• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.31-44
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• 1982

The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3％ of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.

• Journal of Korean Academy of Nursing
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• v.31 no.1
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• pp.126-138
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• 2001

The purpose of this study is to act nursing intervention strategies to promote quality of life (QOL) in Spinal Cord Injury patients. Therefore, the study is designed to evaluate religion, marital status, educational background economic status, level of injury, voiding pattern, transportation by driving, rehabilitation education, self-concept, sexual status, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL, perceived hopelessness, personality and pain for QOL at the same time. It was gathered empirical data was collected using a self report questionnaire from 61 patients during a six month period after SCI at 5 general hospitals, at 2 rehabilitation centers and at 2 rehabilitation schools province from Jun. 18, 1999 through Sep. 28, 1999. The reliability of the 19 instruments was tested with Cronbach's alpha which ranged from .6319 to .9769. For the data analysis a SAS program was used for Pearson correlation coefficients, and stepwise multiple regression. The results were as follows; 1. The mean of total item score in the QOL scale was 2.814, which showed a much lower score than the cancer points. 2. There was a significant correlation between self concept, transportation by driving, perceived barrier, powerlessness, depression, hope, social support, self-efficacy, anxiety, ADL and QOL.(${\gamma}$= .27~-.79, p< .05) 3. Stepwise multiple regression analysis showed that; a) Depression was the main predictor of QOL and account for 53.7% of the variance in QOL. b) Hope, ecomic status and body satisfaction accounted for 8%, 4%, 3.4% respectively and these variables combined accounted for 69.2% of the variance in QOL. In conclusion, to begin with, it is important to reduce depression and to help for SCI points to inspire hope, economic status and body satisfaction. That will be short cut for nursing strategies to enhance QOL.

• Journal of Trauma and Injury
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• v.33 no.2
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• pp.96-103
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• 2020

Purpose: In patients with trauma, rhabdomyolysis (RM) can lead to fatal complications resulting from muscle damage. Thus, RM must be immediately diagnosed and treated to prevent complications. Creatine kinase (CK) is the most sensitive marker for diagnosing RM. However, relying on CK tests may result in delayed treatment, as it takes approximately 1 hour to obtain CK blood test results. Hence, this study investigated whether the neutrophil-to-lymphocyte ratio (NLR) could predict RM at an earlier time point in patients with trauma, since NLR results can be obtained within 10 minutes. Methods: This retrospective study included 130 patients with severe trauma who were admitted to the emergency room of a tertiary institution between January 2017 and April 2020. RM was defined as a CK level ≥1,000 U/L at the time of arrival. Patients with severe trauma were categorized into non-RM and RM groups, and their characteristics and blood test results were analyzed. Statistical analysis was performed using SPSS version 26.0 for Windows. Results: Of the 130 patients with severe trauma, 50 presented with RM. In the multivariate analysis, the NLR (odds ratio [OR], 1.252; 95% confidence interval [CI], 1.130-1.386), pH level (OR, 0.006; 95% CI, 0.000-0.198), presence of acute kidney injury (OR, 3.009; 95% CI, 1.140-7.941), and extremity Abbreviated Injury Scale score (OR, 1.819; 95% CI, 1.111-2.980) significantly differed between the non-RM and RM groups. A receiver operating characteristic analysis revealed that a cut-off NLR value of 3.64 was the best for predicting RM. Conclusions: In patients with trauma, the NLR at the time of arrival at the hospital is a useful biochemical marker for predicting RM.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.127-134
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• 2005

Purpose: Currently, there is a variety of systems available for predicting prognosis of trauma patients such as trauma score, Injury severity score (ISS) and acid-base variables. But it is not clear that the initial acid-base variables are predictors of prognosis in trauma patients at the emergency department. The objective of this study is to compare the base deficit, lactate and strong ion gap as an early predictor of mortality in trauma patients. Methods: Retrospective record review of 136 trauma patients needed to admit to intensive care unit via emergency department (June 2004 to February 2005). Data included age, injury mechanism, ISS, Revised trauma score (RTS), Multiple organ dysfunction score (MODS), Acute physiology and chronic health evaluation III (APACHE III), Glasgow coma scale (GCS), laboratory profiles, calculated anion gap and strong ion gap. Patients were divided into survivors and non-survivors, shock group and non-shock group with comparison by t-test;significance was assumed for p<0.05. Correlation between acid-base variables and mean arterial blood pressure (MABP) was evaluated. Results: There was a significant difference between the RTS (p=0.00), APACHE III (p=0.00), MODS (p=0.00), GCS (p=0.00) of survivors and non-survivors. There was no significant difference between the ISS (p=0.082), lactate (p=0.541), base excess (p=0.468) and SIG (p=0.894) of survivors and non-survivors. There was a significant difference between the RTS (p=0.023), APACHE III (p=0.002), lactate (p=0.000), base excess (p=0.000) and SIG (p=0.000) of shock and non-shock group. There was no significant difference between the ISS (p=0.270), MODS (p=0.442) and GCS (p=0.432) of shock and non-shock group. The base excess was most correlated to MABP (r2=0.150). Conclusion: Initial base deficit, serum lactate and SIG are not predictors of mortality in moderate to severe trauma patients. Initial base deficit, serum lactate and SIG are correlated with the mean arterial blood pressure in trauma patients in emergency department.

• Journal of Trauma and Injury
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• v.35 no.4
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• International conference on construction engineering and project management
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• 2022.06a
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• pp.230-237
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• 2022

It is difficult to predict industrial accidents in the construction industry because many accident factors, such as human-related factors and environment-related factors, affect the accidents. Many studies have analyzed the severity of injuries and types of accidents; however, there were few studies on the prediction of injured body parts. This study aims to develop a classification model to predict the part of the injured body based on accident-related factors. Construction accident cases from June 2018 to July 2021 provided by the Korea Construction Safety Management Integrated Information were collected through web crawling and then preprocessed. A naïve Bayes classifier, one of the supervised learning algorithms, was employed to construct a classification model of the injured body part, which has four categories: 1) torso, 2) upper extremity, 3) head, and 4) lower extremity. The predictor variables are accident type, type of work, facility type, injury source, and activity type. As a result, the average accuracy for each injured body part was 50.4%. The accuracy of the upper extremity and lower extremity was relatively higher than the cases of the torso and head. Unlike the other classifications, such as spam mail filtering, a naïve Bayes classifier does not provide a good classification performance in construction accidents. The reasons are discussed in the study. Based on the results of this study, more detailed guidelines for construction safety management can be provided, which help establish safety measures at the construction site.

• Safety and Health at Work
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• v.11 no.3
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• pp.301-306
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• 2020

Background: The Functional Movement Screen (FMS^TM) is a screening tool used to assess an individual's ability to perform fundamental movements that are necessary to do physically active tasks. The purpose of this study was to assess the ability of FMS to predict occupational injury among Denver Fire Department firefighters. Method: FMS tests were administered from 2012 to 2016. Claim status was defined as any claim occurrence vs. no claim and an overexertion vs. no claim/other claim within 1 year of the FMS. To assess associations between FMS score and claim status, FMS scores were dichotomized into ≤ 14 and > 14. Age-adjusted odds ratios were calculated using logistic regression. Sensitivities and specificities of FMS predicting claims at various FMS score cut points, ranging from 10 to 20 were tested. Results: Of 581 firefighters (mean ± SD, age 38 ± 9.8 y) who completed FMS between February 2015 and March 2018, 188 (32.4%) filed a WC claim in the study time frame. Seventy-two of those (38.3%) were categorized as overexertion claims. There was no association between FMS score and claim status [odds ratio (OR) = 1.27, 95% confidence interval (CI): 0.88 - 1.83] and overexertion claim vs. no claim/other claim (OR = 1.33, 95% CI: 0.81 - 2.21). There was no optimal cutoff for FMS in predicting a WC claim. Conclusions: Although the FMS has been predictive of injuries in other populations, among this sample of firefighters, it was not predictive of a future WC claim.

• Journal of Trauma and Injury
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• v.31 no.3
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• pp.166-173
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• 2018

Purpose: Many traumatic patients die from sepsis and multiple organ failure. Early recognition of post-traumatic sepsis in traumatic patients will help improve the prognosis. Recently, procalcitonin (PCT), macrophage migration inhibitory factor (MIF), and lactic acid have emerged as predictive factors. Our study aims to explore the significance of PCT, MIF and lactic acid as a predictor of posttraumatic-sepsis in trauma patients. Methods: This study was conducted on prospective observational study patients who visited an emergency medical center in a university hospital from March 2014 to February 2016. We measured the white blood cells, c-reactive protein (CRP), lactic acid, PCT, and MIF with serum taken from the patient's blood within 1 hour of the occurrence of the trauma. The definition of post-traumatic sepsis was defined as being part of systemic inflammation response syndrome criteria with infections within a week. Results: A total of 132 patients were analyzed, wherein 74 patients were included in the low injury severity score (ISS) group (ISS <15) and 58 patients were included in the high ISS group (ISS ${\geq}15$). The mean PCT, MIF, and lactic acid levels were higher in the high ISS group (p<0.05). Meanwhile, 38 patients were included in the early sepsis group and 94 patients were included in the non-sepsis group. The mean MIF levels were higher in the sepsis group than the non-sepsis group (p<0.05) and there were no significant differences in the initial CRP, lactic acid, and PCT levels in these two groups. Conclusions: MIF may be considered as a predictive factor for sepsis in trauma patients.

• Journal of Trauma and Injury
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• v.18 no.2
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• pp.101-106
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• 2005

Purpose: The number of the deceased from free-fall is increasing nowadays. Free-fall comes to a great social problem in that even the survivor will be suffering for cord injury or brain injury, and so on. We analyzed the cases of free-fall patients to find out whether the injury severity is mainly correlated with the height of fall. Methods: We retrospectively investigated the characteristics of patients, who fall from the height above 2m from January 2000 to August 2004. We excluded the patients who transferred to other hospital, transferred from other hospital, and not known the height of fall. 145 patients were evaluated. Variables included in data analysis were age, height of fall, injury severity score (ISS), the being of barrier, and the survival or not. To find out the correlation between height of fall and death, we used receive operating characteristics (ROC) curve analysis. Results: The mean age of patients was $36.5{\pm}19.4$ years old. 110 were male and 35 were female. Mean height of fall was $11.1{\pm}8.5m$. 51 patients (35.2%) were died and 30 patients of them (58.9%) got emergency room on dead body. The mean height of fall is $8.9{\pm}5.8m$ for 94 survivors and $15.2{\pm}11.0m$ for the 51 deceased (p<0.001). The area under the ROC curve was 0.646, which means the height of fall was not adequate factor for predicting for death. At 13.5m, as cut?off value, sensitivity is 52.9%, specificity is 86.2%, positive predictive value is 67.5% and negative predictive value is 77.1%. There were statistical differences in mortality rate and ISS between 'below 13.5m group' and 'above 13.5m group', but there was not statistical difference in head and neck AIS. Conclusion: The height of fall is not adequate factor for prediction of death. So other factors like intoxication or not, the being of barrier or protection device need to be evaluated for predicting of free-fall patient's death.

• 순환기질환의공학회:학술대회논문집
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• 2002.11a
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• pp.3-18
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• 2002

Hemorheology plays an important role in atherosclerosis. Hemorheologic properties of blood include whole blood viscosity, plasma viscosity, hemaocrit, RBC deformability and aggregation, and fibrinogen concentration in plasma. Blood flow is determine by three parameters (pressure, lumen diameter, and whole blood viscosity), whole blood viscosity is one of the key physiological variables. However, the significance of whole blood viscosity has not yet not been fully appreciated. Whole blood viscosity has a unique property, non-Newtonian shear-thinning characteristics, which is primarily due to the presence of RBCs. Hence, RBC deformability and aggregation directly affect the magnitude of blood viscosity, and any factors or diseases affecting RBC characteristics influence blood viscosity. Therefore, on can see that whole blood viscosity is the causal mechanism by which traditional risk factors such as hypertension, hyperlipidemia, smoking, exercise, obesity, age, and gender are related to atherogenesis. In this regard, we included whole blood viscosity in the three key determinants of injurious pulsatile flow that results in mechanical injury and protective adaptation in the arterial system. Because whole blood viscosity is a potential predictor of cardiovascular diseases, it should be measured in routine cardiovascular profiles. Incorporating whole blood viscosity measurements into a standard clinical protocol could improve our ability to identify patients at risk for cardiovascular disease and its complications.