• Title/Summary/Keyword: MORTALITY

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Impact of Early Enteral Nutrition on In-Hospital Mortality in Patients with Hypertensive Intracerebral Hemorrhage

  • Lee, Jeong-Shik;Jwa, Cheol-Su;Yi, Hyeong-Joong;Chun, Hyoung-Joon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.99-104
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    • 2010
  • Objective : We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). Methods : We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. Results : The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. Conclusion : These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

Human Health Risk Assessment Due to Air Pollution in the Megacity Mumbai in India

  • Maji, Kamal Jyoti;Dikshit, Anil Kumar;Chaudhary, Ramjee
    • Asian Journal of Atmospheric Environment
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    • v.11 no.2
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    • pp.61-70
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    • 2017
  • This study evaluated the human health risk in terms of the excess number of mortality and morbidity in the megacity Mumbai, India due to air pollution. AirQ software was used to enumerate the various health impacts of critical pollutants in Mumbai in past 22 years during 1992-2013. A relationship concept based on concentration-response relative risk and population attributable-risk proportion was employed by adopting World Health Organization (WHO) guideline for concentrations of air pollutants like $PM_{10}$, $SO_2$ and $NO_2$. For the year 1992 in Mumbai, it was observed that excess number of cases of total mortality, cardiovascular mortality, respiratory mortality, hospital admission due to COPD, respiratory disease and cardiovascular disease were 8420, 4914, 889, 149, 10568 and 4081 respectively. However, after 22 years these figures increased to 15872, 9962, 1628, 580, 20527 and 7905 respectively, but all of these reached maximum in the year 2006. From the result, it is also noted that except COPD morbidity the excess number of cases from 1992-2002 to 2003-2013 increased almost by 30%; and the excess number of mortality and morbidity is basically due to particulate matter ($PM_{10}$) than due to gaseous pollutants.

The Assessment of Severity Adjustment Measures for AMI Patients in Korea (급성심근경색증 환자를 대상으로 한 중증도 보정 방법의 평가)

  • Park, Hyeung-Keun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.164-175
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    • 2003
  • Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

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A Report on the Mass Mortality of the Farmed Japanese Scallop, Patinopecten yessoensis on the Korean Coasts of the East Sea

  • Jo, Q-Tae;Kim, Su-Kyoung;Lee, Chu;Rahman, Mohammad M.;Lee, Chae-Sung;Oh, Bong-Se
    • The Korean Journal of Malacology
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    • v.25 no.2
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    • pp.93-96
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    • 2009
  • Unexpected mass mortality has been one of the drawbacks in front of the stable production of Japanese scallop (Patinopecten yessoensis) on the Gangwon coasts of the East Sea. The preliminary data from our routine observation revealed that the mortality appeared to be related to variation of water temperature in the farming site and the degree of the mortality was dependent on scallop strain. The present study performed to verify the preliminary findings exhibited that the mortality was closely related to daily temperature variation rather than monthly variation. Daily temperature variation was particularly damageable to the scallop during the temperature elevation period. Scallops from hatchery seeds (Chinese strain) were more tolerant against the temperature variation over those from wild seeds. The hatchery scallop gain of the temperature tolerance was probably due to their larval experience to higher temperature in the hatchery as well as their maternal genetic acclimation to upper temperature extreme of the Chinese environment which was recently found.

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Geriatric Syndrome and Mortality among Community-dwelling Older Adults in Korea: 3-year Follow-up Study (한국 노인의 노인증후군과 사망: 3년 추적연구)

  • Lee, Si Eun;Hong, Gwi-Ryung Son
    • Korean Journal of Adult Nursing
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    • v.29 no.1
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    • pp.98-107
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    • 2017
  • Purpose: The purpose of this study was to investigate the effect of geriatric syndrome on mortality among community-dwelling older adults in Korea. Methods: Data were obtained from the Actual Living Condition of the Elderly and Welfare Need Survey, with a baseline study in 2008 and a 3-year follow-up of mortality data. The mortality risk was measured using the hierarchical Cox proportional hazard model. Results: In Cox regression analysis, male (Hazard Ratio [HR], 2.53; 95% Confidence Interval [CI], 2.12~3.01), old age (HR, 2.14; 95% CI, 1.82~2.53), low education level (HR, 1.31; 95% CI, 1.04~1.65), limitation in instrumental activities of daily living (HR, 1.91; 95% CI, 1.60~2.28), depressive symptoms (HR, 1.21; 95% CI, 1.01~1.43), and frailty (HR, 2.32; 95% CI, 1.78~3.03) significantly affected mortality risk. Conclusion: Based on the results of this study, nursing intervention programs should be provided to decrease preventable death in older adults.

Moderating Effect of Structural Complexity on the Relationship between Surgery Volume and in Hospital Mortality of Cancer Patients (일부 암 종의 수술량과 병원 내 사망률의 관계에서 구조적 복잡성의 조절효과)

  • Youn, Kyungil
    • Health Policy and Management
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    • v.24 no.4
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    • pp.380-388
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    • 2014
  • Background: The volume of surgery has been examined as a major source of variation in outcome after surgery. This study investigated the direct effect of surgery volume to in hospitals mortality and the moderating effect of structural complexity-the level of diversity and sophistication of technology a hospital applied in patient care-to the volume outcome relationship. Methods: Discharge summary data of 11,827 cancer patients who underwent surgery and were discharged during a month period in 2010 and 2011 were analyzed. The analytic model included the independent variables such as surgery volume of a hospital, structural complexity measured by the number of diagnosis a hospital examined, and their interaction term. This study used a hierarchical logistic regression model to test for an association between hospital complexity and mortality rates and to test for the moderating effect in the volume outcome relationship. Results: As structural complexity increased the probability of in-hospital mortality after cancer surgery reduced. The interaction term between surgery volume and structural complexity was also statistically significant. The interaction effect was the strongest among the patients group who had surgery in low volume hospitals. Conclusion: The structural complexity and volume of surgery should be considered simultaneously in studying volume outcome relationship and in developing policies that aim to reduce mortality after cancer surgery.

Designing a life actuarial model with reflection of mortality differential by marital status (혼인상태별 사망률의 차이를 반영한 생명보험수리 모형의 설계)

  • Kwon, Hyuk Sung;Kim, Jung Eun
    • Journal of the Korean Data and Information Science Society
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    • v.24 no.3
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    • pp.571-584
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    • 2013
  • Various risk factors other than age and sex affecting human mortality have been identified and quantitatively analyzed by previous studies in many area of research. Marital status is one of key mortality risk factors which affect life expectancy directly or indirectly. Relevant results have implication on risk management for both of social and private insurance. In this paper, a mortality model to reflect mortality differential according to marital status and possible transitions among marital status is designed. Various actuarial calculations were performed and related issues were discussed.

Melanoma Incidence Mortality Rates and Clinico-Pathological Types in the Siberian Area of the Russian Federation

  • Gyrylova, Svetlana Nikolaevna;Aksenenko, Mariya Borisovna;Gavrilyuk, Dmitriy Vladimirovich;Palkina, Nadezda Vladimirovna;Dyhno, Yuriy Alexandrovich;Ruksha, Tatiana Gennadievna;Artyukhov, Ivan Pavlovich
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2201-2204
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    • 2014
  • Russian rates for melanoma incidence and mortality are relatively low as compared to some other white populations but the tumor is of increasing importance. In this paper, data are based on a retrospective descriptive analysis of melanoma epidemiology and clinicopathological characteristics in Krasnoyarsk Territory belonging to the Siberian Federal District of the Russian Federation. The age-adjusted incidence and mortality rates for the period 1996-2009 were determined with subsequent retrospective analysis of clinicopathological data of 103 primary melanoma cases. Our results showed that incidence and mortality rates in the region under consideration match the Russian national trends and correspond to epidemiological data of the countries of Eastern Europe. Stratification of melanoma cases by age, sex, clinicopathological state and localization revealed a prevalence of lesions on the trunk and lower extremities. Most melanomas diagnosed were of superficial spreading type and the third Clark's level of tumor invasion and stage II according to AJCC. In spite of comparatively low rates of incidence and mortality the trend to increase of melanoma cases in the region under consideration obviously calls for more attention and further investigation.

The Spot Sign Predicts Hematoma Expansion, Outcome, and Mortality in Patients with Primary Intracerebral Hemorrhage

  • Han, Ju-Hee;Lee, Jong-Myong;Koh, Eun-Jeong;Choi, Ha-Young
    • Journal of Korean Neurosurgical Society
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    • v.56 no.4
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    • pp.303-309
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    • 2014
  • Objective : The purpose of this study was to retrospectively review cases of intracerebral hemorrhage (ICH) medically treated at our institution to determine if the CT angiography (CTA) 'spot sign' predicts in-hospital mortality and clinical outcome at 3 months in patients with spontaneous ICH. Methods : We conducted a retrospective review of all consecutive patients who were admitted to the department of neurosurgery. Clinical data of patients with ICH were collected by 2 neurosurgeons blinded to the radiological data and at the 90-day follow-up. Results : Multivariate logistic regression analysis identified predictors of poor outcome; we found that hematoma location, spot sign, and intraventricular hemorrhage were independent predictors of poor outcome. In-hospital mortality was 57.4% (35 of 61) in the CTA spot-sign positive group versus 7.9% (10 of 126) in the CTA spot-sign negative group. In multivariate logistic analysis, we found that presence of spot sign and presence of volume expansion were independent predictors for the in-hospital mortality of ICH. Conclusion : The spot sign is a strong independent predictor of hematoma expansion, mortality, and poor clinical outcome in primary ICH. In this study, we emphasized the importance of hematoma expansion as a therapeutic target in both clinical practice and research.

Mortality of Fishes and Shellfishes to Harmful Algal Blooms

  • Lee Sam Geun;Kim Hak Gyoon;Cho Eun Seob;Lee Chang Kyu
    • Fisheries and Aquatic Sciences
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    • v.6 no.3
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    • pp.160-163
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    • 2003
  • Mortality of several species of fish and shellfish exposed to Harmful Algal Blooms (HABs) caused by Cochlodinium polykrikoides, Heterosigam akashiwo, Alexandrium tamarense, Eutreptiella gymnastica, Heterocapsa triquetra and Prorocentrum micans was studied. When fish were exposed to a cell density of 8,000 cells $mL^{-1}$ in C. polykrikoides, $35\%$ of flatfish and darkbanded rockfish died within 48 hrs. However, jacopever rockfish had mortality of higher than $85\%$. Rock bream, filefish and red sea bream showed $100\%$ mortality within 10 hrs with an exposure cell density of 8,000 cells $mL^{-1}$. The rest of HABs except for C. polykrikoides showed that there was no fish and shellfish death throughout the 48 hrs even in the maximum cell density of 100,000 cells $mL^{-1}$ These results imply that C. polykrikoides can have a serious impact on fish mortality and it is regarded as an ichthyotoxic dinoflagellate. The fish death may be attributed to anoxia caused by a combination of the production of reactive oxygen species (ROS) and polysaccharide from C. polykrikoides during blooms.