• Archives of Plastic Surgery
• /
• v.46 no.4
• /
• pp.336-343
• /
• 2019

Background Sternal rigid plate fixation (RPF) has been adopted in recent years in high-risk cases to reduce complications associated with steel wire cerclage, the traditional approach to sternal closure. While sternal RPF has been associated with lower complication rates than wire cerclage, it has its own complication profile that requires evaluation, necessitating a critical examination from a national perspective. This study will report the outcomes and associated risk factors of sternal RPF using a national database. Methods Patients undergoing sternal RPF from 2005 to 2016 in the American College of Surgeons-National Surgical Quality Improvement Program were identified. Demographics, perioperative information, and complication rates were reviewed. Logistic regression analysis was performed to identify risk factors for postoperative complications. Results There were 381 patient cases of RPF identified. The most common complications included bleeding (28.9%), mechanical ventilation >48 hours (16.5%), and reoperation/readmission (15.2%). Top risk factors for complications included dyspnea (odds ratio [OR], 2.672; P<0.001), nonelective procedure (OR, 2.164; P=0.010), congestive heart failure (OR, 2.152; P=0.048), open wound (OR, 1.977; P=0.024), and operating time (OR, 1.005; P<0.001). Conclusions Sternal RPF is associated with increased rates of three primary complications: blood loss requiring transfusion, ventilation >48 hours, and reoperation/readmission, each of which affected over 15% of the study population. Smokers remain at an increased risk for surgical site infection and sternal dehiscence despite RPF's purported benefit to minimize these outcomes. Complications of primary versus delayed sternal RPF are roughly equivalent, but individual patients may perform better with one versus the other based on identified risk factors.

• Journal of Nutrition and Health
• /
• v.52 no.3
• /
• pp.277-284
• /
• 2019

Purpose: Sodium intake is known to be a critical dietary factor in several diseases including cataract. Earlier studies have reported that excess intake of sodium may elevate the risk of cataract. However, little is known about this in Koreans. Thus, the purpose of this study was to examine whether dietary intake of sodium and potassium might modify the risk of cataract. Methods: A total of 1,319 males (219 cases) and 1,966 females (369 cases) from Korean National Health and Nutrition Examination Survey 2012 were analyzed. Energy adjusted dietary intakes of sodium and potassium and their ratios were evaluated to ascertain their associations with the risk of cataract. Dietary intake levels were stratified into quartiles and their risk modifying effects were estimated with logistic regression models with or without subjects' socio-economic characteristics and life styles for each sex. Results: Findings suggested that various descriptive factors were associated with the risk of cataract either in males or females. Males' intake levels of sodium and potassium and their ratios did not differ between phenotypes. Higher intakes or higher ratio was not associated with the risk of cataract. In contrast, female controls had higher intakes of sodium and potassium. Higher intake of potassium reduced the risk of cataract in females. However, such association was not retained when subjects' socioeconomic status and life styles were factored into the analysis. Conclusion: Dietary sodium and potassium intakes minimally affected the risk of cataract in Korean males and females. More studies are needed to ascertain the true pathological effect of sodium intake on cataract aetiology.

• Proceedings of the KSR Conference
• /
• 2003.10b
• /
• pp.271-276
• /
• 2003

In this paper, various hazard factors are reviewed on the train fire accident in railway tunnel and subway. In case studies of systematic risk evaluation on the tunnel fire accident, we have learned the critical fire safety points for accident prevention and damage reduction such as fire-endurance of infrastructure, mortality of heat & toxic smoke, emergency situation control and management of escape requirements etc.. These hazard analysis study will contribute for improving the railway fire-safety and establishing the long-tenn safety management plan.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.11 no.1
• /
• pp.28-31
• /
• 2000

Microscopic surgery of the larynx normally have a low recurrence rate. However, once they do recur, it is uneasy to manage recurrent diseases. Recurrence is often the result of inappropriate postoperative care and voice management. Out of the 764 patients operated for benign inflammatory laryngeal diseases, we have conducted a clinical analysis of 54 cases who have had at least one episode of recurrence after the initial treatment with laryngomicrosurgery (7.1% of recurrence rate). High risk groups for recurrence were determined, and they were related to cigarette smoking, alcohol intake, laryngopharyngeal reflux. From our experience and literature review, we conclude that pre- and postoperative patient education concerning these risk factors and voice usage Is of critical need to prevent recurrence of inflammatory laryngeal lesions after laryngomicrosurgery.

• Journal of Korean Neurosurgical Society
• /
• v.67 no.1
• /
• pp.84-93
• /
• 2024

Objective : We aimed to examine trends in critically ill neurology-neurosurgery (NNS) patients who were admitted to the intensive care unit (ICU) in South Korea and identify risk factors for in-hospital mortality after ICU admission in NNS patients. Methods : This nationwide population-based retrospective cohort study enrolled adult NNS adult patients admitted to the ICU from 2010 to 2019 extracted from the National Health Insurance Service in South Korea. The critically ill NNS patients were defined as those whose main admission departments were neurology or neurosurgery at ICU admission. The number of ICU admission, age, and total cost for hospitalization from 2010 to 2019 in critically ill NNS patients were examined as trend information. Moreover, multivariable logistic regression modeling was used to identify risk factors for in-hospital mortality among critically ill NNS patients. Results : We included 845474 ICU admission cases for 679376 critically ill NNS patients in South Korea between January 1, 2010 to December 31, 2019. The total number of ICU admissions among NNS patients was 79522 in 2010, which increased to 91502 in 2019. The mean age rose from 62.8 years (standard deviation [SD], 15.6) in 2010 to 66.6 years (SD, 15.2) in 2019, and the average total cost for hospitalization per each patient consistently increased from 6206.1 USD (SD, 5218.5) in 2010 to 10745.4 USD (SD, 10917.4) in 2019. In-hospital mortality occurred in 75455 patients (8.9%). Risk factors strongly associated with increased in-hospital mortality were the usage of mechanical ventilator (adjusted odds ratio [aOR], 19.83; 95% confidence interval [CI], 19.42-20.26; p<0.001), extracorporeal membrane oxygenation (aOR, 3.49; 95% CI, 2.42-5.02; p<0.001), and continuous renal replacement therapy (aOR, 6.47; 95% CI, 6.02-6.96; p<0.001). In addition, direct admission to ICU from the emergency room (aOR, 1.38; 95% CI, 1.36-1.41; p<0.001) and brain cancer as the main diagnosis (aOR, 1.30; 95% CI, 1.22-1.39; p<0.001) are also potential risk factors for increased in-hospital mortality. Conclusion : In South Korea, the number of ICU admissions increased among critically ill NNS patients from 2010 to 2019. The average age and total costs for hospitalization also increased. Some potential risk factors are found to increase in-hospital mortality among critically ill NNS patients.

• Journal of Korean Critical Care Nursing
• /
• v.14 no.3
• /
• pp.26-36
• /
• 2021

Purpose : This study aimed to present the incidence of pressure ulcers and identify different associated factors according to the time of occurrence of pressure ulcers in intensive care unit (ICU) patients. Methods : The participants were 313 patients who reported pressure ulcers among 2,908 patients in ICUs at a large tertiary hospital in Gyeonggi-do. Among them, 220 patients (70.3%) had a pressure ulcer before admission, and 93 patients (29.7%) reported newly developed pressure ulcers after admission to the ICU. Data were collected between August 2018 and April 2019. Along with the time of occurrence and characteristics of pressure ulcers, diverse associated factors were gathered through electronic medical records. Data were analyzed using descriptive statistics, independent t-tests, and 𝑥²-tests. Results : Different risk factors associated with pressure ulcers in ICU patients according to the time of occurrence were main diagnosis, score of acute physiology and chronic health evaluation, score of Richmond agitation sedation scale, level of consciousness, administered sedatives, use of a ventilator, insertion of a feeding tube, and the duration of fasting period. Conclusion : Based on the results of this study, healthcare providers, especially ICU nurses, should try to detect early signs and symptoms of pressure ulcers, taking into account the derived factors associated with pressure ulcers in ICU patients. Practical intervention programs and strategies considering the factors associated with pressure ulcers must be developed to prevent and alleviate such ulcers in ICU patients in the future.

• Journal of the Korean Society of Safety
• /
• v.27 no.2
• /
• pp.42-48
• /
• 2012

The present study was motivated by the needs to make diversified scientific approaches toward influential factors like human, technical, organization, policy and environmental on the basis of the specialized information concerning the cause for industrial accidents in a measure to prevent the falling accident which has the biggest priority among the three major frequent industrial accidents. In this connection, diverse policies have been practiced in the meantime, with little effects in fact to reduce occurrence of industrial accidents, seemingly because such policies have been practiced on the direct dimension, instead of tries to nip in the bud of fundamental causes. This study was thus conducted with a view to determine the causes that have influence on falling accidents from the overall context and unearth the factors requiring management with priority. For this aim, "Fall from Height"(2003), a study by HSE, UK was applied to various conditions of korea as an experiment to search for fundamental causes for falling accidents. The major findings of this study might be summed up as exploring a main critical path that has influence upon falling accidents and suggesting effective ways to cut down through the critical path.

• Journal of Korean Critical Care Nursing
• /
• v.4 no.1
• /
• pp.75-87
• /
• 2011

Purpose: This study was done to investigate the DVT-related knowledge and compliance of hospital nurses. Methods: A survey questionnaire was administrated to a convenience sample of 367 nurses working at 3 university hospitals and 4 general hospitals located in Busan. Results: The mean score of DVT-related knowledge was $16.86{\pm}$3.40$ points out of 26, with a percentage of correct answers of 64.8%. The mean score of DVT-related compliance was $21.40{\pm}6.42$ points out of 32. There was a significant correlation between hospital nurses' DVTrelated knowledge and compliance (r=.309, p=.000). The factors for predicting hospital nurses' DVT-related compliance included knowledge of treatment and care areas, the subcategories of DVT knowledge (${\beta}$=.214), knowledge of the area of risk factors (${\beta}$=.105), whether to perform DVT prevention and treatment based on protocols (${\beta}$=.193), the existence of DVT protocols (${\beta}$=.168) and the degree of interest in DVT (${\beta}$=.102) and the total explanatory power of these was 21.3%. Conclusion: To improve compliance on preventing DVT effectively, it is necessary to improve nurses' DVT-related knowledge and interest in DVT through appropriate education. And, it is necessary to develop standardized protocols and guidelines.

• Journal of East-West Nursing Research
• /
• v.25 no.2
• /
• pp.183-192
• /
• 2019

Purpose: This study aimed to examine the mediating effect of illness perception on the relationship between family function and health behavior of patients with risk factors for metabolic syndrome. Methods: This is a cross-sectional correlational study. Data were collected from 160 patients using self-administered questionnaires including the Illness Perception Questionnaire-Revised, Family APGAR, and the Health Behavior Scale. The data were analyzed using Pearson's correlation coefficients, independent t-test and multiple linear regression analysis by the SPSS 23.0 program. Results: Health behavior was significantly correlated with family function (r=.30, p<.001) and illness perception of controllability by treatment (r=-.21, p=.007). Family function was a significant predictor of health behavior and illness perception, and the influence of family function on health behavior was partially mediated by illness perception of controllability by treatment. Conclusion: The findings of this study indicate that family function is a critical factor affecting health behavior and illness perception, and illness perception of controllability by treatment mediates the influence of family function on health behavior. It is necessary to develop a psycho-cognitive intervention program for enhancing supportive family function and for modifying negative illness perceptions to improve health behavior in patients with risk factors for metabolic syndrome.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.46 no.3
• /
• pp.162-173
• /
• 2020

Dental implants are the first option for replacement of missing teeth. Failure usually involves additional cost and procedures. As a result, the physician should limit the risk factors associated with implant failures. Implant site is one of many factors that can influence the success or failure of dental implants. The association between early implant failure (EIF) and implant site has yet to be documented. This review aims to estimate the impact of insertion site on the percentage of EIFs. An electronic and manual search of studies that reported early failure of dental implants based on collection site. A total of 21 studies were included in the review and examined for the association between EIF and alveolar site. Subgroup analysis, including a comparison between implants inserted in four alveolar ridge regions of both jaws was performed. The early failure rate was higher for maxillary implants (3.14%) compared to mandibular implants (1.96%). Applying a random effect, risk ratio (RR), and confidence interval (CI) of 95% revealed higher failure in the maxilla compared to the mandible (RR 1.41; 95% CI [1.19, 1.67]; P<0.0001; I²=58%). The anterior maxilla is more critical for early implant loss than other alveolar bone sites. Implants in the anterior mandible exhibited the best success rate compared of the sites.