• Nutrition Research and Practice
• /
• v.11 no.6
• /
• pp.492-499
• /
• 2017

BACKGROUND/OBJECTIVES: This study aimed to investigate the association of dietary patterns with overweight risk and all-cause mortality in pediatric cancer patients. SUBJECTS/METHODS: Prospective cohort study was undertaken; 83 cancer patients admitted to the pediatric cancer ward at a university hospital in Seoul were included and followed for obesity and death over 24 months. Food consumption data were collected from patients using validated meal order sheets for breakfast, lunch, and dinner at the pediatric cancer ward over 3 days. Using principal component analysis, three dietary patterns were derived from 29 food groups. RESULTS: Eighteen deaths occurred among the patient cohort during the follow-up period. The "spicy & fried meat and fish" dietary pattern was positively associated with overweight risk at both baseline [odds ratio (OR) = 4.396, 95% confidence interval (CI) = 1.111-17.385, P for trend = 0.023] and after 6 months (OR = 4.088, 95% CI = 1.122-14.896, P for trend = 0.025) as well as all-cause mortality (hazard ratios = 5.124, 95% CI = 1.080-24.320, P for trend = 0.042), when comparing the highest and lowest tertiles after adjusting for covariates. The "fish, egg, meat, and fruits & vegetables" dietary pattern was associated with lower overweight risk after 24 months (OR = 0.157, 95% CI = 0.046-0.982, P for trend = 0.084). CONCLUSION: The results imply that dietary patterns might be associated with weight gain and premature death among pediatric cancer patients.

• Korean Circulation Journal
• /
• v.53 no.9
• /
• pp.606-618
• /
• 2023

Background and Objectives: The prognostic or safety implication of renin-angiotensin-aldosterone system inhibitors (RASi) in hypertrophic cardiomyopathy (HCM) are not well established, mainly due to concerns regarding left ventricular outflow tract (LVOT) obstruction aggravation. We investigated the implications of RASi in a sizable number of HCM patients. Methods: We enrolled 2,104 consecutive patients diagnosed with HCM in 2 tertiary university hospitals and followed up for five years. RASi use was defined as the administration of RASi after diagnostic confirmation of HCM. The primary and secondary outcomes were all-cause mortality and hospitalization for heart failure (HHF). Results: RASi were prescribed to 762 patients (36.2%). During a median follow-up of 48.1 months, 112 patients (5.3%) died, and 94 patients (4.5%) experienced HHF. Patients using RASi had less favorable baseline characteristics than those not using RASi, such as older age, more frequent history of comorbidities, and lower ejection fraction. Nonetheless, there was no difference in clinical outcomes between patients with and without RASi use (log-rank p=0.368 for all-cause mortality and log-rank p=0.443 for HHF). In multivariable analysis, patients taking RASi showed a comparable risk of all-cause mortality (hazard ratio [HR], 0.70, 95% confidence interval [CI], 0.43-1.14, p=0.150) and HHF (HR, 1.03, 95% CI, 0.63-1.70, p=0.900). In the subgroup analysis, there was no significant interaction of RASi use between subgroups stratified by LVOT obstruction, left ventricular (LV) ejection fraction, or maximal LV wall thickness. Conclusions: RASi use was not associated with worse clinical outcomes. It might be safely administered in patients with HCM if clinically indicated.

• Hip & pelvis
• /
• v.35 no.3
• /
• pp.206-215
• /
• 2023

Purpose: Delay in performance of hip fracture surgery can be caused by medical and/or administrative reasons. Although early surgery is recommended, it is unclear what constitutes a delayed surgery and whether the impact of delayed surgery can differ depending on the reason for the delay. Materials and Methods: A total of 269 consecutive hip fracture patients over 50 years of age who underwent surgery were prospectively enrolled. They were divided into two groups: early and delayed (time from reaching the hospital to surgery less than or more than 48 hours). Patients were also categorized as fit or unfit based on anesthetic fitness. One-year mortality was recorded, and regression analyses were performed to assess the impact of delay on mortality. Results: A total of 153 patients (56.9%) had delayed surgery with a mean time to surgery of 87±70 hours. A total of 115 patients (42.8%) were considered medically fit to undergo surgery. No difference in one-year mortality was observed between patients with early surgery and those with delayed surgery (P=0.854). However, when assessment of the time to surgery was performed in a continuous manner, mortality increased with prolonged time to surgery, particularly in unfit patients, and higher mortality was observed when the delay exceeded six days (fit: P=0.117; unfit: P=0.035). Conclusion: The effect of delay on mortality was predominantly observed in patients who were not considered medically fit, suggesting that surgical delays might have a greater impact on patients with medical reasons for delay.

• Health Policy and Management
• /
• v.29 no.2
• /
• pp.220-227
• /
• 2019

Background: Potentially avoidable hospitalizations (PAH) contribute to an increased post-discharge mortality. Methods: To investigate the between-hospital variation and the relationship between all predictors and mortality after discharge among older adults with PAH, we studied 15,186 older patients with PAH in 2,200 hospitals included in the National Health Insurance Service-Senior claims database from 2002 to 2013. Multivariable multilevel logistic regression analyses were performed to analyze the variance at between-hospital for mortality after accounting for differences in patient characteristics. Results: The between-hospital variation in mortality that could be attributed to hospital practice variations were 37.6% at 1-week to 13.9% at 12-month post-discharge, after adjustment for individual patient characteristics and hospital-level factors. Hospital-level factors significantly explained mortality at 3 weeks after discharge. Clinics, compared with general hospitals, demonstrated a 2.75 times higher likelihood of deaths at 3-week post-discharge (p<0.001). Compared with private hospitals, public hospitals exhibited 1.61 times higher odds of 3-week mortality (p=0.01). Conclusion: This study demonstrates considerable between-hospital variations in PAH-related mortality that could be attributed to hospital practices. Monitoring of hospitals to identify practice variations would be warranted to improve the survival of older patients with PAH.

• Korean Circulation Journal
• /
• v.53 no.10
• /
• pp.710-719
• /
• 2023

Background and Objectives: In previous studies, high homocysteine levels were associated with high cardiovascular mortality. However, these results were inconsistent with those of randomized controlled trials. We aimed to evaluate the causal role of homocysteine on allcause and cardiovascular mortality using Mendelian randomization (MR) analysis. Methods: This study included the 10,005 participants in the Namwon Study. In conventional observational analysis, age, sex, survey years, lifestyles, body mass index, comorbidities, and serum folate level were adjusted using multivariate Cox proportional regression. MR using 2-stage least squares regression was used to evaluate the association between genetically predicted plasma homocysteine levels and mortality. Age, sex, and survey years were adjusted for each stage. The methylenetetrahydrofolate reductase (MTHFR) polymorphism was used as an instrumental variable for predicting plasma homocysteine levels. Results: Observed homocysteine levels were positively associated with all-cause (hazard ratio [HR], 1.40; 95% confidence interval [CI], 1.26-1.54) and cardiovascular (HR, 1.62; 95% CI, 1.28-2.06) mortality when plasma homocysteine levels doubled. However, these associations were not significant in MR analysis. The HRs of doubling genetically predicted plasma homocysteine levels for all-cause and cardiovascular mortality were 0.99 (95% CI, 0.62-1.57) and 1.76 (95% CI, 0.54-5.77), respectively. Conclusions: This MR analysis did not support a causal role for elevated plasma homocysteine concentrations in premature deaths.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.11
• /
• pp.94-103
• /
• 2016

This study was conducted to investigate the association of serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) with all-cause mortality among populations. The data used were from a Korean Genome and Epidemiology Study (KoGES) based on health examinations and questionnaires. The subjects consisted of 10,110 persons aged 40 and over. Hazard ratio was analyzed using Cox's proportional hazard model. The hazard ratio of AST (${\geq}50.0\;IU/L$) was 2.198 (95% CI: 1.217-3.971) after being adjusted for age, sex, education, regular exercise, smoking, drinking, WHR, and TG. In conclusion, AST was an independent significant risk factor of all-cause mortality, and ALT showed a tendency to increase. Overall, these findings indicate that AST and ALT may be useful tools for predicting mortality.

• Journal of the Korean Data and Information Science Society
• /
• v.27 no.5
• /
• pp.1169-1182
• /
• 2016

Cancer is a typical cause of death in Korea that becomes a major issue in health care. According to Cause of Death Statistics (2014) by National Statistical Office, SMRs (standardized mortality rates) in Busan were counted as the highest among all cities. In this paper, we used data of Busan Regional Cancer Center to estimate the extent of the cancer incidence rate and cancer mortality rate. The data are considered in small areas of administrative units such as Gu/Dong from years 2003 to 2009. All cancer including four major cancers (stomach cancer, colorectal cancer, lung cancer, liver cancer) have been analyzed. We carried out model selection and parameter estimation using spatial multi-level model incorporating a spatial correlation. For the spatial effects, CAR (conditional autoregressive model) has been assumed.

• Korea journal of population studies
• /
• v.11 no.1
• /
• pp.76-86
• /
• 1988

The primary objective of this study was to estimate the level of infant mortality rate and to find the cause of infant deaths prevailed in 1981~86 from vital registration data. In the course of that undertaking we have considered the non-registered portion of infant deaths especially for the non-registered portion of neonatal deaths. The main reason is that deaths occurring in the neonatal period and prior to the registration of the birth leave little incentive for the registration of either the birth or the death. From several ad-hoc survey's results and other countries' experiences it was, however, found that the proportion of neonatal deaths was 69.3%, the proportion of deaths in the period of first month in infanty was 7%, and the proportion of deaths in the period of 2 months and over in infancy was 23.7% respectivily. Thus, adoption the hypothesis that post-neonatal mortality is completly registered, we obtained the extimated number of infant deaths. Attempt to test the hypothesis was also made using the Brougeois- Pichats's function. The result was that the registered number of deaths in the post-neonatal period is almost compatible with the expected number. The major finding in this study was that the level of infant mortality rate in Korea was 19 per thousand live births in 1981 and 13 in 1986. This level of 1986 was almost identical with the level of Japan in 1970. It was also found that there was a difference in the level of infant mortality rate between sexes during 1981-83 but the difference was disappeared in 1985-86. Looking into the cause of infant deaths, it was found from registration that 21.2% of all infant deaths was due to congenital snomalies, 11.5% was due to pneumonia and 5.1% was due to the conditions originating in the perinatal period in that order. This pattern seems to be different with that of U.S.A., Japan and France. However, if we consider the non-registered neo-natal deaths, the order of the cause of infant deaths in Korea will be the same as compared countries. Finally, every efforts should should be made to obtain a good quality of data on infant mortality, making the non-registered events reported completely through hospitals.

• Journal of Menopausal Medicine
• /
• v.24 no.3
• /
• pp.139-142
• /
• 2018

• Kidney Research and Clinical Practice
• /
• v.37 no.4
• /
• pp.420-421
• /
• 2018