• Journal of Hospice and Palliative Care
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• v.17 no.3
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• pp.170-178
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• 2014

Purpose: Delirium is a common and serious neuropsychiatric complication among terminally ill cancer patients. We investigated risk factors related to the development of delirium among hospice care patients. Methods: Between May 2011 and September 2012, we included patients who were mentally alert and had no psychiatric disease or drug addiction at the hospice ward of two local hospitals. Among them, participants who had been diagnosed with delirium by two doctors according to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders-4th edition) criteria were grouped as Delirium Group. We analyzed results of psychometric and other laboratory tests performed at the time of patient's admission - psychometric tests included cognitive function (mini-mental status examination, MMSE), depression (Beck Depression Inventory, BDI), anxiety, and insomnia (Insomnia Severity Index, ISI). Logistic regression analysis was used to compare delirium and the related factors. Cox's proportional hazard model was performed using significant factors of logistic regression analysis. Results: Of the 96 patients who met the inclusion criteria, 41 (42.7%) developed delirium. According to the logistic regression analysis, primary cancer site, cognitive impairment (MMSE < 24), depression ($BDI{\geq}16$), and insomnia ($ISI{\geq}15$) were significant factors related to delirium. Among the four factors, depression (OR 5.130; 95% CI, 2.009~13.097) and cognitive impairment (OR 5.130; 95% CI, 2.009~13.097) were found significant using Cox's proportional hazard model. Conclusion: The development of delirium was significantly related to depression and cognitive impairment among patients receiving hospice care. It is necessary to carefully monitor depression and cognitive function in hospice care.

• Genomics & Informatics
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• v.8 no.4
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• pp.212-218
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• 2010

An accurate system for predicting the survival of patients with oral squamous cell carcinoma (OSCC) will be useful for selecting appropriate therapies. A nomogram for predicting survival was constructed from 96 patients with primary OSCC who underwent surgical resection between January 1994 and June 2003 at the Yonsei Dental Hospital in Seoul, Korea. We performed univariate and multivariate Cox regression to identify survival prognostic factors. For the early stage patients group, the nomogram was able to predict the 5 and 10 year survival from OSCC with a concordance index of 0.72. The total point assigned by the nomogram was a significant factor for predicting survival. This nomogram was able to accurately predict the survival after treatment of an individual patient with OSCC and may have practical utility for deciding adjuvant treatment.

• The Journal of Korean Medicine
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• v.23 no.4
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• pp.91-97
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• 2002

Objective: This study was conducted to know the survival probability of the patients with cerebrovascular disease. Method: 1,341 patients who were suspected of having cerebrovascular disease clinically were investigated by telephone and NHIC (National Health Insurance Corporation) data. Conclusion: 1. The study population was grouped as 'Negative Brain CT findings' (11.8%), 'Hemorrhage' (12.4%) and 'Infarction' (75.7%). 2. The survival probabilities calculated by the Life Table method were statistically significant among brain CT finding groups (P<0.01). 3. The mean survival time calculated by the Kaplan-Meier method were also statistically significant among brain CT finding groups (P<0.01). 4. The result of Cox regression model was that sex (OR=0.7), age (OR=1.07), diabetes mellitus (OR=1.38), and heart disease (OR=1.69) affected the survival of the patients with cerebrovascular disease.

• Tuberculosis and Respiratory Diseases
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• v.43 no.5
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• pp.709-719
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• 1996

Background: Surgical resection is the only way to cure non-small cell lung cancer(NSCLC) and the prognosis of NSCLC in patients who undergo a complete resection is largely influenced by the pathologic stage. After surgical resection, recurrences in distant sites is more common than local recurrences. An effective postoperative adjuvant therapy which can prevent recurrences is necessary to improve long tenn survival Although chemotherapy and radiotherapy are still the mainstay in adjuvant therapy, the benefits of such therapies are still controversial. We initiated this retrospective study to evaluate the effects of adjuvant therapies and analyze the prognostic factors for survival after curative resection. Method: From 1990 to 1995, curative resection was perfomled in 282 NSCLC patients with stage I, II, IIIa, Survival analysis of 282 patients was perfonned by Kaplan-Meier method. The prognostic factors, affecting survival of patients were analyzed by Cox regression model. Results: Squamous cell carcinoma was present in 166 patients(59%) ; adenocarcinoma in 86 pmients(30%) ; adenosquamous carcinoma in II parients(3.9%); and large cell undifferentiated carcinoma in 19 patients(7.1%). By TNM staging system, 93 patients were in stage I; 58 patients in stage II ; and 131 patients in stage rna. There were 139 postoperative recurrences which include 28 local and 111 distant failures(20.1% vs 79.9%). The five year survival rate was 50.1% in stage I ; 31.3% in stage II ; and 24.1% in stage IIIa(p <0.0001). The median survival duration was 55 months in stage I ; 27 months in stage II ; and 16 months in stage rna. Among 131 patients with stage rna, the median survival duration was 19 months for 81 patients who received postoperative adjuvant chemotherapy only or cherne-radiotherapy and 14 months for the other 50 patients who received surgery only or surgery with adjuvant radiotherapy(p=0.2982). Among 131 patients with stage IIIa, the median disease free survival duration was 16 months for 21 patients who received postop. adjuvant chemotherapy only and 4 months for 11 patients who received surgery only(p=0.0494). In 131 patients with stage IIIa, 92 cases were in N2 stage. The five year survival rate of the 92 patients with N2 was 25% and their median survival duration was 15 months. The median survival duration in patients with N2 stage was 18 months for those 62 patients who received adjuvant chemotherapy and 14 months for the other 30 patients who did not(p=0.3988). The median survival duration was 16 months for those 66 patients who received irradiation and 14 months for the other 26 patients who did not(p=0.6588). We performed multivariate analysis to identify the factors affecting prognosis after complete surgical resection, using the Cox multiple regression model. Only age(p=0.0093) and the pathologic stage(p<0.0001) were significam prognostic indicators. Conclusion: The age and pathologic stage of the NSCLC parients are the significant prognostic factors in our study. Disease free survival duration was prolonged with statistical significance in patients who received postoperative adjuvant chemotherapy but overall survival duration was not affected according to adjuvant therapy after surgical resection.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.649-656
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• 2016

This study was a retrospective examination to identify the association of postoperative delirium of the prognosis on following femur fracture surgery in elderly patients. Data was collected from the medical records of elderly patients (aged 65 years or older), who underwent femur fracture surgery from July 2010 to January 2014, following on 3-years in one university hospital. A total of 68 patients were involved. There were 31 cases (45.6%) with delirium and 37 cases (54.4%) without delirium. The participant's average age was 80.8 (patients with delirium), and 81.8 (delirium without patients) years of age, respectively, and most of them were female. There was no significant difference between the two groups. Taking five or more medications, serum creatinine level, and the total medical costs were significantly different in the delirium group and non-delirium group. In addition, the proportional hazard model of Cox to determine the predictors for the major clinical outcome occurring after surgery revealed delirium, five or more multi-drug use, and an experience of transfusion to be significant predictors. In conclusion, postoperative delirium in the elderly undergoing femur fracture surgery can have a negative clinical outcome in patients and caregivers. Therefore, a preoperative evaluation and management of the risk factors will be necessary.

• Journal of Gastric Cancer
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• v.5 no.2
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• pp.113-119
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• 2005

Purpose: Some controversies exist over the prognostic values of lymphatic, venous, and neural invasion in patients with gastric cancer. This study was conducted to confirm the prognostic values of these histopathologic factors in gastric cancer patients who received a gastrectomy. Materials and Methods: Data for clinicopathologic factors and clinical outcomes were collected retrospectively from the medical records of 1,018 gastric cancer patients who received a gastrectomy at Yeungnam University Medical Center between January 1995 and December 1999. A statistical analysis was done using the SPSS program for Windows (Version 10.0, SPSS Inc., USA). The Kaplan-Meier method was used for the survival analysis. Prognostic factors were analyzed by using a multivariate analysis with Cox proportional hazard regression model. Results: Ages ranged from 21 to 79 (median age, 56). A univariate analysis revealed that age, tumor size, location, gross type, depth of invasion, extent of gastrectomy or lymph node dissection, lymph node metastasis, distant metastasis, lymphatic invasion, venous invasion, neural invasion, pathologic stage, histologic type, and curability of surgery had statistical significance. Among these factors, lymph node metastasis, curability of surgery, neural invasion, lymphatic invasion, and depth of invasion were found to be independent prognostic factors by using a multivariate analysis. Venous invasion showed no prognostic value in the multivariate analysis. Conclusion: Neural invasion and lymphatic invasion are useful parameters in determining a prognosis for gastric cancer patients.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.7
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• pp.3233-3238
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• 2014

Background: The aim of this study was to analyze the demographic and clinical characteristics of male breast cancer patients in Serbia, and furthermore to determine overall survival and predictive factors for prognosis. Materials and Methods: In the period of 1996-2006 histopathological diagnosis of breast cancer was made in 84 males at the Institute for Oncology and Radiology of Serbia. For statistical analyses the Kaplan-Meier method, long-rank test and Cox proportional hazards regression model were used. Results: The mean age at diagnosis with breast cancer was $64.3{\pm}10.5$ years with a range from 35-84 years. Nearly 80% of the tumors showed ductal histology. About 44% had early tumor stages (I and II) whereas 46.4% and 9.5% of the male exhibitied stages III and IV, respectively. Only 7.1% of male patients were grade one. One-fifth of all patients had tumors measuring ${\leq}2cm$, and 14.3% larger than 5 cm. Lymph node metastasis was recorded in 40.4% patients and 47% relapse. Estrogen and progesterone receptor expression was positive in 66.7% and 58.3%, respectively. Among 14.3% of individuals tumor was HER2 positive. About two-thirds of all male patients had radical mastectomy (66.7%). Adjuvant hormonal (tamoxifene), systematic chemotherapy (CMF or FAC) and adjuvant radiotherapy were given to 59.5%, 35.7% and 29.8% patients respectively. Overall survival rates at five and ten years for male breast cancer were 55.0% and 43.9%, respectively. According to the multivariate Cox regression predictive model, a lower initial disease stage, a lower tumor grade, application of adjuvant hormone therapy and no relapse occurrence were significant independent predictors for good overall survival. Conclusions: Results of the treatment would be better if disease is discovered earlier and therefore health education and screening are an imperative in solving this problem.

• Journal of the Korean Society of Radiology
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• v.84 no.1
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• pp.197-211
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• 2023

Purpose To evaluate the circuit patency after nitinol bare-metal stent (BMS) placement according to the type of access and location of the stent in dysfunctional hemodialysis access. Materials and Methods Between January 2017 and December 2019, 159 patients (mean age, 64.1 ± 13.2 years) underwent nitinol BMS placement for dysfunctional access. The location of stents was as follows: 18 brachiocephalic vein, 51 cephalic arch, 40 upper arm vein, 10 juxta-anastomotic vein, 7 arteriovenous (AV) anastomosis, and 33 graft-vein (GV) anastomosis. Circuit patency was evaluated by the Kaplan-Meier method, and cox regression model. Results A total of 159 stents were successfully deployed in 103 AV fistula (AVF) and 56 AV graft (AVG). AVG showed lower primary and secondary patency at 12-months compared with AVF (primary patency; 25.0% vs. 44.7%; p = 0.005, secondary patency; 76.8% vs. 92.2%; p = 0.014). Cox regression model demonstrated poorer primary patency at 12 months after stenting in the cephalic arch and GV anastomosis compared with the other sites. Conclusion AVF showed better primary and secondary circuit patency at 12 months following the placement of BMS compared with AVG. Stents in the cephalic arch and GV anastomosis were associated with poorer primary patency at 12 months compared to those in other locations.

• Journal of the Korean Data and Information Science Society
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• v.24 no.1
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• pp.33-39
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• 2013

In the transformation of response variable in partial linear models outliers can cause a bad effect on estimating the transformation parameter, just as in the linear models. To solve this problem the processes of estimating transformation parameter and detecting outliers are needed, but have difficulties to be performed due to the arbitrariness of the nonparametric function included in the partial linear model. In this study, through the estimation of nonparametric function and outlier detection methods such as a sequential test and a maximum trimmed likelihood estimation, processes for transforming response variable robust to outliers in partial linear models are suggested. The proposed methods are verified and compared their effectiveness by simulation study and examples.

• Journal of Korean Biological Nursing Science
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• v.26 no.3
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• pp.228-239
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• 2024

Purpose: This retrospective study was conducted to identify factors associated with repeated suicide attempts by analyzing the electronic medical records of suicide attempters who visited emergency medical centers due to drug intoxication. Methods: Data from January 1, 2020 to December 31, 2021 were collected for this study and analyzed using SPSS/WIN 25.0. Results: In this study, the factors affecting repeated suicide attempts among individuals who visited the emergency medical center due to acute drug intoxication were the presence or absence of psychiatric diseases, the season of drug intoxication, and age. In order to identify the factors affecting repeated suicide attempts in those who presented with acute drug intoxication, logistic regression analysis was performed by inputting psychiatric diseases, season of drug intoxication, and age, all of which exhibited significant differences between those who did and did not attempt suicide again. The presence of psychiatric diseases (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.04~3.80), intoxication occurring in the fall (vs. spring; OR = 3.35, 95% CI = 1.28~8.75), and age ≥ 65 (vs. those under the age of 18; OR = 12.96, 95% CI = 2.02~83.17). The regression model was found to be statistically significant (F = 30.01, p < .001), and the coefficient of determination of Cox and Snell, which represents the explanatory power of the model, was 12.0%. Conclusion: This study suggests that to prevent repeated suicide attempts, it is necessary to develop a tool to evaluate the risk of suicide, use it to evaluate the risk of suicide, and then manage individuals accordingly.