• 기본간호학회지
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• 제12권1호
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• pp.73-80
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• 2005

Purpose: This study examined the relationship between level of activity of daily living (ADL) and Self-Care Agency in patients who have had a spinal cord injury. Method: The participants in the study were 78 persons who had a spinal cord injury and were between 20 and 70 years of age. The data were collected from November 1, 2003 to January 30, 2004. The instruments used in this study were the ADL Check List and Self-Care Agency Scale. The data were analyzed using the SPSS program and included numbers, percentages, t-test and ANOVA, and Pearson correlation coefficients. Results: The total mean score for activity of daily living was $44.21{\pm}16.63$. The total mean score fur Self-Care Agency was $107.45{\pm}15.71$, There was a significant difference between scores for ADL and Self-Care Agency. Conclusion: In order to increase the level of ADL, rehabilitation nurses should ensure that these patients receive training in ADL. Also, it was identified that informational support is important, that is, nurses should help to provide these patients with Self-Care Agency training for ADL.

• International Journal of Advanced Culture Technology
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• 제7권1호
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• pp.8-13
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• 2019

Despite technical advances in healthcare, the rates of hospital-acquired pressure injury (HAPI) are still high although many are potentially preventable. The purpose of this study was to determine whether tree-based prediction modeling is suitable for assessing the risk of HAPI in ICU patients. Retrospective cohort study has been carried out. A decision tree model was constructed with Age, Weight, eTube, diabetes, Braden score, Isolation, and Number of comorbid conditions as decision nodes. We used RStudio for model training and testing. Correct prediction rate of the final prediction model was 92.4 and the Area Under the ROC curve (AUC) was 0.699, which means there is about 70% chance that the model is able to distinguish between HAPI and non-HAPI. The results of this study has limited generalizability as the data were from a single academic institution. Our research finding shows that the data-driven tree-based prediction modeling may potentially support ICU sensitive risk assessment for HAPI prevention.

• 한국농촌간호학회지
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• 제19권1호
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• pp.44-54
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• 2024

Purpose: This study identifies the factors influencing unplanned readmissions among participants of the medical aid community care pilot program. Methods: This descriptive study analyzed data from 1,013 participants in a medical aid community care pilot program. Data were analyzed using multiple logistic regression analysis. Results: The presence of mental illness, injury-related conditions, long-term care grades, and activities of daily living scores are key factors influencing the likelihood of readmission. In particular, the presence of a mental disorder or an injury-related condition increased the probability of readmission, whereas individuals with long-term care grades 1~2 showed a decreased likelihood of readmission. Conclusion: This study emphasizes the importance of enhancing the management of mental and injury-related conditions, effective utilization of long-term care services, and improvement of ADL scores to reduce readmission. These findings offer crucial insights for enhancing the efficiency of home medical care benefit programs and sustainable expansion of services.

• Journal of Trauma and Injury
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• 제21권1호
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• pp.28-35
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• 2008

Purpose: This study was conducted to examine the clinical significance IV-contrasted helical abdomen computed tomography (CT) as a diagnostic screening tool to evaluate hollow viscus injury in blunt abdominal trauma patients. Methods: This is a retrospective study encompassing 108 patients, presenting to Korea University Medical Center (KUMC) Emergency Department (ED) from January 2007 to December 2007, with an initial CT finding suggestive of intra-abdominal injury. An initial non-enhanced abdomen CT was taken, followed by an enhanced CT with intravenous contrast. Patients' demographic data, as well as the mechanisms of injury, were inquired upon and obtained, initial diagnosis, as dictated by specialized radiologists, were added to post-operational (post-OP) findings and to additional CT findings acquired during their hospital stays, and all were combined to arrive at final diagnosis. Initial CT findings were further compared with the final diagnosis, yielding values for sensitivity, specificity, and accuracy, as well as positive and negative predictive values. Patients were further divided into two groups, namely, those that underwent operational intervention and those that did not. The initial CT findings of each group were subsequently compared and analyzed. Results: Initial CT scans revealed abnormal findings in a total of 212 cases - solid organ injuries being the most common finding, as was observed in 97 cases. Free fluid accumulation was evident in another 69 cases. Based on the CT findings, 77 cases (71.3%) were initially diagnosed as having a solid organ injury, 20 cases (18.5%) as having a combined (solid organ + hollow viscus) injury, and 11 cases (10.2%), as having an isolated hollow viscus injury. The final diagnosis however, were somewhat different, with only 67 cases (62.0%) attributed to solid organ injury, 31 cases (28.7%) to combined injury (solid + hollow), and 10 cases (9.3%) to hollow viscus injury. The sensitivity (CI 95%) of the initial helical CT in diagnosing hollow viscus injury was 75.6%, and its specificity was 100%. The accuracy in diagnosing hollow viscus injury was also meaningfully lower compared to that in diagnosis of solid organ injury. Among patients initially diagnosed with solid organ injuries, 10 patients (2 from follow-up CT and 8 from post-OP finding) turned out to have combined injuries. A total of 38 patients underwent an operation, and the proportion of initial CT findings suggesting free air, mesenteric hematoma or bowel wall thickening turned out to be significantly higher in the operation group. Conclusion: Abdominal CT was a meaningful screening test for hollow viscus injury, but the sensitivity of abdominal CT was significantly lower in detecting hollow viscus injury as compared to solid organ injury. This calls for special consideration and careful observation by the ED physicians when dealing with cases of blunt abdominal trauma.

• Journal of Trauma and Injury
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• 제18권2호
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• pp.141-147
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• 2005

Purpose: Recently, The new Injury Severity Score (NISS) has become a more accurate predictor of mortality than the traditional Injury Severity Score (ISS) in the trauma population. Trauma Score Injury Severity Score (TRISS) method, regarded as the gold standard for mortality prediction in trauma patients, still contains the ISS as an essential factor within its formula. The purpose of this study was to determine whether a simple modification of the TRISS by replacing the ISS with the NISS would improve the prediction of in-hospital mortality in a trauma population with blunt head and neck trauma. Objects and Methods: The study population consisted of 641 patients from a regional emergency medical center in Kyoungsangnam-do. Demographic data, clinical information, the final diagnosis, and the outcome for each patient were collected in a retrospective manner. the ISS, NISS, TRISS, and modified TRISS were calculated for each patients. The discrimination and the calibration of the ISS, NISS, modified TRISS and conventional TRISS models were compared using receiver operator characteristic (ROC) curves, areas under the ROC curve (AUC) and Hosmer-Lemeshow statistics. Results: The AUC of the ISS, NISS, modified TRISS, and conventional TRISS were 0.885, 0.941, 0.971, and 0.918 respectively. Statistical differences were found between the ISS and the NISS (p=0.008) and between the modified TRISS and the conventional TRISS (p=0.009). Hosmer-Lemeshow chi square values were 13.2, 2.3, 50.1, and 13.8, respectively; only the conventional TRISS failed to achieve the level of and an excellent calibration model (p<0.001). Conclusion: The modified TRISS is a more accurate predictor of in-hospital mortality than the conventional TRISS in a trauma population of blunt head and neck trauma.

• Journal of Trauma and Injury
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• 제29권3호
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• pp.68-75
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• 2016

Purpose: The purpose of this study was to analyze the effectiveness of regional trauma center's management. Methods: Data collected between January 2013 and December 2015 from a regional trauma center registry was retrospectively reviewed. The patients who had injury severity score (ISS) greater than 15 and over the age of 18 were included. We compared annual general characteristics, the injury mechanism, the pathway of transportation, the injury severity score, the length of stay in emergency department (ED) and hospital, the in-hospital mortality. Results: The annual numbers of enrolled patients were 337, 334 and 278, respectively. No significant differences were found in the annual patient's median ages, injury mechanism, ISS and in-hospital mortality. The annual proportions of coming from other hospital and the median length of stay in hospital were increased after establishment of regional trauma center. The annual median lengths of stay in ED were decreased remarkably. Conclusion: Through the establishment of regional trauma center, the length of stay in ED can be reduced but not in-hospital mortality. More multidisciplinary cooperation and well-organized study is needed to reduce mortality of major trauma patients and maximize effect of regional trauma center.

• 한국학교ㆍ지역보건교육학회지
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• 제13권2호
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• pp.107-118
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• 2012

Backgrounds: In order to prevent dental injuries that often occur in child and adolescent, it is intended to investigate and assess actual state of the injury development, present epidemiological background, and consider and discuss for preparing preventive means against the injury development. Purpose: It was attempted to understand major features of dental injuries developing in child and adolescent and indentify high risk factors of dental injuries in child and adolescent. Methods: In this study, 523 cases of computerized data collected as disease entities of dental injuries among 1-18 years old patient visiting S university hospital located in Seoul in 2009 were analyzed and following results were obtained. Results: It was found that the ratio of dental injuries by genders in child and adolescent was 66.14% of male and 33.86% of female. It was shown also that causes of dental injuries by ages were more in order of falling, bumping, chewing, traffic accident, sports, violence, and crash. In addition places where dental injuries occur by ages were home in less than 5 year old group, park, playground, and play yard in 6-11 year old group, park, playground, and play yard also in 12-14 year old group, and stairs, road, and outdoor places such as mountain climbing, beach, and camping in 15-18 year old group. It was found that time rages when dental injuries in child and adolescent often develop were 15-19 o'clock for falling, 15-19 o'clock for crash, 15-19 o'clock for bumping, 19-03 o'clock for violence, 15-19 o'clock for traffic accident, 15-19 o'clock for sports activity, and 15-19 o'clock for chewing. Conclusion: Background of dental injury inducing factors are very complicated and diversified, so deep study and analysis are required for its prediction. Therefore, it seems necessary to identify risk factors by phases such as before, at, and after accident, establish strategies to reduce injury development, and develop and utilize necessary programs.

• Journal of Trauma and Injury
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• 제28권1호
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• pp.15-20
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• 2015

Purpose: Vascular injuries caused by traffic, industrial accidents and by outside activities have increased in Korea. Especially, vascular injuries to the extremities can lead to limb loss and even mortality if they are not appropriately treated. The aim of the study was to evaluate the surgical outcomes of femoropopliteal vascular management after trauma. Methods: The medical records of 12 patients with femoropopliteal vascular injuries who were treated at Dankook University Hospital from 2011 to 2013 were reviewed. Iatrogenic vascular injuries were excluded. The clinical data including the causes of injury, associated injuries and surgical outcomes were analyzed retrospectively. Results: All patients were male, with a mean age of $46.8{\pm}16.3years$ (range: 26~69 years). The causes of vascular injuries were four traffic accidents, three industrial accidents, two iron plates, one outside activity, one glass injury and one knife injury. The average transit time between the place of the accident place and the emergency department was $3.0{\pm}2.1$ (0.5~12.5) hours, and the average preparation time for surgery was $8.0{\pm}6.7$ (1.7~23.3) hours. The anatomic injuries included the popliteal vessel in seven cases and the femoral vessel in five cases. The average Injury Severity Score (ISS) was $12.0{\pm}5.0$ (5~17), and the average Mangled Extremity Severity Score (MESS) was $5.7{\pm}2.1$ (2~9). The operation methods were four interposition grafts, three end-to-end anastomoses, two direct repairs and three patch angioplasties. One case required amputation of the injured extremity. Conclusion: Early recognition and revascularization of the injured vessel are mandatory to reduce limb loss and to obtain satisfactory outcomes. Therefore, careful/rapid evaluation of the vascular injuries and timely/successful surgical treatment are the keys to salvaging an injured limb.

• 한국전문물리치료학회지
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• 제12권1호
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• pp.54-62
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• 2005

The purpose of this study was to find the effects of using aid in enhancing walking ability inpatients with spinal cord injury who have received rehabilitative care. The study population consisted of 24 spinal cord injury patients referred to the Department of Rehabilitation Medicine in the National Rehabilitation Center (NRC). All subjects were ambulatory with or without an assistive devices. All of the participants were assessed on SCIM II, WISCI II, FIM, MBI, gait speed (m/s), and walking endurance (120 min/m). The data were analyzed using a paired t-test, a one-way ANOVA, and a Duncan test. The results revealed that TSCIM II and all of the items of SCIM II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA A and C group patients (p<.05). The FIM, MBI, and WISCI II of the cervical ASIA D group patients were higher than those of the Thoracic ASIA C group patients (p>.05). The walking velocities of the lumbar ASIA C group patients were higher than those of Thoracic ASIA A group patients (p<.05). The walking endurance of the lumbar ASIA C group patients was higher than that of the thoracic ASIA C group patients (p<.05). The ASIA D group patients used bilateral standard canes or crutches, but none used AFO. The ASIA A and C group patients used bilateral standard walkers with KAFO for standing and walking. The findings suggest that injury level as well as the functionality of walking aids should be considered when formulating a rehabilitative plan for patients with spinal cord injury.

• BMB Reports
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• 제38권3호
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• pp.300-306
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• 2005

Tamoxifen citrate is an anti-estrogenic drug used for the treatment of breast cancer. It showed a degree of hepatic carcinogenesis, when it used for long term as it can decrease the hexose monophosphate shunt and thereby increasing the incidence of oxidative stress in liver rat cells leading to liver injury. In this study, a model of liver injury in female rats was done by intraperitoneal injection of tamoxifen in a dose of 45 mg/kg body weight for 7 successive days. This model produced a state of oxidative stress accompanied with liver injury as noticed by significant declines in the antioxidant enzymes (glutathione-S-transferase, glutathione peroxidase and catalase) and reduced glutathione concomitant with significant elevations in TBARS (thiobarbituric acid reactive substance) and liver transaminases; sGPT (serum glutamate pyruvate transaminase) and sGOT (serum glutamate oxaloacetate transaminase) levels. The oral administration of dimethyl dimethoxy biphenyl dicarboxylate (DDB) in a dose of 200 mg/kg body weight daily for 10 successive days, resulted in alleviation of the oxidative stress status of tamoxifen-intoxicated liver injury in rats as observed by significant increments in the antioxidant enzymes (glutathione-S-transferase, glutathione peroxidase and catalase) and reduced glutathione concomitant with significant decrements in TBARS and liver transaminases; sGPT and sGOT levels. The administration of DDB before tamoxifen intoxication (as protection) is more little effective than its curative effect against tamoxifen-induced liver injury. The data obtained from this study speculated that DDB can mediate its biochemical effects through the enhancement of the antioxidant enzyme activities and reduced glutathione level as well as decreasing lipid peroxides.