• 디지털융복합연구
• /
• 제11권10호
• /
• pp.619-627
• /
• 2013

본 연구는 응급의료기관을 내원 한 행려환자들의 내원, 진료, 발생특성에 따라 체류시간을 살펴본 후 영향을 미치는 관련요인을 파악하여 향후 의료서비스 개선방안을 위한 기초자료를 제공하고자 하는데 그 의의가 있다. 조사대상은 2012년 1월 1일부터 동년 12월 31일까지 1년 동안 충남소재의 응급의료기관을 내원한 행려환자 691명으로 하였으며, 분석방법은 빈도분석, ANOVA, 상관관계분석 후 독립변수를 더 미화하여 다중회귀분석을 실시하였다. 결론을 보면 첫째, 의료기관은 행려환자에 대한 부정적인 인식에서 벗어날 필요가 있으며, 질 좋은 의료서비스 제공 및 응급진료지원체계를 갖추고 있어야 한다. 둘째, 행려환자의 대부분이 남자이고, 40,50대가 절반이상을 차지하고 있어, 이들이 사회적으로 아직까지는 생산성이 높은 연령층이라고 할 수 있으며, 향후 의료적지원 뿐만 아니라 사회복귀프로그램이 포함된 정부 정책의 관리구축 방안이 필요하다.

• Tuberculosis and Respiratory Diseases
• /
• 제65권2호
• /
• pp.99-104
• /
• 2008

연구배경: ARDS는 다양한 원인으로 초래되는 급성 염증성 폐 질환으로서 인공호흡기 치료 등의 여러 의학적 발전에도 불구하고 사망률이 40~60%로 예후가 좋지 않다. 이러한 환자들의 예후를 예측하는 방법으로 APACHE, SPAPS, MAM 등 방법이 있지만 간편하지가 않아서, ARDS가 염증성 폐질환이란 점에 착안하여서 염증 지표로 흔히 사용하는 ESR, CRP의 ARDS 환자에서 예후 인자로서의 역할을 평가해 보고자 하였다. 방 법: 87명의 ARDS 환자들의 중환자실 입원 당시의 ESR, CRP 결과와 APACHE II score 그리고 추적 검사한 결과를 확인하였다. 또한 대상 환자를 생존한 군과 사망한 군으로 나누어서 생존한 환자군에서 총 입원기간, 중환자실 입원기간, 인공 호흡기 치료 기간과 ESR, CRP, APACHE II score들과의 상관관계 및 ESR, CRP의 변화추이와 사망률과의 상관 관계에 대해서 연구하였다. 결 과: 중환자실 입원 당시의 ESR, CRP로는 ARDS 환자의 사망률을 예측하기가 어렸다. 하지만 CRP는 ARDS로 중환자실 치료 후 생존했던 환자군에서 사망했던 환자군에 비해서 치료 초기에 유의하게 감소하였으며, 중환자실 입원 당시 ESR이 높을수록 ARDS 환자들의 총 입원 기간 및 중환자실 입원기간이 길었다. 결 론: CRP의 초기 변화 및 중환자실 입원 당시의 ESR은 ARDS 환자의 예후를 예측하는데 도움이 될 수 있다.

• 한국병원경영학회지
• /
• 제5권1호
• /
• pp.84-104
• /
• 2000

This paper analyzes the technical efficiency of thirty two hospitals in Korea using DEA(Data Envelopment Analysis). DEA provides an efficiency measure for each hospital compared to the most efficient one. The amount and sources of inefficiency that are identified by the DEA are useful for benchmarking to improve efficiency. The results from multiple regression analysis and Wilcoxon Rank Sum test show that bed turnover, hospital size, and average length of stay are related to hospital efficiency.

• Journal of Chest Surgery
• /
• 제27권9호
• /
• pp.808-811
• /
• 1994

We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

• Journal of Trauma and Injury
• /
• 제22권1호
• /
• pp.12-17
• /
• 2009

Purpose: In this study, the prognostic significance of the Injury Severity Score (ISS) and the height of fall in free-fall patients were investigated. Methods: The medical records of 179 victims of falls from a height who were brought alive to the Emergency Department of Gyeongsang National University Hospital between January 2003 and December 2007 were analyzed. The age, the sex of the patients, the rate of admission, the hospital stay, the site of injury, the severity of injury, the rate of surgery, the site of the fall and the presence of alcohol intoxication were evaluated by using a retrospective review of the medical records. Injury severity was measured by using the ISS. Patients were categorized into four subgroups according to the height from where they had fallen. The data were statistically analyzed with using SPSS ver. 10.0. Results: The admission rates for the subgroups with falls of less than 3 stories were significantly lower than those for the subgroups with higher heights of falls (70.7% vs. 100%, p<0.05). These two subgroups showed statistically significant differences in mean hospital stay ($17.11{\pm}24.88$ vs. $56.73{\pm}49.21$, p<0.05), rate of operation (30.6% vs. 53.8%, p<0.05), and mean ISS ($6.86{\pm}4.97$ vs. $13.96{\pm}9.14$, p<0.05). In the correlation analysis, the ISS and the mean hospital stay showed the highest correlation with correlation coefficient of 0.666. Conclusion: In this retrospective analysis of 179 free-fall patients, we evaluated the prognostic factors affecting the outcomes for the free-fall patients. The patients who had fallen from heights of 3 stories or higher showed statistically significant higher rates of admission, longer durations of hospital stay, higher ISSs, and higher operation rates. The most accurate factor in predicting the length of hospital stay was the ISS.

• 품질경영학회지
• /
• 제20권1호
• /
• pp.1-10
• /
• 1992

When we compare different control charting schemes, the average run length of each control chart is usually used. The use of the average run length implies that there is unbounded number of samples or observations. The regression recursive residuals, however, have been applied to the cumulative sum chart to detect whether the mean or variance changes. To implement choice of decision interval, we calculate the probability that certain fixed number of control statistics stay in the in-control state. This probability can be used as the significance level of a test for detecting the change in the residual mean or variance of the data with a finite number of observations.

• 한국전산구조공학회:학술대회논문집
• /
• 한국전산구조공학회 2006년도 정기 학술대회 논문집
• /
• pp.993-1000
• /
• 2006

Practical stability design method of main members of cable-stayed bridges is proposed and discussed through a design example. For this purpose, initial tensions of stay cables and axial forces of main members are firstly determined using initial shaping analysis of bridges under dead loads. And then the effective buckling length using system elastic/inelastic buckling analysis and bending moments considering $P-{\delta}-{\Delta}$ effect by second-order elastic analysis are calculated for main girder and pylon members subjected to both axial forces and moments, respectively. Particularly, load combinations of dead and live loads, in which maximum load effects due to live loads are obtained, are taken into account and effects of live loads on effective buckling lengths are investigated.

• 대한임상독성학회지
• /
• 제17권1호
• /
• pp.14-20
• /
• 2019

Purpose: This study estimated the incidence of delirium and associated risk factors and outcomes in ICU patients with acute poisoning. Methods: Data were collected from ICU patients over 18 years of age that were admitted via the emergency center after presenting with poisoning from 2010 to 2015. Delirium was assessed retrospectively using the Intensive Care Delirium Screening Checklist (ICDSC). Risk factors were evaluated by univariate and multivariate analysis. Results: A total of 199 patients participated in this study and 68 (34.2%) were diagnosed with delirium based on the ICDSC score. The delirium group showed a significantly higher association with prolonged length of stay in the hospital and ICU in comparison with the non-delirium group. The delirium group was associated with greater use of physical restraint. A statistically greater number of patients with pharmaceutical substance poisoning developed delirium over a short period of time than those with non-pharmaceutical substance poisoning. There was no significant difference between the two groups with respect to age, sex, past history, GCS score, vital signs, application of ventilator care and renal replacement therapy. Conclusion: The finding that the delirium group had a greater length of stay in both the hospital and the ICU is consistent with the results of previous worldwide studies of the effects of delirium on the prognosis of patients who were admitted to the ICU, suggesting the possibility for domestic application. Additionally, use of physical restraint was positively related to the incidence of delirium. Thus, interventions for minimizing the use of physical restraints and considering alternatives are needed.

• Journal of Gastric Cancer
• /
• 제15권3호
• /
• pp.151-158
• /
• 2015

Purpose: Obesity is associated with morbidity following gastric cancer surgery, but whether obesity influences morbidity after laparoscopic gastrectomy (LG) remains controversial. The present study evaluated whether body mass index (BMI) and visceral fat area (VFA) predict postoperative complications. Materials and Methods: A total of 217 consecutive patients who had undergone LG for gastric cancer between May 2003 and December 2005 were included in the present study. We divided the patients into two groups ('before learning curve' and 'after learning curve') based on the learning curve effect of the surgeon. Each of these groups was sub-classified according to BMI (<$25kg/m^2$ and ${\geq}25kg/m^2$) and VFA (<$100cm^2$ and ${\geq}100cm^2$). Surgical outcomes, including operative time, quantity of blood loss, and postoperative complications, were compared between BMI and VFA subgroups. Results: The mean operative time, length of hospital stay, and complication rate were significantly higher in the before learning curve group than in the after learning curve group. In the subgroup analysis, complication rate and length of hospital stay did not differ according to BMI or VFA; however, for the before learning curve group, mean operative time and blood loss were significantly higher in the high VFA subgroup than in the low VFA subgroup (P=0.047 and P=0.028, respectively). Conclusions: VFA may be a better predictive marker than BMI for selecting candidates for LG, which may help to get a better surgical outcome for inexperienced surgeons.

• Advances in pediatric surgery
• /
• 제12권2호
• /
• pp.213-220
• /
• 2006

Laparoscopic cholecystectomy has been increasingly used because of several advantages, less pain, better expectation for cosmesis (requires small incisions), and more rapid recovery compared with open cholecystectomy. Oral intake is tolerated on the day of operation or on the next. In this study, we evaluated the effectiveness and safety of laparoscopic cholecystectomy in children. Nine cases of laparoscopic cholecystectomy for acute and chronic cholecystitis in children were performed at Asan Medical Center between April 2002 and April 2004. Laparoscopic cholecystectomy was performed on a total of 10 patients, but one of them was excluded because of the simultaneous splenectomy for sickle cell anemia. Clinical presentation, operative findings, operation time, length of hospital stay, and postoperative complications were analyzed. Mean age was 10.4 (4.15) years, and only 3 of patients were less than 10 years. One patient was female. In 8 the diagnosis was calculous cholecystitis. Mild adhesions were found in 3 cases and intraoperative bile leakage in 2. There was no conversion to open surgery and there were no vascular, bowel, or bile duct injuries. Mean operation time was 82.2 (20.160) minutes; mean length of hospital stay was 2.1 (1.3) day. There was no postoperative complication. Laparoscopic cholecystectomy in children was remarkably free of side effects and complications and had a short recovery time. Laparoscopic cholecystectomy for cholecystitis is considered to be a standard procedure in children.