• Title/Summary/Keyword: Clinical risk factors

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Fall Risk Factors and Characteristics of an Acute Hospital Setting across Clinical Departments (일 종합병원 입원환자의 진료과별 낙상특성 및 위험요인)

  • Jang, In-Sil;Lee, Sun-Gyo
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.21 no.3
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    • pp.264-274
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    • 2014
  • Purpose: This study was done to determine inpatient fall rates in an acute hospital setting and to explore risk factors and characteristics across clinical departments. Methods: The medical records and standardized fall reports of 416 patients admitted between January 1 and December 31, 2012 were reviewed. Descriptive statistics and statistical tests were used, including: t-test, ${\chi}^2$-test, ANOVA. Results: The total fall rate per 1,000 inpatient days was 0.49. Fall rate, fall risk factors and characteristics such as age, type of fallers and mean MFS (Morse Fall Scale) differed significantly among clinical departments. Conclusions: The analysis results show that the fall rates, fall risk factors and characteristics of acute hospital inpatient falls varied significantly across clinical departments. The findings of this study suggest that hospitals should consider differences in fall related characteristics across clinical departments when implementation fall prevention strategies and interventions.

Risk factors for anticoagulant-associated gastrointestinal hemorrhage: a systematic review and meta-analysis

  • Fuxin Ma;Shuyi Wu;Shiqi Li;Zhiwei Zeng;Jinhua Zhang
    • The Korean journal of internal medicine
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    • v.39 no.1
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    • pp.77-85
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    • 2024
  • Background/Aims: There may be many predictors of anticoagulation-related gastrointestinal bleeding (GIB), but until now, systematic reviews and assessments of the certainty of the evidence have not been published. We conducted a systematic review to identify all risk factors for anticoagulant-associated GIB to inform risk prediction in the management of anticoagulation-related GIB. Methods: A systematic review and meta-analysis were conducted to search PubMed, EMBASE, Web of Science, and Cochrane Library databases (from inception through January 21, 2022) using the following search terms: anticoagulants, heparin, warfarin, dabigatran, rivaroxaban, apixaban, DOACs, gastrointestinal hemorrhage, risk factors. According to inclusion and exclusion criteria, studies of risk factors for anticoagulation-related GIB were identified. Risk factors for anticoagulant-associated GIB were used as the outcome index of this review. Results: We included 34 studies in our analysis. For anticoagulant-associated GIB, moderate-certainty evidence showed a probable association with older age, kidney disease, concomitant use of aspirin, concomitant use of the antiplatelet agent, heart failure, myocardial infarction, hematochezia, renal failure, coronary artery disease, helicobacter pylori infection, social risk factors, alcohol use, smoking, anemia, history of sleep apnea, chronic obstructive pulmonary disease, international normalized ratio (INR), obesity et al. Some of these factors are not included in current GIB risk prediction models. such as anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction, etc. Conclusions: The study found that anemia, co-administration of gemfibrozil, co-administration of verapamil or diltiazem, INR, heart failure, myocardial infarction et al. were associated with anticoagulation-related GIB, and these factors were not in the existing prediction models. This study informs risk prediction for anticoagulant-associated GIB, it also informs guidelines for GIB prevention and future research.

Clinical Practice Guideline for Sasang Constitutional Medicine: Prevention and Risk Fators of Sasangin Disease (사상체질병증 임상진료지침: 예방 및 위험인자)

  • Bae, Na-Young;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.82-109
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline (CPG) for Prevention of Sasangin disease pattern of Sasang Constitutional Medicine (SCM) and diseases closely related with Sasang constitution. Each CPG was developed by the national-wide experts committee consisting of SCM professors. Methods At first, we searched the literatures related to SCM such as "Dongeuisusebowon", Textbook of SCM and Clinical Guidebook of SCM. Also we searched the articles related to the studies about risk factors for Sasangin disease pattern of both at home and abroad. Finally, we selected leading risk factors of Sasangin disease pattern and developed CPG for prevention of Sasangin disease pattern of SCM. And then, we searched the literatures related SCM such as "Dongeuisusebowon" and the articles on the correlation between disease and Sasang constitution using case-control studies, observational studies or cross sectional studies of both at home and abroad. Next, we selected diseases closely related with Sasang constitution on the basis of articles including prevalence rate and odds ratio between disease and Sasang constitution and finally developed CPG for these diseases. Results and Conclusions We categorized risk factors of Sasang disease pattern into 2 types: non-modifiable and potentially modifiable. 3 items (age, sex and genetic factors) were classified as non-modifiable risk factors of Sasang disease pattern. 6 items (original symptom, stress, diet and nutrition, physical activity, alcohol and drug misuse) were classified as less well-documented or potentially modifiable risk factors of Sasangin disease pattern. We found out Sasang constitution is more likely to develop some diseases. It was proven that Sasang constitution increase the risk of hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. And there is high probability of Sasang constitution being potential risk factor for obesity, hyperlipidemia, allergy and cancer. Also, we found out Taeeumin is independent risk factor for hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. Therefore we recommend that Taeeumin need to prevent these disease by regular checkups and aggressive management.

Environmental Risk Factors for Children and Adolescents Suffering from Depressive Disorder : Clinical Aspects (소아청소년 우울증에서의 환경적 위험 인자들과 임상적 의미)

  • Lee, Moon-Soo
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.21 no.3
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    • pp.141-146
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    • 2010
  • This summary of literature during the past year reviews published studies relating to risk factors for depressive disorders in children and adolescents. Risk factors include environmental toxins, socio-environmental, and genetic factors. As depression has a complex, multifactorial causal mechanism, it is likely that the accumulation and/ or interaction among multiple risk factors lead to depression. Findings related to the result of toxin exposure have been difficult to interpret given that risk factors tend to interact and that higher mental functions are not easily measurable. However, some findings have been consistent. Clinical research data has also shown that the risk for negative outcomes may be modified both by genetic and environmental factors through a gene environment interplay mechanism.

Sex Differences in the Preventive Effect of Cardiovascular and Metabolic Therapeutics on Dementia

  • Sun Ah Choi;Hye Jin Jee;Katrina Joy Bormate;Yeonjae Kim;Yi-Sook Jung
    • Biomolecules & Therapeutics
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    • v.31 no.6
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    • pp.583-598
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    • 2023
  • Dementia is a clinical syndrome characterized by progressive impairment of cognitive and functional abilities. As currently applied treatments for dementia can only delay the progression of dementia and cannot fundamentally cure it, much attention is being paid to reducing its incidence by preventing the associated risk factors. Cardiovascular and metabolic diseases are well-known risk factors for dementia, and many studies have attempted to prevent dementia by treating these risk factors. Growing evidence suggests that sex-based factors may play an important role in the pathogenesis of dementia. Therefore, a deeper understanding of the differences in the effects of drugs based on sex may help improve their effectiveness. In this study, we reviewed sex differences in the impact of therapeutics targeting risk factors for dementia, such as cardiovascular and metabolic diseases, to prevent the incidence and/or progression of dementia.

Acute lymphoblastic leukemia in children: past, present and future (소아 급성 림프모구 백혈병: 과거, 현재, 미래)

  • Kang, Hyoung Jin;Shin, Hee Young;Ahn, Hyo Seop
    • Clinical and Experimental Pediatrics
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    • v.50 no.7
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    • pp.601-605
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    • 2007
  • The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even adult ALL patients. For nearly 30 years, clinical factors have been used to risk-stratify therapy for children with ALL, so that the most intensive therapies are reserved for those patients at the highest risk of relapse. The risk groups of ALL are divided as standard- (low- plus intermediate-), high- and very high-risk group according to the prognostic factors, and treatment results improved by this risk based treatment. The factors used to risk-stratify therapy include age, gender, presenting leukocyte count, immunophenotype, cytogenetic aberrations including ploidy and translocations, and initial response after 1 to 2 weeks of therapy. But treatment efficacy is the most important determinant and can abolish the clinical significance of most, if at all, prognostic factors. Today, in the era of intensive, multiagent regimens, there is increasing evidence that we have reached the limits of prognostic significance of currently applied clinical risk factors in childhood ALL. As the cure rate of ALL is about 80%, introducing new prognostic factors such as new molecular prognostic markers, new methods of assessment about minimal residual disease, and pharmacogenetic study, with the development of stem cell transplantation and molecular targeted therapy are needed to cure residual 20% of childhood ALL patients without short and long term complications.

Cumulative survival rate and associated risk factors of Implantium implants: A 10-year retrospective clinical study

  • Park, Jin-Hong;Kim, Young-Soo;Ryu, Jae-Jun;Shin, Sang-Wan;Lee, Jeong-Yol
    • The Journal of Advanced Prosthodontics
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    • v.9 no.3
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    • pp.195-199
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    • 2017
  • PURPOSE. The objective of this study was to determine the cumulative survival rate (CSR) and associated risk factors of Implantium implants by retrospective clinical study. MATERIALS AND METHODS. Patients who received Implantium implants (Dentium Co., Seoul, Korea) at Korea University Guro Hospital from 2004 to 2011 were included. The period between the first surgery and the last hospital visit until December 2015 was set as the observation period for this study. Clinical and radiographic data were collected from patient records, including all complications observed during the follow-up period. Kaplan-Meier analysis was performed to examine CSR. Multiple Cox proportional hazard model was employed to assess the associations between potential risk factors and CSR. RESULTS. A total of 370 implants were placed in 121 patients (mean age, 56.1 years; range, 19 to 75 years). Of the 370 implants, 13 failed, including 7 implants that were lost before loading. The 10-year cumulative survival rate of implants was 94.8%. The multiple Cox proportional hazard model revealed that significant risk factor of implant failure were smoking and maxillary implant (P<.05). CONCLUSION. The 10-year CSR of Implantium implants was 94.8%. Risk factors of implant failure were smoking and maxillary implant.

Risk Factors Associated with Clinical Insomnia in Chronic Low Back Pain: A Retrospective Analysis in a University Hospital in Korea

  • Kim, Shin Hyung;Sun, Jong Min;Yoon, Kyung Bong;Moon, Joo Hwa;An, Jong Rin;Yoon, Duck Mi
    • The Korean Journal of Pain
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    • v.28 no.2
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    • pp.137-143
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    • 2015
  • Background: Insomnia is becoming increasingly recognized as a clinically important symptom in patients with chronic low back pain (CLBP). In this retrospective study, we have determined risk factors associated with clinical insomnia in CLBP patients in a university hospital in Korea. Methods: Data from four-hundred and eighty one CLBP patients was analyzed in this study. The Insomnia Severity Index (ISI) was used to determine the presence of clinical insomnia (ISI score ${\geq}15$). Patients' demographics and pain-related factors were evaluated by logistic regression analysis to identify risk factors of clinical insomnia in CLBP. Results: It was found that 43% of patients reported mild to severe insomnia after the development of back pain. In addition, 20% of patients met the criteria for clinically significant insomnia (ISI score ${\geq}15$). In a stepwise multivariate analysis, high pain intensity, the presence of comorbid musculoskeletal pain and neuropathic pain components, and high level of depression were strongly associated with clinical insomnia in CLBP. Among these factors, the presence of comorbid musculoskeletal pain other than back pain was the strongest determinant, with the highest odds ratio of 8.074 (95% CI 4.250 to 15.339) for predicting clinical insomnia. Conclusions: Insomnia should be addressed as an integral part of pain management in CLBP patients with these risk factors, especially in patients suffering from CLBP with comorbid musculoskeletal pain.

Exploring Chemotherapy-Induced Toxicities through Multivariate Projection of Risk Factors: Prediction of Nausea and Vomiting

  • Yap, Kevin Yi-Lwern;Low, Xiu Hui;Chan, Alexandre
    • Toxicological Research
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    • v.28 no.2
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    • pp.81-91
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    • 2012
  • Many risk factors exist for chemotherapy-induced nausea and vomiting (CINV). This study utilized a multivariate projection technique to identify which risk factors were predictive of CINV in clinical practice. A single-centre, prospective, observational study was conducted from January 2007~July 2010 in Singapore. Patients were on highly (HECs) and moderately emetogenic chemotherapies with/without radiotherapy. Patient demographics and CINV risk factors were documented. Daily recording of CINV events was done using a standardized diary. Principal component (PC) analysis was performed to identify which risk factors could differentiate patients with and without CINV. A total of 710 patients were recruited. Majority were females (67%) and Chinese (84%). Five risk factors were potential CINV predictors: histories of alcohol drinking, chemotherapy-induced nausea, chemotherapy-induced vomiting, fatigue and gender. Period (ex-/current drinkers) and frequency of drinking (social/chronic drinkers) differentiated the CINV endpoints in patients on HECs and anthracycline-based, and XELOX regimens, respectively. Fatigue interference and severity were predictive of CINV in anthracycline-based populations, while the former was predictive in HEC and XELOX populations. PC analysis is a potential technique in analyzing clinical population data, and can provide clinicians with an insight as to what predictors to look out for in the clinical assessment of CINV. We hope that our results will increase the awareness among clinician-scientists regarding the usefulness of this technique in the analysis of clinical data, so that appropriate preventive measures can be taken to improve patients' quality of life.

Risk factors for repeat breeder dairy cows and their impacts on reproductive performance

  • Jeong, Jae-Kwan;Kim, Ill-Hwa
    • Korean Journal of Veterinary Research
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    • v.62 no.2
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    • pp.15.1-15.8
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    • 2022
  • The objective of this study was to identify risk factors for repeat breeder dairy cows and their impact on reproductive performance. The characteristics of 1,504 cows, including their peripartum health, nutrition, production, and reproduction, were collected. Cows with metabolic disorder were significantly more likely (odds ratio [OR], 2.47; p < 0.001) and cows with clinical endometritis tended to be more likely (OR, 1.35; p < 0.1) to become repeat breeders than cows without metabolic disorder and clinical endometritis, respectively. Cows initially inseminated > 80 days after calving were less likely (OR, 0.78; p < 0.05) to become repeat breeders than cows initially inseminated ≤ 80 days after calving. As a result, repeat breeding in dairy cows resulted in a 90 day longer (p < 0.0001) mean interval from calving to pregnancy. In conclusion, postpartum metabolic disorder, clinical endometritis, and a short interval from calving to initial insemination were risk factors for repeat breeder dairy cows, resulting in a severely impaired reproductive performance.