• Title/Summary/Keyword: Hospital discharge

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A Comparative Study on Risk Factors Related to Patient with Recurrent Stroke Between Recurrent Group and Non-recurrent Group: Single Hospital Based Cohort Study (뇌졸중 재발자와 비재발자의 뇌졸중 재발 위험 요인의 비교 분석: 일개 병원의 뇌졸중 환자 코호트를 기반으로)

  • Jeon, Mi Yang;Cho, Hyung Je;Park, Mingyeong;Jin, Mi Jeong;Ha, Youngmi
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.219-228
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    • 2020
  • Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

Analysis of Factors Affecting the Hospitalization of Patients Visited the Emergency Department after Deliberate Self-poisoning (의도적 음독후 응급실에 내원한 환자의 입원과 관련된 요인 분석)

  • Noh, Woo Sik;Kim, Hye Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.18 no.2
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    • pp.102-109
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    • 2020
  • Purpose: This study examined factors associated with the hospitalization of patients who visited the emergency department (ED) after deliberate self-poisoning. Methods: The medical records of the patients, who visited the ED at a tertiary teaching hospital after deliberate self-poisoning between March 2017 and December 2019, were reviewed retrospectively. Results: Fifty-seven in the hospitalization and 236 in the discharge group patients were included. The mean age in the hospitalization and discharge group was 48.8±20.4 and 41.8±19.1, respectively (p=0.020). Univariate analysis revealed statistically significant differences in age (p=0.020), mental status (p<0.001), request for help (p=0.046), chronic disease (p=0.036), substance ingested (p<0.001), and risk rescue-rating scale (p<0.001) between the two groups (hospitalization group and discharge group). In multiple logistic regression analysis for predicting the hospitalization of patients after deliberate self-poisoning, the Risk-Rescue Rating Scale (RRRS) was identified (OR=1.493, 95% confidential interval=1.330-1.675, p<0.001). Receiver operating characteristics analysis of RRRS for the decision to hospitalize showed a cut-off value of 38.9, with a sensitivity, specificity, and area under the curve of 96.4%, 77.0%, and 0.949, respectively. Conclusion: The RRRS can be used to determine the hospitalization for patients who visited the ED after deliberate self-poisoning. Nevertheless, multicenter prospective studies will be needed to determine the generalisability of these results.

The Relationship between Metabolic Syndrome Factor Diseases and Falls in Korean Elderly: Using National Hospital Discharge In-depth Injury Survey (한국 노인의 대사증후군 요인 질환과 낙상과의 관련성: 퇴원손상심층조사를 이용하여)

  • Nam, Younghee
    • The Journal of Korean Society for School & Community Health Education
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    • v.23 no.1
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    • pp.29-40
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    • 2022
  • Objectives: The purpose of this study is to identify the relationship between metabolic syndrome factor diseases and falls in the elderly aged 65 years or older and use them as basic data to reduce the risk of falls. Methods: The method of this study was to compare the injury-related characteristics of the fall and non-fall groups with a factor disease of metabolic syndrome in Korea over 65 years of age. Data from the 14th National Hospital Discharge In-depth Injury Survey in 2018 were used to conduct the study. A total of 7,991 data were analyzed using SPSS 23.0. Results: Among the total injuries, the fall group with metabolic syndrome factor disease accounted for 69.0% and the non-fall group 31.0%. Falls occurred in 86.3% of households. In the fall group with metabolic syndrome factor disease, the number of females was 1.9~2.1 times higher than that of males. Compared to 65~69 years of age, the incidence of falls was 1.4~1.5 times higher in 70~79 years, 1.7~2.2 times higher in 80~89 years, and 2.5~3.6 times higher in 90-year-olds and older. In NISS, the incidence of falls was 1.7 times higher in moderate compared to mild. In principle diagnosis, the incidence of falls was 2.2 times higher in S40-S99 compared to S00-S19. Conclusion: The elderly with metabolic syndrome factor disease should continue to promote health through light exercise that can strengthen muscle strength to prevent falls.

Differences in Social and Clinical Characteristics between Readmission and Dehospitalization in Long-Term Inpatients with Schizophrenia (장기 재원 조현병 환자에서 재입원 혹은 탈원에 따른 사회적 및 임상적 특징 차이)

  • Kim, Min-Sun;Park, Sunyoung;Choi, Jin-sook
    • Korean Journal of Schizophrenia Research
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    • v.23 no.1
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    • pp.38-44
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    • 2020
  • Objectives: Dehospitalization of long-term inpatients with schizophrenia can be difficult because of complex factors such as chronic symptoms and low family and social support. The aim of this study was to identify factors related to dehospitalization and readmission of long-term inpatients with schizophrenia. Methods: This retrospective study reviewed the medical records of patients discharged from a psychiatric hospital in Yongin, South Korea, from February 1, 2016, to July 31, 2017. Patients who were hospitalized for over 3 months were divided into two groups: readmission (n=47) and dehospitalization (n=55). Differences in sociodemographic and clinical factors were analyzed between the two groups. Results: Regarding sociodemographic characteristics, female sex, familylessness, discharge to nursing homes, and discharge after symptom improvement were more prevalent in the dehospitalization group, whereas male sex, having a sibling as next of kin, and discharge because of other problems were more prevalent in the readmission group. Among clinical characteristics, hospital stay was longer in the readmission group. Conclusion: In this study, patients without a family showed a tendency to not be readmitted when they were discharged to nursing homes after symptom improvement. Expansion of social welfare support may encourage dehospitalization of long-term inpatients with schizophrenia.

Functional Status and Health Care Utilization among Elders with Hip Fracture Surgery from a Fall (낙상후 대퇴골절 수술 노인의 신체기능, 의료이용 및 낙상의 두려움)

  • Oh, Hee-Young;Im, Young-Mi
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.432-440
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    • 2003
  • Purpose: The purposes of this study were to examine 1) functional status at 2 months after hip fracture surgery 2) health care utilization after a fall episode and 3) fear of falling experienced during first 2 months after a fall episode. Method: With a convenient sample of 99 elderly from six university or general hospitals with hip fracture from a fall, data were collected at 2-3 days before discharge and at 2 months after hip fracture surgery. Result: 1) At 2 months after hip fracture from a fall, significant proportion (25.3%) of elderly was not able to walk indoors. 2) Average length of hospital stay was 27.6 days with a range of 8 to 86 days. About 51% subjects received physical therapy during hospital stay, and only 6.1% subjects received physical therapy following discharge from the hospital. 3) Significant proportion (72.7%) had fear of falling after the fall episode. About 51% reported that they restricted their activities because they had fear of falling. Conclusion: Fall is a dreaded event which result in loss of independence and restriction of activity. Development and application of fall prevention program is critical especially for those with risk factors of fall.

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Post-intensive Care Syndrome and Quality of Life in Survivors of Critical Illness (중환자실 퇴원환자의 집중치료 후 증후군과 삶의 질)

  • Kim, Soo Gyeong;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.1-14
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    • 2016
  • Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ${\geq}36$ months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors.

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Effects of Surgery Volume on In Hospital Mortality of Cancer Patients in General Hospitals (종합병원 암 종별 수술량이 병원 내 사망에 미치는 영향)

  • Youn, Kyung-Il
    • Health Policy and Management
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    • v.24 no.3
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    • pp.271-282
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    • 2014
  • Background: Although the mortality rate in cancers has been decreased recently, it is still one of the leading causes of death in most of the countries. This study analyzed the relationship between surgery volume and in hospital mortality of cancer patients. The purpose of this study is to investigate the relationship in Korean healthcare environment and to provide information for the policy development in reducing cancer mortality. Methods: The study sample was the 20,517 cancer patients who underwent surgery and discharged during a month period between 2008-2011. The data were collected in Patient Survey by Korean Institute of Social Affairs. Logistic regression was used to analyse a comprehensive analytic model that includes a binary dependent variable indicating death discharge and independent variables such as surgery volume, organizational characteristics of hospitals, socio-economical characteristics of the patients, and severity of disease indicators. Results: In chi-square test, as the surgery volume increases, the in-hospitals mortality showed a downward trends. In regression analysis, the relationship between surgery volume and mortality showed significant negative associations in all types of cancer except for pancreatic cancer. Conclusion: In the absence of other information patients undergoing cancer surgery can reduce their risk of operative death by selecting a high-volume hospital. Therefore, policies to enhance centralization of cancer surgery services should be considered.

Study on Cancer Patients Who Visited an Emergency Department with the Side Effects of Chemotherapy (응급실 내원 암환자의 항암화학요법 부작용에 대한 후향적 조사연구)

  • Lim, Soo Jung;Yi, Myungsun
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.1
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    • pp.75-89
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    • 2014
  • Purpose: This study was done to identify conditions of cancer patients who visited an emergency department (ED) with the side effects of chemotherapy. Methods: Data were collected retrospectively from medical records of 294 cancer patients who visited a tertiary hospital in 2009 for treatment of side effects of chemotherapy. Records were reviewed for characteristics of participants and side effects of chemotherapy. Data were analyzed using SPSS software. Results: ED Triage grade 3 was 81.6%. The hospitalization ratio was 72.8%, and 6.5% died during the admission. Most frequent side effects were thrombocytopenia (80.6%), anemia (74.5%), pain (52.0%), neutropenia (50.7%), and leucopenia (46.3%). The hospitalization group showed more severe leucopenia than the discharge group (p=.020). Patients in the group who died had higher scores for dyspnea compared to patients discharged or hospitalized (p<.05). Conclusion: Results of the study suggest that there is a special need to develop a system to manage side effects of chemotherapy. Also it is necessary to provide appropriate care and treatment with prompt initial evaluation when cancer patients with side effects of chemotherapy present in the ED. More effective educational discharge programs should also be developed to help these patients cope with various side effects of chemotherapy.

The Effects of Thoracic Flexibility Exercise on Vital Capacity and Chest Expansion in Patients With Idiopathic Scoliosis (흉부 유연성 운동이 척추측만증 환자의 폐활량과 흉곽 확장에 미치는 영향)

  • Shim, Jae-Hun;Oh, Duck-Won;Lee, Gyu-Wan
    • Physical Therapy Korea
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    • v.9 no.2
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    • pp.145-156
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    • 2002
  • The objectives of this study were to investigate the effects of thoracic flexibility exercise on chest function and mobility and to provide the information of physical therapy for patients with idiopathic scoliosis. Forty female subjects who were diagnosed with scoliosis participated in this study and were divided into the experimental and control groups. The experimental group consisted of 20 patients who were treated with thoracic flexibility exercise program during the admission (10 days) ad one month after discharge. The control group consisted of 20 patients who were not treated with thoracic flexibility exercise program. Vital capacity was measured using a respirometer. The chest expansion were calculated using differences of chest circumference between maximum inspiration and maximum expiration measured under armpits, at the junction between the sternum and xyphoid process, and at the waist. All subjects were measured two times: before the admission and at one month after discharge. Data were compared by groups using independent t-test, Vital capacity and chest expansion values (the armpit, chest and waist values) were significantly higher for the experimental group compared to those of the control group (p<.05). The findings of this study show that thoracic flexibility exercise program can lead to an increase in vital capacity and chest expansion and has a positive effects in relieving symptoms and restoring thoracic mobility.

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Risk Factors of Unplanned Readmission to Intensive Care Unit (중환자실 환자의 비계획적 재입실 위험 요인)

  • Kim, Yu Jeong;Kim, Keum Soon
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.2
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    • pp.265-274
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    • 2013
  • Purpose: The aim of this study was to determine the risk factors contributed to unplanned readmission to intensive care unit (ICU) and to investigate the prediction model of unplanned readmission. Methods: We retrospectively reviewed the electronic medical records which included the data of 3,903 patients who had discharged from ICUs in a university hospital in Seoul from January 2011 to April 2012. Results: The unplanned readmission rate was 4.8% (n=186). The nine variables were significantly different between the unplanned readmission and no readmission groups: age, clinical department, length of stay at 1st ICU, operation, use of ventilator during 24 hours a day, APACHE II score at ICU admission and discharge, direct nursing care hours and Glasgow coma scale total score at 1st ICU discharge. The clinical department, length of stay at 1st ICU, operation and APACHE II score at ICU admission were the significant predictors of unplanned ICU readmission. The predictive model's area under the curve was .802 (p<.001). Conclusion: We identified the risk factors and the prediction model associated with unplanned ICU readmission. Better patient assessment tools and knowledge about risk factors could contribute to reduce unplanned ICU readmission rate and mortality.