• Title/Summary/Keyword: Discharge injury patient

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The Determinant of the Length of Stay in Hospital for Schizophrenic Patients: Using Data from the In-depth Injury Patient Surveillance System (정신분열병 환자의 재원일수 결정요인: 퇴원손상심층조사 자료를 이용하여)

  • Cha, Sun Kyung;Kim, Sung-Soo
    • Journal of Digital Convergence
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    • v.11 no.4
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    • pp.351-359
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    • 2013
  • This study was conducted to investigate the factors that affect the length of stay in hospital for schizophrenic patients. Of the data from the in-depth injury patient surveillance system, the final subject included 2,239 patients with schizophrenia in their final diagnosis. Using SPSS 18.0, a hierarchical regression analysis was performed by sequentially entering the explanatory variables by setting sociodemographic characteristics, discharge characteristics and hospital characteristics as explanatory variables and the length of stay in hospital as a dependent variable. The findings showed that the sociodemographic characteristics had the highest explanatory power and the explanatory power changed when the explanatory variable of the hospital characteristics was added, as opposed to the discharge characteristics. Male, type-1 medicaid, Chungcheong-do and the number of beds were found to be the factors that mostly affect the length of stay. Since this study used the secondary data, it has a limitation in terms of additional variables that could better explain the length of stay for schizophrenic patients. Nevertheless, it has an implication in that it investigated a large scale of data on a national level. For the effort of reducing the length of stay, it is suggested that an effort should be made at the national level, by focusing more on the hospital characteristics as well as the individual characteristics of patients.

Clinical Features of the Patients with Fracture on the Frontal Bone (전두골 골절손상 환자의 임상 고찰)

  • Kim, Sahng Hyun;Whang, Kum;Pyen, Jin Soo;Hu, Chul;Hong, Soon Ki Hong;Kim, Hun Joo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.3
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    • pp.353-359
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    • 2000
  • Objective : The fracture on the frontal bone in head-injured patients may be commonly encountered in the clinical situations. Biomechanical studies demonstrate that the anterior wall of the frontal sinus is intermediate in its ability to resist fracture on direct impact. If the frontal sinus is large and the anterior table is able to disperse the force of the impact over a greater area, the posterior table and intracranial contents usually can be spared. We analyzed the clinical features of the patients who presented with frontal skull fracture due to frontal blows. Patients and Methods : From January, 1992 to December, 1997, 172 patients with frontal skull fracture were selected among 1911 patients with head injury who were admitted to department of neurosurgery. Clinical records and radiological studies of all patients were reviewed and evaluated retrospectively. Results : The neurobehavioral changes was seen in 34 cases(19.8%) and showed statistical significances in case of facial bone fractures, acute subdural hematoma(SDH), and positive frontal lobe releasing sign(p<0.05). The good glasgow outcome score group(GOS, good recovery & moderate disability) at discharge was revealed in 77.3% of total patient population. The poor GOS group(severe disability & vegetative state & death) at discharge was revealed in 22.7%. The poor GOS group at discharge have statistical significances with acute epidural hematoma(EDH), traumatic intraventricular hemorrhage(t-IVH), traumatic intracranial lesion, poor initial glasgow coma scale(GCS) scores & Revised Trauma Score(RTS)(p<0.05). Conclusion : Because of their anatomical relationships and neurobehavioral patterns due to vulnerability of the frontal lobe, the frontal injury should be considered as complicated facial injuries. Therefore, these patients are more likely to have a cosmetic or neuropsychiatric problems.

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A Case Report of Hemiparesis After Head Injury Treated with Traditional Korean Medicine (두부 외상 이후 발생한 반신부전마비 한의 치료 1례 보고)

  • Kim, Chae-eun;An, Da-young;Sun, Seung-ho;Jerng, Ui min;Kim, Mikyung
    • The Journal of Internal Korean Medicine
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    • v.43 no.5
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    • pp.817-826
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    • 2022
  • Objectives: The aim of this study is to report a case in which a patient showed recovery from hemiparesis after a head injury. Methods: A 60-year-old woman who suffered a head injury received Korean medicine treatment, including herbal decoctions, acupuncture, electroacupuncture, and physical treatment for 32 days. The response before and after treatment was evaluated using the Manual Muscle Test, the Korean version of the Modified Barthel Index, and walking status. Results: After treatment, the range of the Manual Muscle Test grades of her left lower extremity increased from 1-3 to 2-4. Her score on the Korean version of the Modified Barthel Index improved from 60 to 90. The patient, who was in a wheelchair at the time of admission, walked with a cane upon discharge. Conclusion: This study suggests that intervention with Korean medicine could be one of the therapeutic options for improving hemiparesis after head injury.

The effects of Contant Use of Herbal Medicine with Western Medicine On Liver and Kidney Functions (중풍환자에서 장기간의 한약과 양약의 병용투여가 간장 및 신장에 미치는 영향)

  • An, Joung-jo;Park, So-ae;Moon, Seung-hee
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.10 no.1
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    • pp.27-32
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    • 2009
  • Object : The purpose of this study was to evaluate whether herbal medication may injure the liver function and kidney function in stroke patients. Method : We observed the serum AST, ALT, r-GTP, Creatinine, BUN of 78 patient from May 1. 2008 to June 30. 2009 admitted in Oriental Hospital of Daejeon University. Liver function and Kidney function tests were done on admission and before discharge. And all patients take herbal medicine with Western medicine. Result : AST, ALT, r-GTP, Creatinine, BUN decreased on discharge compared with the value on admission. The liver function and kidney function test score(AST, ALT, r-GTP, Creatinine, BUN) by administration period of herbal medication was not significantly changed. Conclusion : This study suggests that general herbal medication does not injure liver function and kidney function of human.

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Characteristics and changes in delivery and puerperium complicaion : Based on the 2006-2017 Korea National Hospital Discharge In-depth Injury Survey (출산 및 산후 합병증 행태의 특성과 변화 분석 : 퇴원손상심층조사자료를 이용하여)

  • Kyunghee, Lee;Jieun, Hwang
    • The Journal of Korean Society for School & Community Health Education
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    • v.23 no.4
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    • pp.29-39
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    • 2022
  • Objectives: The purpose of this study was to assess the incidence of delivery and puerperium complications in South Korea and analyze the correlations between the patient's characteristics and delivery and complications before and after 10 years. Methods: This study used the data from an Korean National Hospital Discharge In-depth Injury Survey. Cases of which the principal diagnosis and second diagnoses were disease classification ICD code O00-O99(Pregnancy, childbirth and the puerperium) were defined as the study subjects, and the first study group was divided as the year of discharge from 2005 to 2007, and the second study group from 2015 to 2017. Results: The number of patients discharged whose principal diagnosis or second diagnoses was O00-O99 was 21,598(Weighted 423,306) from 2005 to 2007 and 19,028(Weighted 364,384) from 2015 to 2017, which decreased by 13.9% compared to 10 years ago. The average age of discharged patients increased by about 2 years and was statistically significant (p<.0001). Factors associating spontaneous delivery, caesarean section and puerperium complication were hospitalization route, bed size, maternal age, length of hospital stay, and the year of discharge. Conclusion: Based on the results of this study, health and education policies and economic support for medical care for high-risk pregnancy and delivery management would be necessary continuously. In addition, policies to strengthen the medical system for high-risk pregnancy management in non-metropolitan areas with high fertility rates would also be needed.

Inter-regional Transport Accident Mode Comparison Using National Hospital Discharge Patients Injury Survey (퇴원손상환자조사를 이용한 지역간 운수사고 양상 비교)

  • Lim, Nam-Gu;Lee, Jin-Yong;Na, Baeg-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.2
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    • pp.747-754
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    • 2012
  • The purpose of this study was to compare inter-regional accident modes using the National Hospital Discharge Patient Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized as 5 groups according to their financial self-reliance ratio. The main results are as follows. First, transport accidents had increased by the age group of 25 to 44 but decreased thereafter. Second, the frequency of car accidents was the highest among several types of transport accidents. Most common site of transport accidents was roads and highways. Third, there was significant difference in the modes of transport accident among regions. Fourth, emergency admission rate was quite different according to regional groups but it was no significant difference by economic status. Lastly, there was significant difference in injury patterns by region groups. In regions which were high economic status, there were relatively less serious injury patterns such as sprain, strain, dislocation while regions which were in low economic status had experienced serious injury including fracture, stab wound, and open fracture. We could find the difference in accident modes by regional economic status. Therefore, health authority should consider different accident prevention strategies by regional groups.

Secondary Analysis on Pressure Injury in Intensive Care Units

  • Hyun, Sookyung
    • International journal of advanced smart convergence
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    • v.10 no.2
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    • pp.145-150
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    • 2021
  • Patients with Pressure injuries (PIs) may have pain and discomfort, which results in poorer patient outcomes and additional cost for treatment. This study was a part of larger research project that aimed at prediction modeling using a big data. The purpose of this study were to describe the characteristics of patients with PI in critical care; and to explore comorbidity and diagnostic and interventive procedures that have been done for patients in critical care. This is a secondary data analysis. Data were retrieved from a large clinical database, MIMIC-III Clinical database. The number of unique patients with PI was 2,286 in total. Approximately 60% were male and 68.4% were White. Among the patients, 9.9% were dead. In term of discharge disposition, 56.2% (33.9% Home, 22.3% Home Health Care) where as 32.3% were transferred to another institutions. The rest of them were hospice (0.8%), left against medical advice (0.7%), and others (0.2%). The top three most frequently co-existing kinds of diseases were Hypertension, not otherwise specified (NOS), congestive heart failure NOS, and Acute kidney failure NOS. The number of patients with PI who have one or more procedures was 2,169 (94.9%). The number of unique procedures was 981. The top three most frequent procedures were 'Venous catheterization, not elsewhere classified,' and 'Enteral infusion of concentrated nutritional substances.' Patient with a greater number of comorbid conditions were likely to have longer length of ICU stay (r=.452, p<.001). In addition, patient with a greater number of procedures that were performed during the admission were strongly tend to stay longer in hospital (r=.729, p<.001). Therefore, prospective studies focusing on comorbidity; and diagnostic and preventive procedures are needed in the prediction modeling of pressure injury development in ICU patients.

Successful Management of Post-Traumatic Hydrocephalus and Pseudomeningocele Following Traumatic Brain Injury in a Cat

  • Hyoung-Won Seo;Jeong-Min Lee;Hae-Boem Lee;Yoon-Ho Roh;Tae-Sung Hwang;Kun-Ho Song;Joong-Hyun Song
    • Journal of Veterinary Clinics
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    • v.40 no.1
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    • pp.56-61
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    • 2023
  • A 5-month-old female domestic short-haired cat presented with a history of seizure episodes for two months following an animal bite injury to the head. There were no remarkable findings on physical and neurological examination or blood analysis. Computed tomography revealed a fracture of the left parietal bone with an inward displacement of the bone fragment while magnetic resonance imaging revealed an enlarged temporal horn of the left lateral ventricle and a pseudomeningocele compressing the adjacent cerebral parenchyma. Subsequently, cerebrospinal fluid analysis results were normal. The patient was diagnosed with traumatic brain injury (TBI), with subsequent post-traumatic hydrocephalus (PTH) and pseudomeningocele. Despite treatment with phenobarbital and levetiracetam, seizures were not sufficiently controlled. Craniectomy for bone fragment removal and duraplasty were performed after a week. The patient then returned to normal condition with no further seizure activity. On repeated MRI two months after discharge, the hydrocephalus of the lateral ventricle and pseudomeningocele were enlarged; however, the patient maintained a good clinical status without any neurological signs. To the best of our knowledge, PTH and intracranial pseudomeningoceles have not yet been reported in cats. PTH and pseudomeningocele are among the complications of TBI and may not have any significant relevance with the clinical signs in this case. Thus, to broaden our knowledge about PTH and pseudomeningocele in cats, we describe serial changes in the clinical findings of this cat over the treatment period.

Laryngotracheal stenosis in burn patients with inhalation injury (흡인화상환자에서 발생하는 후두 및 기관 협착)

  • Park Il-Seok;Chang Jai-Hyuk;Kim Beom Gyu;Kim Yong Bok;Rho Young Soo;Ahn Hwoe Young;Kim Jong Hyun
    • Korean Journal of Bronchoesophagology
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    • v.11 no.1
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    • pp.10-14
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    • 2005
  • Background and Objectives : Laryngotracheal stenosis in bum patients with inhalation have features distinct from other stenosis after intubation or tracheostomy. However few studies have been reported and the incidence was reported variable. The purpose of this study is to evaluate the clinical manifestation and the incidence of laryngotracheal stenosis in bum patients with inhalation. Methods We retrospectively analyzed 138 bum Patients diagnosed inhalation injury who admitted to Hangang Sacred Heart Hospital from July 2002 to June 2004. Result : 5 patients were developed laryngotracheal stenosis. The incidence of Laryngotracheal stenosis in bum patients with inhalation was $3\%$. Symptom developed early in 2 patients, late in 3 patients.4 patients required trachostomy as initial airway support. The location of stenosis is subglottic region except 1 patient. Montgomery T-tube was inserted in 3 patients, and Single-stage laryngotracheal reconstruction was performed in 1 patient. Conclusion Incidence of laryngotracheal stenosis in our study is lower than other reports due to late presentation of symptom and early discharge after acute bum stage. Inhalation injury may lead to severe complication and sequelae, therefore physicians should be have a awareness for early diagnosis and all burn patients who have a history of inhalation injury should be followed closely.

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A Prognostic Factor for Prolonged Mechanical Ventilator-Dependent Respiratory Failure after Cervical Spinal Cord Injury : Maximal Canal Compromise on Magnetic Resonance Imaging

  • Lee, Subum;Roh, Sung Woo;Jeon, Sang Ryong;Park, Jin Hoon;Kim, Kyoung-Tae;Lee, Young-Seok;Cho, Dae-Chul
    • Journal of Korean Neurosurgical Society
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    • v.64 no.5
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    • pp.791-798
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    • 2021
  • Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.