, handling things alone, lack of others' understanding, becoming an expert, and needs for improvement. Participating triage nurses faced many challenges and difficult situations in emergency departments. They felt burden and loneliness as initial evaluator. Also, they felt pride in their work and struggled to become a professional. Conclusion: This study is the first qualitative study that has focused on exploring the experiences of triage nurses in emergency departments in Korea. The results provide description and in-depth understanding of working experiences of triage nurses. The results provide valuable fundamental data for regulation, clinical practice, education, and research for triage nurses in Korean emergency departments.