• Title/Summary/Keyword: Complications

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Clinical Study on the Complications after Stroke (뇌졸중으로 한방병원에 입원치료 하였던 환자들의 합병증에 관한 임상적 고찰)

  • 김관식;서관수;김동웅;신선호;한명아;정용준;장통영;양재훈
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.227-235
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    • 2000
  • Background and Purpose : Medical and Neurological complications in patients with acute stroke may affect their prognosis including death rate, function and admission period. Some of these complications may be preventable. But few data exist regarding complications occurring in the first weeks. So we sought to observe the type, timing, and frequency of complications in hospitalized patients after stroke. Methods : We retrospectively examined the case notes of patients admitted in Won Kwang Oriental Medical Hospital after stroke. Two observers inspected the case notes using predifined diagnostic criteria and recorded the type, timing, and frequency of complications that occurred during the inpatient period. Results : Complications were recorded in 43 patients(82.7%). The most common medical complications were constipation(25.0%) and shoulder pain(21.2%). The most frequent serious medical problems were pulmonary infection(9.6%) and UTI(7.7%). The most common neurological complications were insomnia(34.6%) and dysphagia(23.7%). The most frequent serious medical problem was mental deterioration(7.7%). Conclusion : Complications after acute stroke are common. There were more medical complications than neurological complications. So we should compile much knowledge about medical complications and treat them actively. The differences between our study and previous studies are attributable to the different methods including patient selection and diagnostic criteria.

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Complications of Tracheotomy cannula and its prevention (기관 캐눌러에 의한 합병증과 예방법)

  • 손진호;강지원;이현석;전병규;신승헌;박재율;안욱수
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.35-42
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    • 1998
  • The complications of a tracheotomy are caused by inappropriate surgical techniques, unsuitable cannula selections, and improper wound care. Among these, the solutions to problems of surgical technique and wound care have been reported in many articles. Detailed methods for preventing complications by the cannula are rare. The authors tried to find a way of preventing complications by the cannula Materials and Methods : The authors analized complications in 70 patients who had a temporary tracheotomy and were wearing a cannula. And the complications were compared between 4 commercial cannulas used in our institute. The examination methods used were a simple neck lateral radiogram and flexible endoscopy. Results: The order of most commonly found complications were as followed; at the suprastoma, end of cannula, level of tracheotomy, and infrastoma. Among 4 cannulas, a particular product had so many complications compared to the other 3 cannulas. The most common cause of complications was unsuitable cannula. All complications were cured with no sequelae. Flexible endoscopy is far superior to radiologic exam for detecting tracheal complications. Conclusion: Flexible endoscopy through the tracheostoma is very helpful for detecting complications early and determining if a proper cannula is used, which can prevent further complications such as stenosis or innominate artery rupture. The authors, therfore, recommend using the flexible endoscopy to all patients wearing tracheotomy tubes. Some complications can simply be prevented by replacing the one to another cannula properly fit for the individual patients. Various cannulas should be prepared at the hospital because the tracheal curvature and distance of skin to trachea are individualized.

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Complications of Calcaneal Fracture (종골 골절의 합병증)

  • Bae, Su-Young
    • Journal of Korean Foot and Ankle Society
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    • v.17 no.2
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    • pp.84-92
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    • 2013
  • Quite high prevalence of acute and chronic complications of calcaneal fractures has been reported. Acute complications include blisters, wound necrosis or infection. Late complications include subtalar arthritis, calcaneal malunion, lateral subfibular impingement, tendon problems, sural nerve complications. There are many surgical or nonsurgical treatment modalities to manage those complications. However strategic initial surgical approach with gentle soft tissue handling accompanied by comprehensive understanding about numerous complications might be the best tool to achieve pain free and functional heel after treating calcaneal fractures.

Complications of a Tube Thoracostomy Performed by Emergency Medicine Residents (응급의학과 전공의가 시행한 흉관 삽입술의 합병증에 대한 고찰)

  • Cho, Dai Yun;Sohn, Dong Suep;Cheon, Young Jin;Hong, Kihun
    • Journal of Trauma and Injury
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    • v.25 no.2
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    • pp.37-43
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    • 2012
  • Purpose: A tube thoracostomy is an invasive procedure that places patients at risk for complications. Tube thoracostomies are frequently performed by emergency medicine residents. Thus, the purpose of the study was to assess both the complication rate for tube thoracostomies performed by emergency medicine residents and the factors associated with these complications. Methods: A retrospective chart review of all patients who had undergone a tube thoracostomy performed by emergency medicine residents between January 2008 and February 2009 was conducted at a university hospital. Complications were divided into major and minor complications and into immediate and delayed complications. Complications requiring corrective surgical intervention, requiring the administration of blood products, or involving situations requiring intravenous antibiotics were defined as major. Complications that were detected within 2 hours were defined as immediate. Results: Tube thoracostomies were performed in 189 patients, and 70 patients(37%) experienced some complications. Most complications were immediate and minor. In multiple logistic regressions, BMI, hypotension and resident seniority were significantly associated with complications. Conclusion: The prevalence of complications was similar to these in previous reports on the complications of a tube thoracostomy. Most complications from tube thoracostomies performed by emergency medicine residents were immediate and minor complications. Thus, emergency medicine residents should be allowed to perform closed tube thoracostomies instead of thoracic surgeons.

The Study of Lipid-peroxidation, Antioxidant Enzymes, and the Antioxidant Vitamins in NIDDM Patients with Microvascular-diabetic Complications (한국인 제2형 합병증동반 당뇨병 환자에 있어 과산화지질, 항산화 효소, 및 항산화비타민에 관한 연구)

  • 하애화
    • Journal of Nutrition and Health
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    • v.32 no.1
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    • pp.17-23
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    • 1999
  • The purpose of this study was to determine the extent of oxidative stress in NIDDM patients with diabetic complications and to determine the relationship between oxidative stress and diabetic complications. For this study, 139 NIDDM patients were recruited, 85 with diabetic complications and 54 without complications were recruited. The concentration of malondialdehyde(MDA) and the activities of antioxidant enzymes including catalase, superoxide dismutase(SOD), gluthatione peroxidase(GSH-Px)were determined. The daily intakes and plasma concentrations of beta-carotene, lycopene, lutein nd alpha-tocopherol were determined by food frequency questionnaire and by high performance liquid chromatography(HPLC), respectively. Among the antioxidant enzymes studied, only GSH-Px activity was lower in NIDDM patient, with diabetic complications than in those without complications(2.91$\pm$0.80 vs 3.54$\pm$0.44 U/mgHb, p<0.05). Those NIDDM patients with diabetic complications had higher MDA concentrations than those without diabetic complications(1.40$\pm$0.25 vs 1.25$\pm$0.11 nmol/ml, p<0.05). There were no significant differences in the dietary intakes of total carotenoids(2854 vs 2824ug/day)or vitamin E (9.5$\pm$3.2 vs 9.5$\pm$2.0mg/day)between NIDDA patients with and without complications. However, the plasma concentrations of beta-carotene and lycopene were significantly lower in NIDDM patients with complications than in NIDDM patients without complications (Beta-carotene : 24.2$\pm$12.5 vs 33.1$\pm$16.2(ug/dl), lycopene : 2.8$\pm$2.1 vs 4.3$\pm$2.8(ug/dl)). This study showed that in NIDDM patients with complications, the lipid peroxidation of erythrocytes was higher increased and the antioxidant reserves were significantly dipleted, compared with NIDDM patients without complications. The lower plasma concentrations of beta-carotene and lycopene in NIDDM patients may be due to the presence of diabetic complication, not due to the lower dietary intakes of antioxidant vitamins. To define the role of carotenoids in diabetes, more experimental and clinical studies are needed.

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Prognostic Implications of Postoperative Infectious Complications in Non-Small Cell Lung Cancer

  • Jang, Hyo-Jun;Song, Jae Won;Cho, Sukki;Kim, Kwhanmien;Jheon, Sanghoon
    • Journal of Chest Surgery
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    • v.51 no.1
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    • pp.41-52
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    • 2018
  • Background: Few studies have evaluated the long-term impact of postoperative infectious complications in patients with non-small cell lung cancer (NSCLC). We aimed to determine the impact of infectious complications on long-term outcomes after surgical resection for NSCLC. Methods: We performed a retrospective study of 1,380 eligible patients who underwent pulmonary resection for NSCLC from 2003 to 2012. Complications were divided into infectious complications and non-infectious complications. Kaplan-Meier survival analysis was used to compare unadjusted 5-year cancer-specific survival (CSS) rates and recurrence-free survival (RFS) rates. Cox regression was used to determine the impact of infectious complications on 5-year CSS and RFS. Results: The rate of total complications and infectious complications was 24.3% and 4.3%, respectively. In the node-negative subgroup, the 5-year CSS and RFS rates were 75.9% and 57.1% in patients who had infectious complications, compared to 87.9% and 78.4% in patients who had no complications. Infectious complications were a negative prognostic factor for 5-year RFS (hazard ratio, 1.92; 95% confidence interval, 1.00-3.69; p=0.049). In the node-positive subgroup, the 5-year CSS rate and RFS were 44.6% and 48.4% in patients who had infectious complications, compared to 70.5% and 48.4% for patients who had no complications. Conclusion: Postoperative infectious complications had a negative impact on CSS and RFS in node-negative NSCLC. Our findings may help improve risk assessment for tumor recurrence after pulmonary resection for node-negative NSCLC.

Risk Factors for the Severity of Complications in Minimally Invasive Total Gastrectomy for Gastric Cancer: a Retrospective Cohort Study

  • Roh, Chul Kyu;Lee, Soomin;Son, Sang-Yong;Hur, Hoon;Han, Sang-Uk
    • Journal of Gastric Cancer
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    • v.21 no.4
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    • pp.352-367
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    • 2021
  • Purpose: Minimally invasive gastrectomy is a promising surgical method with well-known benefits, including reduced postoperative complications. However, for total gastrectomy of gastric cancers, this approach does not significantly reduce the risk of complications. Therefore, we aimed to evaluate the incidence and risk factors for the severity of complications associated with minimally invasive total gastrectomy for gastric cancer. Materials and Methods: The study included 392 consecutive patients with gastric cancer who underwent either laparoscopic or robotic total gastrectomy between 2011 and 2019. Clinicopathological and operative characteristics were assessed to determine the features related to postoperative complications after minimally invasive total gastrectomy. Binomial and multinomial logistic regression models were used to identify the risk factors for overall complications and mild and severe complications, respectively. Results: Of 103 (26.3%) patients experiencing complications, 66 (16.8%) and 37 (9.4%) developed mild and severe complications, respectively. On multivariate multinomial regression analysis, independent predictors of severe complications included obesity (OR, 2.56; 95% CI, 1.02-6.43; P=0.046), advanced stage (OR, 2.90; 95% CI, 1.13-7.43; P=0.026), and more intraoperative bleeding (OR, 1.04; 95% CI, 1.02-1.06; P=0.001). Operation time was the only independent risk factor for mild complications (OR, 1.06; 95% CI, 1.001-1.13; P=0.047). Conclusions: The risk factors for mild and severe complications were associated with surgery, indicating surgical difficulty. Surgeons should be aware of these potential risks that are related to the severity of complications so as to reduce surgery-related complications after minimally invasive total gastrectomy for gastric cancer.

Complications of nephrotic syndrome

  • Park, Se-Jin;Shin, Jae-Il
    • Clinical and Experimental Pediatrics
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    • v.54 no.8
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    • pp.322-328
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    • 2011
  • Nephrotic syndrome (NS) is one of the most common glomerular diseases that affect children. Renal histology reveals the presence of minimal change nephrotic syndrome (MCNS) in more than 80% of these patients. Most patients with MCNS have favorable outcomes without complications. However, a few of these children have lesions of focal segmental glomerulosclerosis, suffer from severe and prolonged proteinuria, and are at high risk for complications. Complications of NS are divided into two categories: disease-associated and drug-related complications. Disease-associated complications include infections (e.g., peritonitis, sepsis, cellulitis, and chicken pox), thromboembolism (e.g., venous thromboembolism and pulmonary embolism), hypovolemic crisis (e.g., abdominal pain, tachycardia, and hypotension), cardiovascular problems (e.g., hyperlipidemia), acute renal failure, anemia, and others (e.g., hypothyroidism, hypocalcemia, bone disease, and intussusception). The main pathomechanism of disease-associated complications originates from the large loss of plasma proteins in the urine of nephrotic children. The majority of children with MCNS who respond to treatment with corticosteroids or cytotoxic agents have smaller and milder complications than those with steroid-resistant NS. Corticosteroids, alkylating agents, cyclosporin A, and mycophenolate mofetil have often been used to treat NS, and these drugs have treatment-related complications. Early detection and appropriate treatment of these complications will improve outcomes for patients with NS.

Complications of reverse shoulder arthroplasty: a concise review

  • Kim, Su Cheol;Kim, Il Su;Jang, Min Chang;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.24 no.1
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    • pp.42-52
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    • 2021
  • Reverse shoulder arthroplasty is an ideal treatment for glenohumeral dysfunction due to cuff tear arthropathy. As the number of patients treated with reverse shoulder arthroplasty is increasing, the incidence of complications after this procedure also is increasing. The rate of complications in reverse shoulder arthroplasty was reported to be 15%-24%. Recently, the following complications have been reported in order of frequency: periprosthetic infection, dislocation, periprosthetic fracture, neurologic injury, scapular notching, acromion or scapular spine fracture, and aseptic loosening of prosthesis. However, the overall complication rate has varied across studies because of different prosthesis used, improvement of implant and surgical skills, and different definitions of complications. Some authors included complications that affect the clinical outcomes of the surgery, while others reported minor complications that do not affect the clinical outcomes such as minor reversible neurologic deficit or minimal scapular notching. This review article summarizes the processes related to diagnosis and treatment of complications after reverse shoulder arthroplasty with the aim of helping clinicians reduce complications and perform appropriate procedures if/when complications occur.

Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort

  • Kang, Jeongmook;Park, Yoon-Hyung;Yang, Kwang Ik;Cruz, Jose Rene Bagani;Hwangbo, Young
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.1
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    • pp.37-44
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    • 2020
  • Objectives: This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients. Methods: As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated. Results: Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44). Conclusions: Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD.