• 보건행정학회지
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• 제21권4호
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• pp.541-564
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• 2011

This study aimed to investigate health outcome of acute myocardial infarction (AMI) patients such as mortality and length of stay in hospital and to identify factors associated with the health outcome according to the comorbidity index. Nation-wide representative samples of 3,748 adult inpatients aged between 20-85 years with acute myocardial infarction were derived from the Korea National Hospital Discharge Injury Survey, 2005-2008. Comorbidity index was measured using the Charlson Comorbidity Index (CCI). The data were analyzed using t-test, ANOVA, multiple regression, logistic regression analysis in order to investigate the effect of comorbidity on health outcome. According to the study results, the factors associated with length of hospital stay of acute myocardial infarction patients were gender, insurance type, residential area scale, admission route, PCI perform, CABG perform, and CCI. The factors associated with mortality of acute myocardial infarction patients were age, admission route, PCI perform, and CCI. CCI with a higher length of hospital stay and mortality also increased significantly. This study demonstrated comorbidity risk adjustment for health outcome and presented important data for health care policy. In the future study, more detailed and adequate comorbidity measurement tool should be developed, so patients' severity can be adjusted accurately.

• Child Health Nursing Research
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• 제18권1호
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• pp.43-52
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• 2012

Purpose: The purpose of this study was to provide basic data for suitable neonate blood glucose maintenance by investigating and analyzing the blood glucose level of post cardiovascular surgery neonates in the ICU for the effect of blood glucose levels on the following outcomes; ICU stay, hospital stay, mechanical ventilation time, morbidity, and mortality. Methods: The participants were 143 neonates in the ICU after having had cardiovascular surgery. The design for this study was an investigation of the blood glucose levels of the neonates and retrospective analysis of patient outcomes according to blood glucose level. Results: The results for the neonate groups showed that the factors of hospital stay, ICU stay, mechanical ventilation time and mortality, for the group with a blood glucose level over 140 mg/dL were longer and higher than for the group with blood glucose of less than 100 mg/dL or the group between 100-139 mg/dL. Conclusion: The results of this study indicate that when caring for neonates after cardiovascular surgery, it is important to recognize the influence of blood glucose levels on patient outcomes like hospital days, ICU stay, length of time on mechanical ventilation and mortality. Further, care guidelines for neonates' glucose level management need to be developed.

• 대한임상독성학회지
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• 제18권2호
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• pp.116-122
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• 2020

Acute respiratory failure is an important risk factor for mortality in patients with acute pesticide poisoning. Therefore, it is necessary to investigate the risk factors to predict respiratory failure in these patients. This study retrospectively investigated the clinical features of respiratory failure among patients with acute pesticide poisoning requiring mechanical ventilation. This study included patients who were admitted with intentional poisoning by pesticide ingestion from January 2017 to December 2019. Paraquat intoxication was excluded. Among 469 patients with acute pesticide poisoning, 398 patients were enrolled in this study. The respiratory failure rate was 30.4%. The rate of respiratory failure according to the type of pesticide was carbamate (75.0%), organophosphate (52.6%), glufosinate (52.1%), glyphosate (23%), pyrethroid (8.9%), and others (17%). The mortality was 25.6% in the respiratory failure group. The risk factors for respiratory failure were old age, low body mass index, and ingestion of more than 300 mL. In conclusion, respiratory failure is a risk factor for mortality in pesticide poisoning. Old age, low body mass index, and ingestion of more than 300 mL are the risk factors for predicting respiratory failure.

• Journal of Yeungnam Medical Science
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• 제41권2호
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• pp.96-102
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• 2024

Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

• Journal of Cerebrovascular and Endovascular Neurosurgery
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• 제25권3호
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• pp.297-305
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• 2023

Objective: The term "weekend effect" refers to an increase in the mortality rate for hospitalizations occurring on weekends versus weekdays. In this study, we investigated whether such an effect exists in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (currently the standard treatment for this condition) at a single center in Japan. Methods: We surveyed 151 patients who underwent mechanical thrombectomy for acute ischemic stroke with large vessel occlusion (75 and 76 patients were treated during daytime and nighttime, respectively) from January 2019 to June 2021. The items evaluated in this analysis were the rate of modified Rankin Scale ≤2 or prestroke scale, mortality, and procedural treatment time. Results: The rates of modified Rankin Scale ≤2 or prestroke scale and mortality at 90 days after treatment did not differ significantly between daytime and nighttime (41.3% vs. 29.0%, p=0.11; 14.7% vs. 11.8%, p=0.61, respectively). The door-to-groin time tended to be shorter during daytime versus nighttime (57 [IQR: 42.5-70] min vs. 70 [IQR: 55-82]) min, p=0.0507). Conclusions: This study did not reveal differences in treatment outcome between daytime and nighttime in patients undergoing mechanical thrombectomy for acute ischemic stroke with large vessel occlusion. Therefore, the "weekend effect" was not observed in our institution.

• 한국병원경영학회지
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• 제19권2호
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• pp.44-54
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• 2014

In spite of effective curative therapy, morbidity and mortality remain high for hospitalized patients with tuberculosis(TB) in Korea. The purpose of this study was to identify patient and hospital characteristics associated with hospital care outcome. Using annual patient survey data produced by Korea Institute for Health and Social Affair, we identified 8,562 hospital discharge with primary diagnosis of TB. Logistic regression analyses were performed on a model that included age, gender, residence area, insurance status, hospital admission source, length of stay, hospital ownership and class of hospital as the explanatory variables and outcome of treatments as the dependent variable. The results show that negative outcome was associated with the patients older than 65 years, medical aid beneficiary, admission through emergency department, and the patients admitted to public owned hospitals. On the other hand, the patients who were admitted to teaching hospitals were associated with positive outcome. To improve hospital treatment outcome of TB patients, more vigorous strategies should be implemented targeting the older and poor population in regard to social support as well as the clinical management and prevention.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.477-482
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• 2018

Intraoperative pulmonary thromboembolism is a high mortality situation. Early mortality in patients with pulmonary thromboembolism varies from 2% in normotensive patients to 30% in patients with cardiogenic shock. The use of extracorporeal cardiopulmonary resuscitation can improve survival and neurologic outcomes of cardiac arrest. We report a case of intraoperative massive pulmonary thromboembolism with circulatory collapse and cardiac arrest during anesthesia for pelvic bone fracture surgery, which were rescued by extracorporeal membrane oxygenation.

• Childhood Kidney Diseases
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• 제27권2호
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• pp.82-88
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• 2023

Chronic kidney disease (CKD) causes numerous changes that destabilize homeostasis, of which anemia is one of its important complications. Anemia significantly reduces the quality of life in children with CKD and plays a crucial role in the progression of cardiovascular disease such as left ventricular hypertrophy, a major cause of mortality in those with advanced CKD. The treatment of anemia is a pivotal factor in reducing morbidity and mortality rates in children with CKD, representing one of the methods for enhancing patients' quality of life.

• Journal of Trauma and Injury
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• 제34권1호
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• pp.3-12
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• 2021

Purpose: To evaluate the severity of trauma, many scoring systems and predictive models have been presented. The quick Sequential Organ Failure Assessment (qSOFA) is a simple scoring system based on vital signs, and we expect it to be easier to apply to trauma patients than other trauma assessment tools. Methods: This study was a cross-sectional study of trauma patients who visited the emergency department of Jeju National University Hospital. We excluded patients under the age of 18 years and unknown outcomes. We calculated the qSOFA, the Modified Early Warning Score (mEWS), Revised Trauma Score (RTS), and Injury Severity Score (ISS) based on patients' initial vital signs and assessments performed in the emergency department (ED). The primary outcome was mortality within 14 days of trauma. We analyzed qSOFA scores using multivariate logistic regression analysis and compared the predictive accuracy of these scoring systems using the area under the receiver operating characteristic curve (AUROC). Results: In total, 27,764 patients were analyzed. In the multivariate logistic regression analysis of the qSOFA, the adjusted odds ratios with 95% confidence interval (CI) for mortality relative to a qSOFA score of 0 were 27.82 (13.63-56.79) for a qSOFA score of 1, 373.31 (183.47-759.57) for a qSOFA score of 2, and 494.07 (143.75-1698.15) for a qSOFA score of 3. In the receiver operating characteristic (ROC) curve analysis for the qSOFA, mEWS, ISS, and RTS in predicting the outcomes, for mortality, the AUROC for the qSOFA (AUROC [95% CI]; 0.912 [0.871-0.952]) was significantly greater than those for the ISS (0.700 [0.608-0.793]) and RTS (0.160 [0.108-0.211]). Conclusions: The qSOFA was useful for predicting the prognosis of trauma patients evaluated in the ED.

• Journal of Chest Surgery
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• 제39권3호
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• pp.214-219
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• 2006

배경: 식도천공은 비교적 흔하지 않지만, 높은 이환율과 사망률을 나타낸다. 치료와 결과는 증상의 시간에 따라 크게 결정된다. 저자들은 식도천공 환자들을 최근의 치료방법으로 치료하여 결과를 후향적으로 조사하여 보았다 대상 및 방법: 1990년 3월부터 2005년 3월까지 식도 파열로 치료한 환자들을 후향적 분석하였다. 28명 환자들에서(남자 22명, 여자 6명: 평균나이 51세, 최소 17세에서 최고 82세)천공의 원인을 보면 이물질 9명, 외상 7명, 자연적 파열 7명, 의인성 5명이었다. 환자중 18명은 24시간 내 진단되었으며, 10명은 24시간 이후에 진단되었다. 21명($75\%$)에서 일차 봉합술을 시행하였으며, 4명에서는 식도 절제술, 3명의 환자에서는 위루술과 배농술를 시행하였다. 결과: 병원 사망률은 $18\%$이며, 그리고 의인성에서 사망률이 증가하였다(p <0.05). 천공위치, 천공 후 시간, 치료방법은 사망률에 영향을 미치지 못했다. 수술 후 누출은 4명의 환자에서 생겼으며, 보존적인 치료로 회복이 되었다. 결론: 식도 파열은 진단과 치료가 어렵기 때문에 아직도 위험한 질환이다. 대부분의 환자에서 증상의 발현시간에 관계없이 일차 재건술이 사망률을 낮출 수 있다. 정확한 진단과 조기 치료가 식도파열 환자들의 성공적인 치료에 필수적이다.