• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.249-255
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• 2018

Objective As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group. Methods For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ${\geq}85years$. Participants' sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded. Results During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P<0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001). Conclusion With increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

• ETRI Journal
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• v.28 no.5
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• pp.593-606
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• 2006

Thanks to the great possibilities of providing different types of telecommunication traffic to a large geographical area, satellite networks are expected to be an essential component of the next-generation internet. As a result, issues concerning the designing and testing of efficient connection-admission-control (CAC) strategies in order to increase the quality of service (QoS) for multimedia traffic sources, are attractive and at the cutting edge of research. This paper investigates the potential strengths of a generic digital-video-broadcasting return-channel-via-satellite (DVB-RCS) system architecture, proposing a new CAC algorithm with the aim of efficiently managing real-time multimedia video sources, both with constant and high variable data rate transmission; moreover, the proposed admission strategy is compared with a well-known iterative CAC mainly designed for the managing of real-time bursty traffic sources in order to demonstrate that the new algorithm is also well suited for those traffic sources. Performance analysis shows that, both algorithms guarantee the agreed QoS to real-time bursty connections that are more sensitive to delay jitter; however, our proposed algorithm can also manage interactive real-time multimedia traffic sources in high load and mixed traffic conditions.

• Journal of Communications and Networks
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• v.4 no.3
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• pp.230-245
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• 2002

Usually the network-throughput maximization problem for constant-bit-rate (CBR) circuit-switched traffic is posed for a fixed offered load profile. Then choices of routes and of admission control policies are sought to achieve maximum throughput (usually under QoS constraints). However, similarly to the notion of channel “capacity,” it is also of interest to determine the “network capacity;” i.e., for a given network we would like to know the maximum throughput it can deliver (again subject to specified QoS constraints) if the appropriate traffic load is supplied. Thus, in addition to determining routes and admission controls, we would like to specify the vector of offered loads between each source/destination pair that “achieves capacity.” Since the combined problem of choosing all three parameters (i.e., offered load, admission control, and routing) is too complex to address, we consider here only the optimal determination of offered load for given routing and admission control policies. We provide an off-line algorithm, which is based on Lagrangian techniques that perform robustly in this rigorously formulated nonlinear optimization problem with nonlinear constraints. We demonstrate that significant improvement is obtained, as compared with simple uniform loading schemes, and that fairness mechanisms can be incorporated with little loss in overall throughput.

• Journal of Korean Critical Care Nursing
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• v.11 no.3
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• pp.45-57
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• 2018

Purpose : This study was performed to identify the influencing factors of unplanned intensive care unit (ICU) readmission. Methods : The study adopted a Rretrospective case control cohort design. Data were collected from the electronic medical records of 844 patients who had been discharged from the ICUs of a university hospital in Incheon from June 2014 to December 2014. Results : The study found the unplanned ICU readmission rate was to be 6.4%(n=54). From the univariate analysis revealed that, major symptoms at $1^{st}$ ICU admission, severity at $1^{st}$ ICU admission (CPSCS and APACHE II), duration of applying ventilator application during $1^{st}$ ICU admission, severity at $1^{st}$ discharge from ICU (CPSCS, APACHE II, and GCS), and application of $FiO_2$ with oxygen therapy, implementation of sputum expectoration methods, and length of stay of ICU at $1^{st}$ ICU discharge were appeared to be significant; further, decision tree model analysis revealed that while only 4 variables (sputum expectoration methods, length of stay of ICU, $FiO_2$ with oxygen therapy at $1^{st}$ ICU discharge, and major symptoms at $1^{st}$ ICU admission) were shown to be significant. Conclusions : Since sputum expectoration method was the most important factor to predictor of unplanned ICU readmission, a assessment tool for the patients' capability of sputum expectoration needs to should be developed and implemented, and standardized ICU discharge criteria, including the factors identified from the by empirical evidences, might should be developed to decrease the unplanned ICU readmission rate.

• Journal of Korean Clinical Nursing Research
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• v.28 no.1
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• pp.1-12
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• 2022

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x² test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

• 전자공학회논문지 IE
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• v.48 no.4
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• pp.47-52
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• 2011

In this paper, we analyse the performance of cellular system for call admission method considering to various service types. The call admission control method using the effective bandwidth concept is employed in this paper. In addition, the bandwidth for a new calls and a handover calls is allocated by taking account of the blocking rate of new calls and the dropping rate of handover calls. We reserved wireless resource and used waiting buffer for hanover calls. We simulated using computer for the performance analysis of system.

• Korean Journal of Adult Nursing
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• v.19 no.1
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• pp.45-54
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• 2007

Purpose: This study was to identify the significant acute physiological predictors of mortality and of functional and cognitive recovery in hemorrhagic stroke patients. Methods: The subjects were 108 hemorrhagic stroke patients admitted to Neurological Intensive Care Unit of a university hospital. Results: The significant physiological predictors of mortality and of functional and cognitive recovery were quite different upon admission Glasgow Coma Scale scores: respiratory rate, hematocrit, serum pH, osmolality, and $PaCO_2$ were the predictors in the subjects with a high Glasgow Coma Scale scores while blood pressure, $PaO_2$, respiratory rate, and hematocrit in the subjects with a low Glasgow coma scale scores. Conclusion: The physiological derangements induced by acute stroke are undoubtedly influence clinical outcome. More study is required to determine their diverse impacts on clinical outcomes.

• Journal of Trauma and Injury
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• v.23 no.2
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• pp.113-118
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• 2010

Purpose: Prolonged stay in the emergency department (ED), which is closely related with the time interval from the ED visit to a decision to admit, might be associated with poor outcomes for trauma patients and with overcrowding of the ED. Therefore, we examined the factors affecting the delay in the decision to admit severe trauma patients. Also, a multidisciplinary department system was preliminarily evaluated to see if it could reduce the time from triage to the admission decision. Methods: A retrospective observational study was conducted at a tertiary care university hospital without a specialized trauma team or specialized trauma surgeons from January 2009 to March 2010. Severe trauma patients with an International Classification of Disease Based Injury Severity Score (ICISS) below 0.9 were included. A multivariable logistic regression analysis was used to find independent variables associated with a delay in the decision for admission which was defined as the time interval between ED arrival and admission decision exceeded 4 hours. We also simulated the time from triage to the decision for admission by a multidisciplinary department system. Results: A total of 89 patients were enrolled. The average time from triage to the admission decision was $5.2{\pm}7.1$ hours and the average length of the ED stay was $9.0{\pm}11.5$ hours. The rate of decision delay for admission was 31.5%. A multivariable regression analysis revealed that multiple trauma (odds ratio [OR]: 30.6, 95%; confidence interval [CI]: 3.18-294.71), emergency operation (OR: 0.55, 95%; CI: 0.01-0.96), and treatment in the Department of Neurosurgery (OR: 0.07, 95%; CI: 0.01-0.78) were significantly associated with the decision delay. In a simulation based on a multidisciplinary department system, the virtual time from triage to admission decision was $2.1{\pm}1.5$ hours. Conclusion: In the ED, patients with severe trauma, multiple trauma was a significant factor causing a delay in the admission decision. On the other hand, emergency operation and treatment in Department of Neurosurgery were negatively associated with the delay. The simulated time from triage to the decision for admission by a multidisciplinary department system was 3 hours shorter than the real one.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.4 no.2
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• pp.39-45
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• 2009

Objectives : The aim of this study is to compare the improvement of Low back pain (LBP) depending on male Inpatient's Brachlalankle Pulse Wave Velocity (baPWV), Method : We evaluated 35 LBP inpatients who took pulse wave velocity test during admission at Jaseng hospital from November 2008 to september 2009. We used applanation tonometry method to measure pulse wave velocity and numerical rating scale to measure patient's improvement. Result : At admission, standard deviation of normal group's NRS was $7.44{\pm}1.67$ and high risk group's was $7.57{\pm}2.09$(P=0.678). After 5 days of admission, standard deviation of normal group's NRS was $5.67{\pm}1.94$ and high risk group's was $6.00{\pm}2.17$(P=0.680). After 10 days of admission, standard deviation of normal group's NRS was $4.00{\pm}1.80$ and high risk group's was $4.95{\pm}1.96$(P=0.281). After 15 days of admission, standard deviation of normal group's NRS was $2.89{\pm}1.62$ and high risk group's was $4.10{\pm}1.92$(P=0.124). At discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504). Comparison between admission and discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504) Conclusion : Low back patients with high Brachialankle Pulse Wave Velocity, showed slower improvement rate compare to patients within normal rate. But statically, had no significance.

• Journal of Advanced Navigation Technology
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• v.13 no.6
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• pp.901-906
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• 2009

This paper proposes a call admission control(CAC) method for wireless networks, which is based on the upper bound of a possibility distribution of handoff calls dropping rates. The possibility distribution is estimated in a fuzzy inference and a learning algorithm in neural network. The learning algorithm is considered for tuning the membership functions(then parts)of fuzzy rules for the inference. The fuzzy inference method is based on a weighted average of fuzzy sets. The proposed method can avoid estimating excessively large handoff calls dropping rates, and makes possibile self-compensation in real time for the case where the estimated values are smaller than real values. So this method makes secure CAC, thereby guaranteeing the allowed CDR. From simulation studies we show that the estimation performance for the upper bound of call dropping rate is good, and then handoff call dropping rates in CAC are able to be sustained below user's desired value.