• Journal of Preventive Medicine and Public Health
• /
• 제35권2호
• /
• pp.123-128
• /
• 2002

Objective : To examine the relationship between cigarette smoking, alcohol and cancer mortality in men in the Kangwha cohort after 12 years and 10 months of follow up. Methods : The subjects consisted of 2,681 men in the Kangwha cohort aged over 55 in 1985. Number of deaths and the time to death front all cancers and other cause were measured and the data for the smoking and drinking habits were obtained from the baseline survey data in 1985. All subjects were categorized into four groups according to their smoking habits: non-smokers, ex-smokers, mode(ate-smokers (1-19 cigarettes per day), heavy-smokers ($\geq$20 cigarettes per day). In addition, they were also categorized according to their drinking habits: non-drinkers, light-drinkers ($\leq$1 drink per week), moderate-drinkers (<3 drinks per day), heavy-drinkers ($\geq$3 drinks per day). The cancer specific death rates were calculated according to their smoking and drinking status. The adjusted risk ratio for all cancer deaths according to their smoking and drinking status were estimated using the Cox's proportional hazard regression model. Results : Using nonsmokers as the reference category, the adjusted risk ratio for all cancer deaths were 1.573(95% CI=1.003-2.468) for heavy-smokers. For lung cancer deaths, the adjusted risk ratios were 3.540(95% CI=1.251-10.018) for moderate-smoker and 4.114(95% CI=1.275-13.271) for heavy-smokers. Compared to non-drinkers, the adjusted risk ratio for stomach cancer was 2.204(95% CI=1.114-4.361) for light-drinkers. Conclusion : Smoking is the most significant risk factor for cancer deaths particularly lung cancer.

• Journal of Preventive Medicine and Public Health
• /
• 제36권4호
• /
• pp.367-372
• /
• 2003

Objectives : There are many concerns about ginseng as a cancer chemopreventive substance, but there have been few epidemiological studies on ginseng, This study sought to examine the relationships between ginseng intake and cancer incidence in the Kangwha cohort. Methods ; Between March 1985 and December 1999, 2697 males, aged 55 or over, as of 1985, were followed up for their cancer incidence. The cancer incidence rate, standardized incidence ratio and risk ratios were calculated according to ginseng intake. A Cox proportional hazard model was used to adjust for age at entry, smoking, alcohol intake, hypertension, and body mass index. Results & Conclusions : The ginseng intake group had the same cancer (C00-C97) incidences (Standardized Incidence Ratio: SIR=1.11, 95% Confidence Interval=0.97-1.27) and the same risk ratio (RR=1.09, 95% Confidence Interval=0.85-1.41) as the no-intake group. Analyzing the subjects that had followed up from 1990, however, the ginseng intake group had lower cancer incidences at all sites (RR=0.79, 95% Confidence Interval=0.58-1.09). This was a cohort study to try and evaluate the association between ginseng intake and the incidences of cancer, The results of this study provide no clear conclusions on the cancer preventive effects of ginseng. Therefore, further study is needed in the future.

• Journal of Gastric Cancer
• /
• 제22권3호
• /
• pp.197-209
• /
• 2022

Purpose: This study systematically evaluated the implications of advanced age on post-surgical outcomes following gastrectomy for gastric cancer using a national database. Materials and Methods: The 2011-2017 National Inpatient Sample was used to isolate patients who underwent gastrectomy for gastric cancer. From this, the population was stratified into those belonging to the younger age cohort (18-59 years), sexagenarians, septuagenarians, and octogenarians. The younger cohort and each advanced age category were compared in terms of the following endpoints: mortality following surgery, length of hospital stay, charges, and surgical complications. Results: This study included a total of 5,213 patients: 1,366 sexagenarians, 1,490 septuagenarians, 743 octogenarians, and 1,614 under 60 years of age. Between the younger cohort and sexagenarians, there was no difference in mortality (2.27 vs. 1.67%; P=0.30; odds ratio [OR], 1.36; 95% confidence interval [CI], 0.81-2.30), length of stay (11.0 vs. 11.1 days; P=0.86), or charges ($123,557 vs. $124,425; P=0.79). Compared to the younger cohort, septuagenarians had higher rates of in-hospital mortality (4.30% vs. 1.67%; P<0.01; OR, 2.64; 95% CI, 1.67-4.16), length of stay (12.1 vs. 11.1 days; P<0.01), and charges ($139,200 vs. $124,425; P<0.01). In the multivariate analysis, septuagenarians had higher mortality (P=0.01; adjusted odds ratio [aOR], 2.01; 95% CI, 1.18-3.43). Similarly, compared to the younger cohort, octogenarians had a higher rate of mortality (7.67% vs. 1.67%; P<0.001; OR, 4.88; 95% CI, 3.06-7.79), length of stay (12.3 vs. 11.1 days; P<0.01), and charges ($131,330 vs. $124,425; P<0.01). In the multivariate analysis, octogenarians had higher mortality (P<0.001; aOR, 4.03; 95% CI, 2.28-7.11). Conclusions: Advanced age (>70 years) is an independent risk factor for postoperative death in patients with gastric cancer undergoing gastrectomy.

• Journal of Periodontal and Implant Science
• /
• 제42권3호
• /
• pp.67-72
• /
• 2012

Purpose: Rheumatoid arthritis (RA) is a chronic multi-systemic disease that causes damage to the bone and connective tissues. This study was conducted in order to accurately measure the correlation between RA and periodontitis, and to obtain an unbiased estimate of the effect of RA on periodontal indices. Methods: In this historical cohort study, which was conducted from February to May 2011 in Hamadan city, Iran, 53 exposed people (with RA) were compared with 53 unexposed people (without RA) in terms of clinical periodontal indices (the outcomes of interest) including 1) plaque index (PI), 2) bleeding on probing (BOP), and 3) clinical attachment loss (CAL). Results: A sample of 106 volunteers were evaluated, 53 rheumatoid versus 53 non-rheumatoid subjects. There was a statistically significant correlation between RA and BOP (P<0.001) and between RA and CAL (P<0.001). However, there was no statistically significant correlation between RA and any of the periodontal indices. No correlation was seen between gender and any of the indices either. There was a strong positive correlation between age and all three periodontal indices (P<0.001). Conclusions: The present study indicated a potential effect of RA on periodontal indices. However, much more evidence based on a prospective cohort study is needed to support the cause and effect relationship between RA and periodontal indices.

• Journal of Korean Neurosurgical Society
• /
• 제63권6호
• /
• pp.730-737
• /
• 2020

Objective : Spinal degeneration is a progressive disease, worsening over time. Lumbar degenerative disease (LDD) is a major spinal disease in elderly patients. Surgical treatment is considered for medically intractable patients with LDD and reoperation after primary surgery is not uncommon. The surgical outcome is occasionally unpredictable because of comorbidities. In the present study, the relationship between comorbidities and the incidence of reoperation for LDD over time was determined. Methods : The claims data of the health insurance national database were used to identify a cohort of patients who underwent spinal surgery for LDD in 2009. The patients were followed up until 2016. Medical comorbidity was assessed according to the Charlson comorbidity index (CCI). Cox proportional hazard regression modeling was used to identify significant differences in sex, surgery, age, causative disease, and comorbidity. Results : The study cohort included 78241 patients; 10328 patients (13.2%) underwent reoperation during the observation period. The reoperation rate was statistically higher (p<0.01) in males, patients 55-74 years and 65-74 years of age, and patients with decompression or discectomy. Significant association was found between increasing reoperation rate and CCI score (p<0.01). Based on multivariate analysis of comorbidities, the significantly higher reoperation rates were observed in patients with peripheral vascular disease, pulmonary lung disease, peptic ulcer, diabetes, and diabetes complications (p<0.01). Conclusion : The study results indicate the reoperation rate for LDD is associated with patient comorbidities. The comorbidities identified in this study could be helpful in future LDD studies.

• 대한두개안면성형외과학회지
• /
• 제22권5호
• /
• pp.254-259
• /
• 2021

Background: Prophylactic antibiotics are commonly used in craniofacial surgeries. Despite the low risk of surgical site infection after nasal surgery, a lack of consensus regarding the use of antibiotic prophylaxis in the closed reduction of nasal bone fractures has led to inappropriate prescribing patterns. Through this study, we aimed to investigate the status of prophylactic antibiotic use in closed reductions of nasal bone fractures in Korea. Methods: This retrospective cohort study was conducted using data from the National Health Insurance Service-National Sample Cohort of Korea from 2005 to 2015. We analyzed the medical records of patients who underwent closed reduction of nasal bone fractures. The sex, age, region of residence, comorbidities, and socioeconomic variables of the patients were collected from the database. Factors that affect the prescription of perioperative antibiotics were evaluated using multivariate logistic regression analysis. Results: A total of 3,678 patients (mean±standard deviation of age, 28.7±14.9 years; 2,850 men [77.5%]; 828 women [22.5%]) were included in this study. The rate of antibiotic prescription during the perioperative period was 51.4%. Approximately 68.8% of prescriptions were written for patients who had received general anesthesia. The odds of perioperative prophylactic antibiotic use were significantly higher in patients who received general anesthesia than who received local anesthesia (odds ratio, 1.59). No difference was found in terms of patient age and physician specialty. Second-generation cephalosporins were the most commonly prescribed antibiotic (45.3%), followed by third- and first-generation cephalosporins (20.3% and 18.8%, respectively). In contrast, lincomycin derivatives and aminoglycosides were not prescribed. Conclusion: The findings of this study showed that there was a wide variety of perioperative antibiotic prescription patterns used in nasal bone surgeries. Evidence-based guidance regarding the prescribing of antimicrobial agents for the closed reduction of nasal bone fractures should be considered in future research.

• 근관절건강학회지
• /
• 제27권3호
• /
• pp.219-228
• /
• 2020

Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

• 사상체질의학회지
• /
• 제34권1호
• /
• pp.46-57
• /
• 2022

Background Adherence to healthy diet acts as a key role to modify sedentary lifestyle in real life setting. Constitution type of traditional Korean medicine has been prediagnosed to risk factors of cardiometabolic diseases. This study aims to evaluate the associations between body composition and healthy eating status in Korean adults by their constitution type. Methods Of 4046 participants from Korean Medicine Daejeon Citizen Cohort study, Korean Medicine Daejeon Citizen Cohort (KDCC) study were included for analysis. Demographic, health-related behaviors and Korean Medicine (KM) type were surveyed based on a general health-related questionnaire. Anthropometric measurements and dietary factors by using Korean Healthy Eating Index (KHEI) were assessed only in the half of the original participants. Results 50.8% of Taeeum was observed from eligible 1967 participants (66.7%, women). The highest KHEI score was observed in soyang group (52.0±0.3, p=0.006) compared to other two groups. In taeeum group, lower appendicular skeletal muscle mass (ASM)(%)(Taeeum: 38.7±0.1 vs. Soeum/Soyang: 39.2±0.1, p < 0.05), and higher percent of body fat (PBF)(%) (Taeeum: 32.9±0.2 vs. Soeum/Soyang: 29.0±0.2, p < 0.05) by the lowest tertile (T1) of the KHEI score, respectively. When the KHEI score increased by 1 point in taeeum group, a positive relationship was observed, which increased by 0.015% of ASM, however, a negatively related to in which body fat mass (BFM) decreased by 0.022 kg and PBF decreased by 0.024%. Conclusion Customized nutritional management is required that could help maintaining physical health and diet by their constitution type.

• Journal of Web Engineering
• /
• 제14권22호
• /
• pp.4885-4900
• /
• 2022

A high rate of Meniere's disease (MD) in patients with osteoporosis has been suggested. This research intended to estimate the bidirectional association of MD with osteoporosis. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort 2002-2019 was examined. In study I, 9529 patients with MD and 38,116 control I participants were analyzed for a previous history of osteoporosis. In study II, 65,858 patients with osteoporosis and 65,858 control II participants were analyzed for a previous history of MD. Stratified Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MD for osteoporosis in study I and of osteoporosis for MD in study II. The rate of a prior history of osteoporosis was 13.3% for the MD group and 11.3% for the control I group. The patients with MD had a 1.12 times higher HR for previous osteoporosis (95% CI = 1.04-1.20). In study II, the rate or a prior history of MD was 3.7% for patients with osteoporosis and 2.0% for the control II group. The patients with osteoporosis had a 1.50 times higher HR for previous MD (95% CI = 1.40-1.61). Most subgroups according to age, sex, and comorbid conditions demonstrated consistent bidirectional associations between MD and osteoporosis. Adult patients with MD had a greater risk of osteoporosis. In addition, adult patients with osteoporosis also showed a higher risk of MD.

• Tuberculosis and Respiratory Diseases
• /
• 제84권4호
• /
• pp.317-325
• /
• 2021

Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.