• Clinical and Experimental Emergency Medicine
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• 제5권4호
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• pp.249-255
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• 2018

Objective As aging progresses, clinical characteristics of elderly patients in the emergency department (ED) vary by age. We aimed to study differences among elderly patients in the ED by age group. Methods For 2 years, patients aged 65 and older were enrolled in the study and classified into three groups: youngest-old, ages 65 to 74 years; middle-old, 75 to 84 years; and oldest-old, ${\geq}85years$. Participants' sex, reason for ED visit, transfer from another hospital, results of treatment, type of admission, admission department and length of stay were recorded. Results During the study period, a total 64,287 patients visited the ED; 11,236 (17.5%) were aged 65 and older, of whom 14.4% were 85 and older. With increased age, the female ratio (51.5% vs. 54.9% vs. 69.1%, P<0.001), medical causes (79.5% vs. 81.3% vs. 81.7%, P=0.045), and admission rate (35.3% vs. 42.8% vs. 48.5%, P<0.001) increased. Admissions to internal medicine (57.5% vs. 59.3% vs. 64.7%, P<0.001) and orthopedic surgery (8.5% vs. 11.6% vs. 13.8%, P<0.001) also increased. The ratio of admission to intensive care unit showed no statistical significance (P=0.545). Patients over age 85 years had longer stays in the ED (330.9 vs. 378.9 vs. 407.2 minutes, P<0.001), were discharged home less (84.4% vs. 78.9% vs. 71.5%, P<0.001), and died more frequently (6.3% vs. 10.4% vs. 13.0%, P<0.001). Conclusion With increased age, the proportion of female patients and medical causes increased. Rates of admission and death increased with age and older patients had longer ED and hospital stays.

• 보건행정학회지
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• 제29권2호
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• pp.237-244
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• 2019

Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.

• 대한한방내과학회지
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• 제42권4호
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• pp.622-627
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• 2021

Objective: This study was designed to analyze the utility of routine chest X-ray on Korean medicine hospital admission. Methods: The chest X-ray reports and medical records of 618 patients who were admitted to Daejeon Korean Medicine Hospital from May 1, 2021 to June 30, 2021 were retrospectively reviewed. Results: Of the 618 patients newly hospitalized from May 1, 2021 to June 30, 2021, 560 patients (excluding readmission) were analyzed. The mean age of 560 patients was 53.26±17.20 years. There were 52 patients with abnormal findings, and their mean age was 69.62±15.59 years. Many of these patients had chest symptoms and a history of chest disease. There was no case that showed a significant diagnostic result by chest X-ray examination. Conclusion: The diagnostic usefulness of routine chest X-rays in Korean medicine hospital admission is low. But this does not mean that there is no need to perform routine chest X-rays upon admission.

• Clinical and Experimental Pediatrics
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• 제57권11호
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• pp.489-495
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• 2014

Purpose: The aims of this study were to document our single-center experience with pediatric acute fulminant myocarditis (AFM) and to investigate its clinical features and short-term outcomes. Methods: We performed a retrospective chart review of all children <18 years old who were diagnosed with AFM between October 2008 and February 2013. Data about patient demographics, initial symptoms, investigation results, management, and outcomes between survivors and nonsurvivors were collected. Results: Seventeen of 21 patients (80.9%) with myocarditis were diagnosed with AFM. Eleven patients (64.7%) survived to discharge, and 6 (35.3%) died. Electrocardiography on admission revealed dysrhythmia in 10 patients (58.8%); of these, all 7 patients with a complete atrioventricular block survived. Fractional shortening upon admission was significantly different between the survivors (16%) and nonsurvivors (8.5%) (P=0.01). Of the serial biochemical markers, only the initial brain natriuretic peptide (P=0.03) and peak blood urea nitrogen levels (P=0.02) were significantly different. Of 17 patients, 4 (23.5%) required medical treatment only. Extracorporeal membrane oxygenation (ECMO) was performed in 13 patients (76.5%); the survival rate in these patients was 53.8%. ECMO support was initiated >24 hours after admission in 4 of the 13 patients (30.7%), and 3 of those 4 patients (75%) died. Conclusion: AFM outcomes may be associated with complete atrioventricular block upon hospital admission, left ventricular fractional shortening at admission, time from admission to the initiation of ECMO support, initial brain natriuretic peptide level, and peak blood urea nitrogen level.

• 사회복지연구
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• 제37호
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• pp.369-397
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• 2008

본 연구는 정신장애인의 정신의료기관 입 퇴원 과정을 이해관계자들의 행위양상과 행위가 드러나는 맥락을 중심으로 분석함으로써, 국가관리의 문제점들을 노정하여 보다 실효성이 있는 정책대안을 구축하기 위한 기초자료를 제공하고자 한다. 연구의 참여자는 각 정신보건영역에 근무하는 사회복지사와 간호사 중 6명을 선정하고, 이들의 심층면접을 토대로 자료를 수집하고 분석하였다. 연구결과, 공공관리의 바깥에서 이루어지는 입원형태, 정신장애인 입원에 대한 국가관리의 공백, 정신의료기관의 입원치료에 대한 형식적 국가관리, 장기입원의 구조화, 공공퇴원관리체계의 무기력과 기능의 전치현상 등의 5개 주제가 발견되었다. 정신의료기관의 입 퇴원의 국가관리가 정신보건법상의 제도적 장치에도 불구하고 이를 다시 민간의료기관에 위탁 가능케 함으로써, 관리의 공백과 이 과정에서의 인권침해 현상이 나타나고 있었다. 또한 퇴원후 관리에서도 국가관리는 무기력함을 드러내고 있었으며, 이는 공공기관들의 기능전치현상이 한 원인으로 자리잡고 있었다. 이러한 연구결과를 토대로 하여, 우리나라 정신장애인의 입원과정, 퇴원과정에서의 인권침해를 방지하기 위한 법적 제도적 보완과 지역사회 지지기반 확충을 위한 적극적인 정책을 제언하였다.

• 대한한방내과학회지
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• 제40권3호
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• pp.506-516
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• 2019

Objectives: This study aimed to report five patients who had multiple rib fractures after a traffic accident who improved with the combination of Korean medical admission treatment. Methods: We collected the data of traffic accident patients with multiple rib fractures who were admitted to the Daejeon Jaseng Hospital of Korean Medicine from April 2018 to May 2018 to receive the combinational Korean medical treatment. We observed these cases of patients treated by Acupuncture, Pharmacopuncture, Herbal medicine, Oriental physical therapy, Chuna treatment. We measured the validity of the treatment with a numerical rating scale (NRS) and the European Quality of Life-5 Dimension (EQ5D) at admission, at two weeks, and at the discharge date of hospitalization. Results: At the end of the treatment, all patients showed a decrease in NRS scores and in increase in EQ5D. The median NRS score was 6 (5-7) at the date of admission and 4 (2-7) at two weeks and then decreased to 3 (2-6). The median EQ5D score was 0.513 (0.350-0.752) at the date of admission and 0.692 (0.418-0.913) at two weeks, and then increased to 0.783 (0.671-0.913). Conclusions: After the combination of Korean medicine admission treatment, five patients with multiple rib fractures after a traffic accident showed that the treatments were effective. However, the number of subjects was insufficient and individual efficacy was not measured in this study. Therefore, further studies are needed on this topic.

• 한국전문물리치료학회지
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• 제31권1호
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• pp.48-54
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• 2024

Background: Promoting patients' safe return home at discharge and reducing length of stay in hospital is key for Restorative Rehabilitation Institution (RMI). Objects: This study was designed to identify the factors influencing the return to home and length of stay among various factors. Methods: A total of 120 stroke patients (76 males and 44 females) who were hospitalized in an adult inpatient unit of a RMI for more than 2 months were retrospectively analyzed for this study (multivariate logistic regression analyses, p < 0.001). As predictor variables for assessing the return to home and length of stay, demographic data (sex, age, duration between onset and admission, length of stay, caregiver after discharge, occupation after discharge, reason for discharge, and household type after discharge) were collected. Additionally, following measurements were selectively collected from patient's medical records: scores of Mini-Mental State Examination Korean version (K-MMSE), modified Barthel Index Korean version (K-MBI), Berg Balance Scale and Functional Ambulation Category were obtained at admission and discharge. Results: The K-MMSE at admission and K-MBI at discharge were found to be the predictors of return to home. Additionally, K-MBI at admission influenced the length of stay. Conclusion: This study suggests cognitive functioning at admission and the level of activities of daily living at discharge predicted the return to home and length of stay.

• 한방재활의학과학회지
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• 제31권1호
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• pp.187-193
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• 2021

Objectives To report two patients with distal raidus fracture after a traffic accident improved by the complex of Korean medical admission treatment. Methods We collected data from April 2019 to October 2019. We surveyed the validity of the treatment with the range of motion (ROM), the European quality of life-5 dimension (EQ5D) and a numerical rating scale (NRS) at admission, two weeks, and discharge date of hospitalization. Results At the end of treatment, both patients had increased ROM, EQ5D and reduced NRS scores. Conclusions After the Korean medicine admission treatment, two patients showed to have been effective.

• 한방재활의학과학회지
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• 제27권4호
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• pp.163-170
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• 2017

Objectives The objective of this study is to report 4 patients who had vertebral compression fracture after traffic accident, that had a complex korean medical admission treatment. Methods In this study we collected the data of traffic accident patients that came to receive intense Korean medical treatment, and had compression fracture of the lumbar spine. A total of 4 patients were studied and we compared the Visual Analogue Scale (VAS) score and the Pain-Free Walking Distance (PFWD) at addmission date and 19th day of hospitalization. Results After receiving an average of 22.25 days of admission treatment, all patients showed a significant decrease in VAS scores and increase in PFWD. The median VAS score at date of admission was 6.5 (VAS 6~9) and decreased to 3.5 (VAS 3~5), median PFWD was 37.5 (30~45) m and increased to 435 (420~450) m. Conclusions After complex korean medicine admission treatment, 4 patients with vertebral compression fracture caused by traffic accident showed decrease of pain and increase of walking distance. But there is a need for further studys to be done on treatment methods and evaluation methods.

• 대한화상학회지
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• 제22권2호
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• pp.25-29
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• 2019

Purpose: This study was performed to investigate the effect of plasma lactate clearance as predictive factor of major burn patients. Methods: A retrospective review was performed on 119 patients from January 2014 to December 2018, who were admitted as severe burn patients to ICU unit. Plasma lactate was measured upon admission to the hospital and 24hrs after admission. And, hospital day, ICU day, TBSA (Total Body Surface Area) and numbers of surgical intervention were collected after admission. Results: Higher lactate clearance showed negative statistical correlation with survival, hospital day, ICU day & number of surgical interventions. Conclusion: In this study, 24hr lactate clearance might be used as predictor of clinical prognosis following major burn injury.