• Title/Summary/Keyword: 환자의 분류

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Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

The Relationship between FEV1 and PEFR in the Classification of the Severity in COPD Patients (만성 폐쇄성 폐질환 환자의 중증도 분류시 FEV1과 PEFR의 연관성)

  • Shin, Sang Youl;Ho, Yoon Jae;Kim, Sun Jong;Yoo, Kwang Ha
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.5
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    • pp.507-514
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    • 2005
  • Background : Measurement of the $FEV_1$ and PEFR in COPD patients is a significant indicator of the disease severity, the response to treatment and the acute exacerbation. However, it is not known if PEFR can be used to determine the severity of COPD because the agreement between PEFR and $FEV_1$ in COPD patients is not well known. Methods : From September, 2003 to August, 2004, 125 out patients with COPD who were treated at the pulmonary clinic in KonKuk University Hospital were enrolled in this study. The $FEV_1$ and PEFR of each patient were measured and all the data was analyzed using SPSS. Results : The average predicted $FEV_1$ % and PEFR % was $56.98{\pm}18.21%$ and $70{\pm}27.60%$, respectively. There was linear correlation between the predicted $FEV_1$ % and predicted PEFR %. There was no correlation between age of the COPD patients and the predicted PEFR %. There was correlation between dyspnea, which is a subjective symptom of the patients, and the predicted PEFR %. Conclusion : In COPD patients, the classification of the severity by PEFR tends to underestimate the state of the disease compared with the classification of the severity by the $FEV_1$. Therefore, the classification of the severity by PEFR should be interpreted carefully in patients with severe symptoms. Once the classification of the severity has made, the follow-up examination may use the PEFR instead of the $FEV_1$.

Estimation of the steps of cardiovascular disease by machine learning based on aptamers-based biochip data (기계학습에 의한 압타머칩 데이터 기반 심혈관 질환 단계의 예측)

  • Kim Byoung-Hee;Kim Sung-Chun;Zhang Byoung-Tak
    • Proceedings of the Korean Information Science Society Conference
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    • 2006.06a
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    • pp.85-87
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    • 2006
  • 압타머칩은 (주)제노프라에서 개발한 새로운 개념의 바이오칩으로서, 압타머(aptamer)를 이용하여 혈액중의 특정 단백질군의 상대적인 양의 변화를 측정할 수 있으며, 질병 진단에 바로 응용할 수 있는 도구이다. 본 논문에서는 압타머칩 데이터 분석을 통해 심혈관 질환 환자의 질병 진행 단계를 예측할 수 있음을 보인다. 정상, 안정/불안정성 협심증, 심근경색의 네 단계로 표지된 환자의 혈액 샘플로부터 제작한 (주)제노프라의 3K 압타머칩 데이터를, 일반 DNA 마이크로어레이 분석과 동일한 과정을 거쳐 분류한 결과, 각 단계별 환자샘플이 확연히 구분되는 것을 확인하였다. 분산분석 결과 P-Value를 이용하여 자질 선택을 수행하고, 분류 알고리즘으로는 신경망, 결정트리, SVM, 베이지안망을 적용한 결과. 각 알고리즘별로 50대 남성환자 31개의 샘플에 대하여 $77{\sim}100%$의 정확도로 심혈관 질환의 단계를 구분해내었다.

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A Study on the Guideline of Spatial Composition and Circulation in Triages and Entrances Area in Emergency Departments for Efficient Infection Control (응급부 진입구역과 환자분류구역의 감염관리를 위한 환자동선과 공간구성 계획에 대한 연구)

  • Kang, Jeeeun;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.1
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    • pp.41-49
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    • 2019
  • Purpose: After Mers breakout in 2015, major hospital in Korea have been renovated the emergency department to make a separate infection control zone for high-risk patient with potential infection and to improve a triage area and an entrance area for efficient patient evaluation. However, there are no specific design standards to reinforce infection control for patients and staffs safety. Therefore, it is important to establish of initial design factors in the triage and entrance area as a guideline. Methods: 5 cases which had been recently renovated are selected to analyze patient circulation and spatial composition in a triage area and an entrance area. The partial floor plans of each case are represented as bubble diagrams to help understanding of different patient circulation flows. Based on this analysis, significant design factors which should be considered in planning stage for infection control have been extracted. Results: 13 design factors are established. Using these design factors, patient circulation diagram is generated to provide an optimized suggestion for efficient infection control. Implications: This suggestion provides basic databases to start to establish design guideline in the triage area and the entrance area to minimize infection spreading in the emergency department.

The Study on the Perception of Self-Regulation in Diabetic Patients (당뇨병 환자의 자기조절 인식에 관한 연구)

  • Han, Hye-Sook;Bae, Sun-Hee;Park, Young-Sun
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2021.01a
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    • pp.107-109
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    • 2021
  • 본 연구는 당뇨병 환자의 자기조절에 대한 주관적 유형과 특성을 분석하고자 시도되었으며, 당뇨병 환자의 주관성을 연구하는데 효과적인 Q방법론을 적용하였다. 대상자는 제2형 당뇨병을 진단받은 사람으로서 경구약이나 인슐린 주사로 치료받고 있으나 현재는 입원한 싱태가 아닌 사람 38명으로 구성하였으며, Q표본 40개의 진술문을 가장 부정(-4)에서 가장 긍정(+4) 범위의 9점 척도 상에 분류하도록 하였다. Q분류된 자료는 QUANL PC program을 이용하여 주요인분석(principal component factor analysis)과 배리맥스 회전(varimax rotation)을 통해 Q 요인분석이 행해졌다. 분석결과 당뇨병환자 자기조절에 대학여 제 1유형은 근거기반 순응형, 제2유형은 위기의식 자립거부형, 제3유형은 정보기반 관계지향형, 제4유형은 자기신뢰 실천형, 제5유형은 주관적 결핍 기반 반응 행동형으로 5가지 유형의 관점을 보여주었다. 따라서 당뇨병 환자 효율적 관리방법을 위해 당뇨병 환자의 질병 관리의 부정적 행위 성향을 이해하고, 당뇨지식 교육, 당뇨관리 정보 및 긍정적 심리를 통한 자기조절 프로그램을 개발 할 필요가 있다.

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Information System Research for Safe Transportation in the era of Pandemic Infectious Disease (팬데믹 감염병 시대에 안전이송을 위한 정보시스템 연구)

  • Kim, Seung-Yong;Hwang, In-Cheol;Kim, Dong-Sik
    • Proceedings of the Korean Society of Disaster Information Conference
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    • 2022.10a
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    • pp.335-336
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    • 2022
  • 연구목적: 감염병 유행시 감염병 의심 환자의 구급활동을 위해 출동한 소방대원의 안전을 확보하고, 현장에서 수집된 정보를 바탕으로 지역별 감염병 의심환자 발생 현황을 파악하여 현장 통제 및 지원이 가능한 소방 감염병 관리 시스템을 개발하고자 한다. 연구방법: 감염병 의심 환자를 분류할 수 있는 스마트폰 앱을 개발하여 감염병 의심 여부를 확인하고, 감염병 의심 환자로부터 감염을 방지하기 위해 환자 식별용 NFC태그를 1회용 형태로 개발한다. 현장에서 입력되는 감염병 의심 응급환자 관련 데이터를 수집하고 분석할 수 있는 관리 시스템을 개발하여 해당 업무 관련자에게 제공하여 감염병 의심 응급환자의 이송을 개선하는지 평가한다. 연구결과: 실험결과 스마트폰 앱에 구현된 알고리듬을 통해 감염병 의심 여부를 판단할 수 있었으며, 적정 이송병원으로 이송함으로써 재이송 비율히 현저히 감소되었다. 결론: 본 연구를 통해 응급의료 서비스에 ICT 기술을 적용하여 응급의료 서비스를 개선할 수 있는 가능성을 확인하였으며 특히 감염병 의심환자에 대한 적정병원 이송으로 이송시간 단축 및 응급환자의 소생률 향상과 함께 구급대원의 안전을 적극적으로 확보할 수 있을 것으로 기대된다.

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Patient Adaptive Pattern Matching Method for Premature Ventricular Contraction(PVC) Classification (조기심실수축(PVC) 분류를 위한 환자 적응형 패턴 매칭 기법)

  • Cho, Ik-Sung;Kwon, Hyeog-Soong
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.16 no.9
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    • pp.2021-2030
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    • 2012
  • Premature ventricular contraction(PVC) is the most common disease among arrhythmia and it may cause serious situations such as ventricular fibrillation and ventricular tachycardia. Particularly, in the healthcare system that must continuously monitor patient's situation, it is necessary to process ECG (Electrocardiography) signal in realtime. In other words, the design of algorithm that exactly detects R wave using minimal computation and classifies PVC by analyzing the persons's physical condition and/or environment is needed. Thus, the patient adaptive pattern matching algorithm for the classification of PVC is presented in this paper. For this purpose, we detected R wave through the preprocessing method, adaptive threshold and window. Also, we applied pattern matching method to classify each patient's normal cardiac behavior through the Hash function. The performance of R wave detection and abnormal beat classification is evaluated by using MIT-BIH arrhythmia database. The achieved scores indicate the average of 99.33% in R wave detection and the rate of 0.32% in abnormal beat classification error.

A Search for Analogous Patients by Abstracting the Results of Arrhythmia Classification (부정맥 분류 결과의 축약에 기반한 유사환자 검색기)

  • Park, Juyoung;Kang, Kyungtae
    • KIISE Transactions on Computing Practices
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    • v.21 no.7
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    • pp.464-469
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    • 2015
  • Long-term electrocardiogram data can be acquired by linking a Holter monitor to a mobile phone. However, most systems are designed to detect arrhythmia through heartbeat classification, and not just for supporting clinical decisions. In this paper, we propose an Abstracting algorithm, and introduce an analogous pateint search system using this algorithm. An analogous patient searcher summarizes each patient's typical pattern using the results of heartbeat, which can greatly simplify clinical activity. It helps to find patients with similar arrhythmia patterns, which can help in contributing to diagnostic clues. We have simulated these processes on data from the MIT-BIH arrhythmia database. As a result, the Abstracting algorithm provided a typical pattern to assist in reaching rapid clinical decisions for 64% of the patients. On an average, typical patterns and results generated by the abstracting algorithm summarized the results of heartbeat classification by 98.01%.

Characteristics of Brain Perfusion in Patients of Parkinson's Disease (파킨슨병 환자의 뇌관류 분석)

  • Jeong, Young-Jin;Park, Min-Jung;Kim, Jae-Woo;Kang, Do-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.17-28
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    • 2008
  • Purpose: It was well known that cerebral blood perfusion is normal or diffusely decreased in the majority of patients with Parkinson's disease (PD). Actually we interpreted brain perfusion SPECT images of PD patients in the clinical situation, we observed various cerebral perfusion patterns in patients with PD. So we performed brain perfusion SPECT to know the brain perfusion patterns of PD patients and the difference of perfusion patterns according to the sex and the age. Also we classified PD patients into small groups based on the brain perfusion pattern. Methods and Materials: Two hundred nineteen patients (M: 70, F: 149, mean age: $62.9{\pm}6.9$ y/o) who were diagnosed as PD without dementia clinically and 55 patients (M:15, F:40, mean age: $61.4{\pm}9.2$ y/o) as normal controls who had no past illness history were performed $^{99m}Tc$-HMP AO brain perfusion SPECT and neuropsychological test. Results: At first, we compared all patients with PD and normal controls. Brain perfusion in left inferior frontal gyrus, left insula, left transverse temporal gyrus, left inferior parietal lobule, left superior parietal lobule, right precuneus, right caudate tail were lower in patients with PD than normal controls. Secondly, we compared male and female patients with PD and normal controls, respectively. Brain perfusion SPECT showed more decreased cerebral perfusion in left hemisphere than right side in both male and female patients compared to normal controls. And there was larger hypoperfusion area in female patients compared with male. Thirdly, we classified patients with PD and normal controls into 4 groups according to the age and compared brain perfusion respectively. In patient below fifties, brain perfusion in both occipitoparietal and left temporal lobe were lower in PD group. As the patients with PD grew older, hypoperfusion area were shown in both frontal, temporal and limbic lobes. Fourthly, We were able to divide patients into small groups based on cerebral perfusion pattern. There was normal cerebral blood perfusion in 32 (14.7%) of 219 patients with PD, decreased perfusion on the frontal lobe in 45 patients (20.6%), the temporal lobe in 39 patients (17.4%), the parietal lobe in 39 patients (17.9%), the occipital lobe in 40 patients (18.3%), diffuse area in 14 patients (6.4%) and unclassified in 10 patients (4.6%). Fifthly, we compared the results of the neuropsychological test and cerebral perfusion pattern. There was no correlation between two tests except visuospatial function. Conclusion: Various perfusion state were found in patients with PD according to the age and sex. Also we were able to classify perfusion state into several groups and compare the neuropsychological test with cerebral perfusion.

Influential Factors on patient assessment Execution Given Emergency Medical Care Transportation of Cerebro-Vascular Accident Patients (뇌혈관질환 환자 이송 시 환자평가 시행에 미치는 요인)

  • Roh, Sang-Gyun;Kim, Jee-Hee
    • Proceedings of the Korea Institute of Fire Science and Engineering Conference
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    • 2012.04a
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    • pp.178-181
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    • 2012
  • 이 연구 대상자는 일개 대학병원 응급의료센터로 소방구급대를 통해 내원한 환자 중 컴퓨터 단층촬영으로 뇌졸중으로 진단된 환자에서 이송 시 환자평가 시행에 영향을 미치는 요인을 분석한 연구이다. 연구결과 환자 평가에 영향을 미치는 요인은 환자분류(응급, 비응급, 지연), 의식상태(AVPU 척도)보다는 구급대원 자격별이 병원 전 뇌졸중 환자 이송 시 환자평가 시행에 영향을 미치는 것으로 확인되었다.

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