• Title/Summary/Keyword: Infant Mortality Rate

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Predictive Factors for Severe Thrombocytopenia and Classification of Causes of Thrombocytopenia in Premature Infants

  • Shin, Hoon Bum;Yu, Na Li;Lee, Na Mi;Yi, Dae Yong;Yun, Sin Weon;Chae, Soo Ahn;Lim, In Seok
    • Neonatal Medicine
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    • v.25 no.1
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    • pp.16-22
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    • 2018
  • Purpose: This study investigated predictive factors for severe neonatal thrombocytopenia, which greatly increases the need for intensive care and is associated with a high mortality rate in premature infants. Factors adopted for prompt identification of at-risk newborns include blood test results and birth history. This study analyzed the relationship between the presence of severe neonatal thrombocytopenia and the mortality rate. The causes of thrombocytopenia in premature infants were also examined. Methods: This retrospective study evaluated 625 premature infants admitted to the neonatal intensive care unit (NICU) at Chung-Ang University Medical Center. The neonates were classified into 3 groups according to the severity of thrombocytopenia: mild ($100{\times}10^9/L{\leq}platelet<150{\times}10^9/L$), moderate ($50{\times}10^9/L{\leq}platelet<100{\times}10^9/L$), or severe (platelet<$50{\times}10^9/L$). Analysis of blood samples obtained at the onset of thrombocytopenia included platelet count, white blood cell (WBC) count, hemoglobin level, hematocrit level, absolute neutrophil count, and high-sensitivity C-reactive protein level. Results: Of the 625 premature infants admitted to our NICU, 214 were detected with thrombocytopenia. The mortality rate in thrombocytopenic neonates was 18.2% (39/214), whereas a mortality rate of only 1.0% was observed in non-thrombocytopenic neonates. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants. Severe thrombocytopenia was noted more frequently in premature infants with higher WBC counts and in those with a younger gestational age. Conclusion: Platelet count, WBC count, and gestational age are reliable predictors for severe neonatal thrombocytopenia. The major causes of thrombocytopenia were perinatal insufficiency and sepsis in premature infants.

Bochdalek's Hernia in Neonate -A Clinical Review of 14 Cases- (신생아 Bochdalek 탈장의 외과적 고찰)

  • 문승호
    • Journal of Chest Surgery
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    • v.28 no.5
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    • pp.481-486
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    • 1995
  • During the Dec.1990 to April.1994, 14 patients were diagnosed in the Department of Thoracic and Cardiovascular surgery, Medical college of Chonnam National University,as having congenital Bochdalek hernia. All of them diagnosed and operated before the age of 20 days, neonatal period. 3 of 14 were died after operation, so mortality rate was 21%, the deaths occurred in 1,1,13 days neonate. In this retrospective study we describe our experience and results with review of the literature.

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Death in the Neonatal Intensive Care Unit (신생아 중환자실의 사망에 관한 연구)

  • Koo, So-Eun;Kim, Hee-Young;Park, Kyoung-A;Lim, Gin-A;Park, Hye-Won;Lee, Byoung-Sop;Kim, Ellen Ai-Rhan;Kim, Ki-Soo;Pi, Soo-Young
    • Neonatal Medicine
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    • v.16 no.2
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    • pp.154-162
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    • 2009
  • Purpose: Death is an important problem for physicians and parents in neonatal intensive care unit. This study was intended to evaluate the mortality rate, causes of death, and the change of mortality rate by year for infants admitted to the neonatal intensive care unit. Methods: We retrospectively surveyed the medical records of the infants who were admitted to the neonatal intensive care unit at Asan Medical Center and who died before discharge between 1998 and 2007. Gestational age, birth weight, gender, time to death and the underlying diseases related to the causes of infant deaths and obtained from the medical records and analyzed according to year. Results: A total of 6,289 infants were admitted and 264 infants died during the study period. The overall mortality rate was 4.2%. For very low and extremely low birth weight infants, the mortality rate was 10.6% and 21.4%, respectively. There was no significant change in the mortality rate during the study period. Prematurity related complications and congenital anomalies were the conditions most frequently associated with death in the neonatal intensive care unit. of the infant deaths 37.1% occurred within the first week of life. Conclusion: Even though a remarkable improvement in neonatal intensive care has been achieved in recent years, the overall mortality rate has not changed. To reduce the mortality rate, it is important to control sepsis and prevent premature births. The first postnatal week is a critical period for deaths in the neonatal intensive care unit.

한국인 최초의 생명표에 관하여

  • 구자흥;유동선
    • Journal for History of Mathematics
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    • v.13 no.2
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    • pp.1-12
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    • 2000
  • The first life tables of the Korean, the so-called Chosun Joomin Saengmyong_Pyo were constructed by Misusima, the head professor, and his faculty members of Preventive Medicine Department, Division of Medical Science, Keijo Imperial University in 1937. The above mentioned life tables were based on the age specific mortality rates by the resident registration and the data of a couple of total population censuses conducted by the Governor of Chosun Government General in 1925 and 1930. And they revealed the following facts: (1) by the first Abridged Life Tables of Korean(Chosunin), the expected life span of Korean male and female were 32 and 35 from 1925 to 1930, respectively. (2) the infant mortality rate of Korean male and female were 252- and 230-person among 1000-born respectively. In conclusion, nobody knows the level of those Life Tables, but it is important in terms of that they are the origin of Korean life tables.

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Effects of Air Pollution on Public and Private Health Expenditures in Iran: A Time Series Study (1972-2014)

  • Raeissi, Pouran;Harati-Khalilabad, Touraj;Rezapour, Aziz;Hashemi, Seyed Yaser;Mousavi, Abdoreza;Khodabakhshzadeh, Saeed
    • Journal of Preventive Medicine and Public Health
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    • v.51 no.3
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    • pp.140-147
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    • 2018
  • Objectives: Environmental pollution is a negative consequence of the development process, and many countries are grappling with this phenomenon. As a developing country, Iran is not exempt from this rule, and Iran pays huge expenditures for the consequences of pollution. The aim of this study was to analyze the long- and short-run impact of air pollution, along with other health indicators, on private and public health expenditures. Methods: This study was an applied and developmental study. Autoregressive distributed lag estimating models were used for the period of 1972 to 2014. In order to determine the co-integration between health expenditures and the infant mortality rate, fertility rate, per capita income, and pollution, we used the Wald test in Microfit version 4.1. We then used Eviews version 8 to evaluate the stationarity of the variables and to estimate the long- and short-run relationships. Results: Long-run air pollution had a positive and significant effect on health expenditures, so that a 1.00% increase in the index of carbon dioxide led to an increase of 3.32% and 1.16% in public and private health expenditures, respectively. Air pollution also had a greater impact on health expenditures in the long term than in the short term. Conclusions: The findings of this study indicate that among the factors affecting health expenditures, environmental quality and contaminants played the most important role. Therefore, in order to reduce the financial burden of health expenditures in Iran, it is essential to reduce air pollution by enacting and implementing laws that protect the environment.

Current Status of Korean Premature Infant Care and its Prospective (한국 미숙아 관리의 현황과 전망)

  • Shin Yeong-Hee
    • Child Health Nursing Research
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    • v.9 no.1
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    • pp.96-106
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    • 2003
  • Advances in neonatal care system and research have resulted in an increased survival rate among low birth weight infants in the industrialized countries. Recent Korean neonatal mortality and morbidity statistics, and current status of Korean neonatal intensive care facilities were reviewed here for the sake of future improvement and research. Morbidity statistics revealed that perinatal diseases accounted for 80% of the death of premature infants implying the possibility of its reduction by the vigorous prenatal care service in future.On the basis of extensive studies of nutritional support and growth rate of premature infants, commercial formulas for premature infants have been developed and various aspects of feeding techniques are standardized. However, problem of growth deficit of premature infants remains unsolved as medical problem. NICU specialists are challenged with the tasks of prenatal education or provision of care that minimizes the neurodevelopmental problems seen in preterm infants, various short-term outcome researches have been reported and those are reviewed here to promote research interest in the field of neonatal nursing. Systemic long-term outcome studies are also awaited in Korea for the formulation of welfare policy in future. Nursing science has to embrace all these interdisciplinary studies as their own research field in collaboration with neonatologist, nutritionist, rehabilitation therapist, social workers and teachers.

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Morbidity and Mortality Trends in Preterm Infants of <32 Weeks Gestational Age with Severe Intraventricular Hemorrhage : A 14-Year Single-Center Retrospective Study

  • Eui Kyung Choi;Hyo-jeong Kim;Bo-Kyung Je;Byung Min Choi;Sang-Dae Kim
    • Journal of Korean Neurosurgical Society
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    • v.66 no.3
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    • pp.316-323
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    • 2023
  • Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

Development of the Model for Community-based Health Care Program for Premature Infants and Family (미숙아를 위한 지역중심 건강관리사업의 모델개발)

  • Ahn Young-Mee
    • Child Health Nursing Research
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    • v.8 no.2
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    • pp.129-140
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    • 2002
  • The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.

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A Study of Life Table of Korean People : Based on 1986 Data (한국인의 생명표 작성에 관한 연구)

  • 김연희
    • Korea journal of population studies
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    • v.12 no.2
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    • pp.45-55
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    • 1989
  • In recent years the life expectancy of the Korean people has been increasing appreciably because of the improvement in living conditions and public health facilities as well. However, there exist considerable constraints in the measurement of Korea's mortality rate. In elaboration, there are quite a few persons who do not submit birth and death reports, thereby lowering the reliability of statistical data. The 1978-1979 life table of the Korean people is still considered the latest one. Nevertheless, a decade has passed since its publication, and the need for a better life table reflecting realities is inc-reasingly growing. Capitalizing on the annual report of demographic statistics and demographic sample survey data m 1988, I have worked out the 1986 tentative life table of the Korean people and found out the following : 1. The male life expectancy in the 1978-1979 life table of the Korean people is 62.7 years old, and that of the female sex is 69.1 years old whereas the average life expectancy of the male sex in the 1986 life table stands at 66.3 years old, and that of the female sex is 74.5 years old. The average life expectancy is up by 3.5 years old for the male sex and also, up 5.4 years old for the female sex, res-pe ctively. 2. A gap between the male and female life expectancies in the 1978-1979 life table was 6.4 years old, while that of the 1986 life table was 8.2 years old. It means the female life expectancy has increased substantially. 3. The infant mortality rate has decreased, compared with the 1978-1979 level, yet it is still above those of Japan and Taiwan. 4. The mortality rate of the middle - aged men in the forties remains high, as was the case in the 1978-1979 period.

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Optimal Burn-in Time under Cumulative Pro-Rata Replacement Warranty

  • Yun, Won-Young;Lee, Yang-Woo;Chung, Il-Han;Luis Ferreira
    • International Journal of Reliability and Applications
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    • v.2 no.4
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    • pp.241-251
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    • 2001
  • In this paper, optimal bum-in time to minimize the total mean cost, which is the sum of manufacturing cost with burn-in and cumulative warranty-related cost, is obtained. When the products with cumulative pro-rata warranty have high failure rate in the early period (infant mortality period), a burn-in procedure is adopted to eliminate early product failures. After burn-in, the posterior product life distribution and the warranty-related cost are dependent on burn-in time; long burn-in period may reduce the warranty-related cost, but it increases the manufacturing cost. The paper provides a methodology to obtain total mean cost under burn-in and cumulative pro-rata warranty. Property of the optimal burn-in time is analyzed, and numerical examples and sensitivity analysis are studied.

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