• Journal of Preventive Medicine and Public Health
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• 제43권1호
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• pp.42-49
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• 2010

Objectives: To compare the performance of three International Statistical Classification of Diseases, 10th Revision translations of the Charlson comorbidities when predicting in-hospital among patients with myocardial infarction (MI). Methods: MI patients ${\geq}20$ years of age with the first admission during 2006 were identified(n=20,280). Charlson comorbidities were drawn from Heath Insurance Claims Data managed by Health Insurance Review and Assessment Service in Korea. Comparisions for various conditions included (a) three algorithms (Halfon, Sundararajan, and Quan algorithms), (b) lookback periods (1-, 3- and 5-years), (c) data range (admission data, admission and ambulatory data), and (d) diagnosis range (primary diagnosis and first secondary diagnoses, all diagnoses). The performance of each procedure was measured with the c-statistic derived from multiple logistic regression adjusted for age, sex, admission type and Charlson comorbidity index. A bootstrapping procedure was done to determine the approximate 95% confidence interval. Results: Among the 20,280 patients, the mean age was 63.3 years, 67.8% were men and 7.1% died while hospitalized. The Quan and Sundararajan algorithms produced higher prevalences than the Halfon algorithm. The c-statistic of the Quan algorithm was slightly higher, but not significantly different, than that of other two algorithms under all conditions. There was no evidence that on longer lookback periods, additional data, and diagnoses improved the predictive ability. Conclusions: In health services study of MI patients using Health Insurance Claims Data, the present results suggest that the Quan Algorithm using a 1-year lookback involving primary diagnosis and the first secondary diagnosis is adequate in predicting in-hospital mortality.

• Journal of Acupuncture Research
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• 제24권3호
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• pp.19-28
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• 2007

Objectives : This study was conducted in order to analyze the admission patients of facial nerve paralysis by Sasang constitution. Methods: A clinical study was done on 61 admission patients who were diagnosed and treated as facial nerve paralysis (Bell's palsy) from September, 2005 to May 2006 at the Dept. of Acupuncture and Moxibution, Chung-ju Hospital, college of Daejeon Oriental Medicine. We classified 61 patients according to Sasang constitution by QSCC II, attack side, sex, cause factor, concomitant symptom and Yanagihara' s score at the admission and discharge, and analyzed the improvement of Yanagihara's score between Sasang constitution groups. Results: 1. By sex, the ratio of Taeumin was higher than that of Soyangin in female. 2. By attack side, there is no significant difference between constitution groups In concomitant symptoms and cause factors. 3. By improvement of Yanagihara's scores between admission and discharge, the improvement score in Soyangin was a little bit higher than that in Soeumin, but there is no significant difference. Conclusion : The results suggest that there is no significant difference in all aspects except sex in Sasang constitution. But it is considered that we need to keep on studying afterwards because we had limits in getting enough patients.

• 대한한방내과학회지
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• 제33권2호
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• pp.172-179
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• 2012

Objectives : This study was designed to quantify the characteristics, main diagnosis and complications in the intensive care unit (ICU) at an Oriental Medical Hospital. Methods : The medical records of 44 patients admitted to the ICU at Kyunghee Oriental Medical Hospital between January 1, 2011 and December 31, 2011 were reviewed. Basic characteristics of patients, admission channel, main diagnosis, east-western medical therapy, mortality, and complications were investigated retrospectively based on medical notes. Results : 1. The total number of patients was 44. Males were 63.6%, females 36.3%. Average admission days was 15.9. 2. The most frequent age group is eighties, 38.6%. 3. The most frequent disease is cerebrovascular disease, 61.3%. 4. The medical therapy done after admission to ICU was intubation. Central vein insertion was performed next, followed by Foley's catheter insertion, ventilator, tracheostomy, nasogastric intubation, and thoracentesis in order. The proportion of Oriental medical treatment provided to the patients of ICU was as follows: herbal medication only 6.8%; herbal medication plus acupuncture 31.8%; herbal medication, acupuncture electro-acupuncture, plus subcutaneous acupuncture 2.3%; and none 27.3%. 5. The number of cases of complications occurred since ICU admission was 18. The most frequently observed complication was infection, including 6 cases of pneumonia and 4 cases of urinary tract infection. Conclusions : We suggest that ICUs of Oriental medical hospitals need to be managed effectively to treat diseases including cerebrovascular disease and prevent complications.

• Journal of Korean Neurosurgical Society
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• 제56권1호
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• pp.34-41
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• 2014

Objective : The purpose of this study was to describe the clinical characteristics, treatment outcomes, and prognostic factors in patients with brain abscesses treated in a single institute during a recent 10-year period. Methods : Fifty-one patients with brain abscesses who underwent navigation-assisted abscess aspiration with antibiotic treatment were included in this study. Variable parameters were collected from the patients' medical records and radiological data. A comparison was made between patients with favorable [Glasgow Outcome Scale (GOS) ${\geq}4$] and unfavorable (GOS <4) outcomes at discharge. Additionally, we investigated the factors influencing the duration of antibiotic administration. Results : The study included 41 male and 10 female patients with a mean age of 53 years. At admission, 42 patients (82%) showed either clear or mildly disturbed consciousness (GCS ${\geq}13$) and 24 patients (47%) had predisposing factors. The offending microorganisms were identified in 25 patients (49%), and Streptococcus species were the most commonly isolated bacteria (27%). The mean duration of antibiotic administration was 42 days. At discharge, 41 patients had a favorable outcome and 10 had an unfavorable outcome including 8 deaths. The decreased level of consciousness (GCS <13) on admission was likely associated with an unfavorable outcome (p=0.052), and initial hyperglycemia (${\geq}140mg/dL$) was an independent risk factor for prolonged antibiotic therapy (p=0.032). Conclusion : We found that the level of consciousness at admission was associated with treatment outcomes in patients with brain abscesses. Furthermore, initial hyperglycemia was closely related to the long-term use of antibiotic agents.

• 대한지역사회영양학회지
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• 제23권1호
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• pp.48-59
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• 2018

Objectives: This study was performed to investigate the effect of active nutrition care on feeding and nutritional status of elderly patients receiving long-term enteral tube feeding. Methods: Subjects included 77 elderly patients who had received enteral nutrition more than one week before admission. Nutrition care was provided to patients supplied less calories than required. Feeding intolerance was examined and managed every day and formula was adjusted to meet nutritional requirement during the first 3 months after admission. Patients were classified into under or over 80% of percent ideal body weight (PIBW) and medical records were used to compare changes in weight,, biochemical indices, and nutritional status during the study. Results: Weight, BMI, triglyceride and total cholesterol in blood, hemoglobin, and hematocrit levels were significantly lower in patients under 80% of the PIBW than in those over 80% of the PIBW at admission. The percentage of supply to required calories was also lower in patients under 80% of the PIBW. After 1 month of nutritional care, supplied volume of formula was significantly increased in patients under 80% of the PIBW. Weight, BMI, and PIBW were increased and there were no differences between groups after 6 months. In addition, the concentrations of triglyceride and total cholesterol in blood, hemoglobin, and hematocrit tended to increase in patients under 80% of the PIBW, leading to no difference between groups after 3 months. Conclusions: Personalized active nutrition care is effective to increase weight and improve feeding and nutritional status in underweight elderly patients receiving long-term enteral nutrition.

• Korean Journal of Radiology
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• 제23권8호
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• pp.828-834
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• 2022

Objective: This study aimed to assess the outcomes of outpatient day-care management of unruptured intracranial aneurysm (UIA), and to present the risks associated with different management strategies by comparing the outcomes and adverse events between outpatient day-care management and management with longer admission periods. Materials and Methods: This retrospective cohort study used prospectively registered data and was approved by a local institutional review board. We enrolled 956 UIAs from 811 consecutive patients (mean age ± standard deviation, 57 ± 10.7 years; male:female = 247:564) from 2017 to 2020. We compared the outcomes after embolization among the different admission-length groups (1, 2, and ≥ 3 days). The outcomes included pre- and post-modified Rankin Scale (mRS) scores and rates of adverse events, cure, recurrence, and reprocedure. Events were defined as any cerebrovascular problems, including minor and major stroke, death, or hemorrhage. Results: The mean admission period was 2 days, and 175 patients (191 aneurysms), 551 patients (664 aneurysms), and 85 patients (101 aneurysms) were discharged on the day of the procedure, day 2, and day 3 or later, respectively. During the mean 17-month follow-up period (range 6-53 months; 2757 patient years), no change in post-mRS was observed compared to pre-mRS in 99.6% of patients. Cure was achieved in 95.6% patients; minimal recurrence that did not require re-procedure occurred in 3.5% patients, and re-procedure was required in 2.3% (22 of 956) patients due to progressive enlargement of the recurrent sac during follow up (mean 17 months, range, 6-53 months). There were eight adverse events (0.8%), including five cerebrovascular (two major stroke, two minor strokes and one transient ischemic stroke), and three non-cerebrovascular events. Statistical comparison between groups with different admission lengths (1, 2, and ≥ 3 days) revealed no difference in the outcomes. Conclusion: This study revealed no difference in outcomes and adverse events according to the admission period, and suggested that UIA could be managed by outpatient day-care embolization.

• 기본간호학회지
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• 제13권3호
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• pp.428-436
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• 2006

Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

• 성인간호학회지
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• 제27권3호
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• pp.347-357
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• 2015

Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.

• 대한한방내과학회지
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• 제13권1호
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• pp.46-60
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• 1992

Clinical observation was done on 496cases of the Out-patients and 136cases of the In-patients more than 65 years of age in Department of Internal Medicine, Oriental Medical Hospital in Dong Guk Univ. from March 1991 to February 1992. The results were as follows; 1. The ratio of senile (more than 65 years of age) was 16.4% in total Out-patients, was 38.1% in total In-patients. 2. The ratio of male to female was 1:1.1 in the Out-patients, In-patients was 1.2:1. The age distribution showed the large number in the 65-69 year group, the female more than the male in 70 th's group. 3. The diagnostic distribution was noted in the Out-patients as follows, Respiratory Dis. 50.6%, Cardiovascular Dis 16.4%, Brain Neurogic Dis. 14.5%, Gastrointestinal Dis. 8.1%. in the In-patients. Brain Neurogic Dis. was 76.5%, Cardiovascular Dis was 19.8%. 4. The ratio of the season distribution in the Out-patients was as follows, spring 40.2%, winter 21.2%, summer 20.9%, in the In-patients. winter was 35.9%, autumn was 25.0%, spring was 19.9%. 5. The utilization of therapeutic clinic before coming the Oriental Medical Hospital in Dong Guk Univ, was as follows, the ratio of the Out-patients was noted a hospital or clinic was 57.1%, no-treatment 22.9%, a oriental medical hospital or clinic was 8.3%. In the admission was noted no-treatment was 38.3%, a oriental medical hospital or clinic was 35.3%. 6. The ratio of the periods from onset to Out-patients department was noted within 5days was 7.3%, over 1 year was 52.6%. In the admission was noted within 1 day was 41.9%, within 7 days was 71.8%. 7. The ratio of the therapeutic periods in the Out-patients department was noted within 10 days was 48.3%, over 60 days was 7.1%. 8. The ratio of the admission periods was noted within 10 days was 45.6%, the median of the admissio was 10.8 days. Brain Neurogic Dis's median was 20.2 days. 9. The therapeutic result was noted the case of improvement was 75.7% in the admission. 10. The ratio of the Out-patients department after discharging was 53.7%, in the case of Brain Neurogic Dis. was 60.7%.

• Journal of Trauma and Injury
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• 제26권2호
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• pp.47-52
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• 2013

Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.