• 제목/요약/키워드: Critical risk factors

검색결과 369건 처리시간 0.041초

Risk Factors for Predicting Hypoxia in Adult Patients Undergoing Bronchoscopy under Sedation

  • Choi, Ji Soo;Lee, Eun Hye;Lee, Sang Hoon;Leem, Ah Young;Chung, Kyung Soo;Kim, Song Yee;Jung, Ji Ye;Kang, Young Ae;Park, Moo Suk;Chang, Joon;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • 제83권4호
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    • pp.276-282
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    • 2020
  • Background: Flexible bronchoscopy is one of the essential procedures for the diagnosis and treatment of pulmonary diseases. The purpose of this study was to identify the risk factors associated with the occurrence of hypoxia in adults undergoing flexible bronchoscopy under sedation. Methods: We retrospectively analyzed 2,520 patients who underwent flexible bronchoscopy under sedation at our tertiary care university hospital in South Korea January 1, 2013-December 31, 2014. Hypoxia was defined as more than 5%-point reduction in the baseline percutaneous oxygen saturation (SpO2) or SpO2 <90% for >1 minute during the procedure. Results: The mean age was 64.7±13.5, and 565 patients developed hypoxia during the procedure. The mean sedation duration and midazolam dose for sedation were 31.1 minutes and 3.9 mg, respectively. The bivariate analysis showed that older age, a low forced expiratory volume in one second (FEV1), use of endobronchial ultrasound, the duration of sedation, and the midazolam dose were associated with the occurrence of hypoxia during the procedure, while the multivariate analysis found that age >60 (odds ratio [OR], 1.32), a low FEV1 (OR, 0.99), and a longer duration of sedation (>40 minutes; OR, 1.33) were significant risk factors. Conclusion: The findings suggest that patients older than age 60 and those with a low FEV1 tend to develop hypoxia during the bronchoscopy under sedation. Also, longer duration of sedation (>40 minutes) was a significant risk factor for hypoxia.

기술혁신 정보가 기업가치에 미치는 영향 (Effects of Information Release for Technological Innovation on Firm's Value)

  • 조성표;박정환
    • 기술혁신연구
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    • 제12권3호
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    • pp.159-177
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    • 2004
  • Technological innovation is one of the critical success factors determining firm's Technological innovation is one of the critical success factors determining firm's value in the knowledge based economy. The study examines whether the information release on technological innovation has information contents in the stock market. The abnormal returns and cumulative abnormal return were calculated by using Market and Risk Adjusted Return Model. The results say that the market positively reacts to the information release of technological innovation on the event date. Especially, the disclosure on technology development causes stable increase of the firm's value. It is concluded that the market reacts favorably to technological innovations.

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퍼지-FMEA기법을 이용한 차량탑재형 고소작업대 사고의 주요 유해위험요소 위험우선순위 결정 (Determination of Critical Hazard Factors in Vehicle-Mounted MEWP using Fuzzy-FMEA)

  • 오세윤;이강돈;신재호;임재용
    • 한국안전학회지
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    • 제38권1호
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    • pp.9-17
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    • 2023
  • In this study, we aimed to identify the important hazard factors and determine their criticality in causing serious accidents in vehicle-mounted mobile elevated work platforms (MEWPs). Fuzzy failure modes and effects analysis (FMEA)was performed using accident data and a survey of experts. To determine the hazard factors, the accident data for the last 10 years were used and a questionnaire survey was designed. The questionnaire survey was sent to four experts in the field of occupational safety to determine the severity, occurrence, and detectability of serious accidents in MEWPs. Furthermore, objective RPN scores and risk priority were obtained using fuzzy FMEA. Finally, the criticality of hazard factors in descending order was found to be overloading, non-installation or defective installation of outriggers, breakage due to wire rope aging, and illegal remodeling of vehicle structures. The results were verified by comparing the occurrence data of serious disasters.

Age Distribution and Clinical Results of Critically Ill Patients above 65-Year-Old in an Aging Society: A Retrospective Cohort Study

  • Song I Lee;Jin Won Huh;Sang-Bum Hong;Younsuck Koh;Chae-Man Lim
    • Tuberculosis and Respiratory Diseases
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    • 제87권3호
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    • pp.338-348
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    • 2024
  • Background: Increasing age has been observed among patients admitted to the intensive care unit (ICU). Age traditionally considered a risk factor for ICU mortality. We investigated how the epidemiology and clinical outcomes of older ICU patients have changed over a decade. Methods: We analyzed patients admitted to the ICU at a university hospital in Seoul, South Korea. We defined patients aged 65 and older as older patients. Changes in age groups and mortality risk factors over the study period were analyzed. Results: A total of 32,322 patients were enrolled who aged ≥65 years admitted to the ICUs between January 1, 2007, and December 31, 2017. Patients aged ≥65 years accounted for 35% and of these, the older (O, 65 to 74 years) comprised 19,630 (66.5%), very older (VO, 75 to 84 years) group 8,573 (29.1%), and very very older (VVO, ≥85 years) group 1,300 (4.4%). The mean age of ICU patients over the study period increased (71.9±5.6 years in 2007 vs. 73.2±6.1 years in 2017) and the proportions of the VO and VVO group both increased. Over the period, the proportion of female increased (37.9% in 2007 vs. 43.3% in 2017), and increased ICU admissions for medical reasons (39.7% in 2007 vs. 40.2% in 2017). In-hospital mortality declined across all older age groups, from 10.3% in 2007 to 7.6% in 2017. Hospital length of stay (LOS) decreased in all groups, but ICU LOS decreased only in the O and VO groups. Conclusion: The study indicates a changing demographic in ICUs with an increase in older patients, and suggests a need for customized ICU treatment strategies and resources.

철도 건널목사고 위험도 평가 모델 개발 (Development of Risk Assessment Models for the Level-Crossing Accidents)

  • 왕종배;박찬우;최돈범;김민수
    • 한국철도학회:학술대회논문집
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    • 한국철도학회 2008년도 춘계학술대회 논문집
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    • pp.1524-1530
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    • 2008
  • Generally a road vehicle's wrong entry into level crossing gives rise to hazardous events, the eventual collision with a approaching train depends on the effective operation of safety barriers such a abnormal condition detecting or emergency braking. In this paper, the risk assessment models developed for the level-crossing accidents will be introduced. The definition of hazardous events and the related hazardous factors are identified by the review of the accident history and engineering interpretation of the accident behavior. A probability of the hazardous events will be evaluated by the FTA, which is based on the accident scenario. For the severity estimation, the critical factors which can effect on the consequence will be reviewed during the ETA. Finally, the number of casualty for the public(vehicle drivers) and the train passengers are converted into an equivalent fatality.

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자살 : 유전자-환경 상호작용 (Suicide : Gene-Environment Interaction)

  • 김용구
    • 생물정신의학
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    • 제17권2호
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    • pp.65-69
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    • 2010
  • Gene-environment interactions are important in pathogenesis of suicide or suicidal behavior. Twin and adoption studies and family studies show that genetic factors play a critical role in suicide or suicidal behavior. Given the strong association between serotonergic neurotransmission and suicide, recent molecular genetic studies have focused on polymorphisms of serotonin genes, especially on serotonin transporter and tryptophan hydroxylase genes. Some studies have revealed a significant interaction between s allele of the serotonin transporter gene and the risk of suicide attempt associated with childhood trauma. In addition, the polymorphism of brain-derived neurotrophic factor gene also may influence the effect of childhood trauma in relation to the risk of attempting suicide. Future studies should explore genetic and environmental factors in suicide or suicidal behavior and examine for gene and environment interaction.

Safety of Workers in Indian Mines: Study, Analysis, and Prediction

  • Verma, Shikha;Chaudhari, Sharad
    • Safety and Health at Work
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    • 제8권3호
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    • pp.267-275
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    • 2017
  • Background: The mining industry is known worldwide for its highly risky and hazardous working environment. Technological advancement in ore extraction techniques for proliferation of production levels has caused further concern for safety in this industry. Research so far in the area of safety has revealed that the majority of incidents in hazardous industry take place because of human error, the control of which would enhance safety levels in working sites to a considerable extent. Methods: The present work focuses upon the analysis of human factors such as unsafe acts, preconditions for unsafe acts, unsafe leadership, and organizational influences. A modified human factor analysis and classification system (HFACS) was adopted and an accident predictive fuzzy reasoning approach (FRA)-based system was developed to predict the likelihood of accidents for manganese mines in India, using analysis of factors such as age, experience of worker, shift of work, etc. Results: The outcome of the analysis indicated that skill-based errors are most critical and require immediate attention for mitigation. The FRA-based accident prediction system developed gives an outcome as an indicative risk score associated with the identified accident-prone situation, based upon which a suitable plan for mitigation can be developed. Conclusion: Unsafe acts of the worker are the most critical human factors identified to be controlled on priority basis. A significant association of factors (namely age, experience of the worker, and shift of work) with unsafe acts performed by the operator is identified based upon which the FRA-based accident prediction model is proposed.

초등학교 급식의 비빔밥 생산과정에 따른 미생물적 품질평가 (Microbiological Quality Assessment of Bibimbap Production Flow in Elementary School Foodservice)

  • 김복란;채순주
    • 대한가정학회지
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    • 제43권2호
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    • pp.19-31
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    • 2005
  • The purpose of this study was to evaluate the microbiological quality and assure the hygienic safety of the Bibimbap production in elementary school foodservice in accordance with the HACCP(Hazzard Analysis Critical Control Point) program. The time-temperature relationship and the microbiological quality(total plate count and coliform bacteria count) were assessed to find the critical control point(CCP) during each of the production phase. In the pre-preparation phase, the risk factors of the raw ingredients exceeded the standard level suggested by Solberg et al. Mungbean starch jelly, egg and Kochujang were satisfactory in that no coliform groups were observed over the standard TPC level. In particular, there was a high the risk of beef from the early stages in terms of the coliform level. In the pre-preparation phase, green pumpkin had more coliform groups than the standard level even after washed, which calls for special attention to washing, sterilization, secondary infection of the handler, and the required time for pre-preparation of raw vegetables. In the cooking phase, the temperature of the soybean sprout and mungbean starch jelly decreased to 42$^{\circ}C$ and 26$^{\circ}C$, respectively, which was within the risk zone. In particular, mungbean starch jelly had a great risk factor even after boiling in hot water. During the storage stage before serving, a lot of ingredients were exposed to poor management of temperature and time and thus exceeded the standard level in the total plate counts. In particular, the microbiological count of beef was five times the standard level. Green pumpkins and soybean sprouts were left at 15-38$^{\circ}C$ that is within the risk zone for a long period of time after they were cooked. It is highly recommended that the time of the storage stage before consumption should be shortened and that proper devices should be used to prevent proliferation of bacteria. The number of TPC of the utensils was satisfactory enough, but the knife used exceeded the standard level and thus was a risk factor of bacteria proliferation.

Prevalence of Latent Tuberculosis Infection among Health Care Workers in South Korea: A Multicenter Study

  • Jo, Kyung-Wook;Hong, Yoonki;Park, Jae Seuk;Bae, In-Gyu;Eom, Joong Sik;Lee, Sang-Rok;Cho, Oh-Hyun;Choo, Eun Ju;Heo, Jung Yeon;Woo, Jun Hee;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • 제75권1호
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    • pp.18-24
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    • 2013
  • Background: We investigated the prevalence of latent tuberculosis infection (LTBI) among the health care workers (HCWs) and analyzed its risk factors in South Korea. Methods: A standard questionnaire regarding the baseline demographics and risk factors for LTBI was given to each participant and tuberculin skin test (TST), QuantiFERON-TB GOLD In-Tube (QFT-GIT) assay, and chest radiography were performed. Results: A total of 493 participants, 152 (30.8%) doctors and 341 (69.2%) nurses were enrolled in eight tertiary referral hospitals. The mean age of the subjects was 30.6 years old, and 383 (77.7%) were female. Of the 152 doctors, 63 (41.4%) and 36 (23.7%) were positive by TST and by QTF-GIT, respectively, and among the 341 nurses, 119 (34.9%) and 49 (14.4%) had positive TST and QFT-GIT results, respectively. Overall, the agreement between the two tests was 0.22 by the chance corrected proportional agreement rate (kappa coefficient) in 493 subjects. Experience of working in tuberculosis (TB)-related departments was significantly associated with positive LTBI test results by QFT-GIT assay, not by TST. In multivariate analysis, only age was independently associated with increased risk of a positive TST result, while age and experience of working in TB-related departments (odds ratio, 2.29; 95% confidence interval, 1.01-5.12) were independently associated with increased risk of a positive QFT-GIT result. Conclusion: A high prevalence of LTBI was found among South Korean HCWs. Considering the association between the experience of working in TB-related departments and high risk of LTBI, QFT-GIT may be a better diagnostic test for LTBI than TST in HCWs.

혈액투석환자의 근감소증 관련요인 (Factors Associated with Sarcopenia among Hemodialysis Patients)

  • 신혜윤;민혜숙
    • 중환자간호학회지
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    • 제15권1호
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    • pp.24-34
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    • 2022
  • Purpose : This descriptive survey aims to identify the prevalence of factors associated with sarcopenia among hemodialysis patients. Methods : The study subjects were 137 patients with chronic kidney failure undergoing hemodialysis in three artificial kidney centers in B and Y cities. Data were collected from August 1 to September 30, 2020, using the SARC-F (Strength, Assistant walking, Rising from a chair, Climbing stairs, Falls) questionnaire, Mini Nutritional Assessment-Short Form (MNA-SF), International Physical Activity Questionnaire (IPAQ-SF), Bioelectrical Impedance Analysis (BIA), and a grip dynamometer. The collected data were analyzed using t-tests, crossover analysis, and logistic regression using the IBM SPSS 23 program. Results : The prevalence of sarcopenia among hemodialysis patients, determined using the SARC-F questionnaire, was 16.1%. The associated factors of sarcopenia among hemodialysis patients were found to be gender (OR=6.44, p =.002), age (OR=1.07, p =.015), nutritional status (OR=10.37, p =.027), and albumin level (OR=0.10, p =.014). These findings are supported by an explanatory power of 46.3% (p =.597). Conclusion : The identified risk factors for sarcopenia in hemodialysis patients were; sex, age, nutritional status, and albumin level. The findings of this study can serve as clinical evidence for the development of an intervention program for preventing and managing sarcopenia in patients undergoing hemodialysis.