• Title/Summary/Keyword: Morbidity, mortality

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Comparison of diagnostic methods on failure of passive immunoglobulin transfer to Korean-indigenous calves (한우 송아지의 초유 섭취 수준 측정 진단법 비교)

  • Lee, Byoung-Seok;Kang, Mun-Il;Chung, Yong-Un;Lee, Chai-Yong;Han, Dong-Un;Wee, Sung-Hwan;Yoon, So-Rah;Cho, Jae-Jin;Kang, Ju-Won
    • Korean Journal of Veterinary Service
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    • v.31 no.4
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    • pp.505-519
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    • 2008
  • For screening the appropriate field diagnostic techniques to failure of passive immunoglobulin transfer(FPT) in Korean-indigenous calves, 258 sera was examined by spectinophotometry for total protein(TP) and globulin(Glo), sodium sulfate precipitation test(SSPT), zinc sulfate turbidity test(ZSTT), and single radial immunodiffusion test(sRID). All calves aged within 6-week old. Morbidity and mortality to various diseases, mainly including enteric and respiratory disorders, were 18.9%(49) and 4.2%(11), respectively. FPT was 27,9%(72/258) when the cutoff point of TP was $4.5g/d{\ell}$ and among them the morbidity and mortality were 27.9% and 6.9%, respectively. FPT was 29.1%(75/258) when the cutoff point of Glo was $2.0g/d{\ell}$ and among them the morbidity and mortality were 29.0% and 6.9%, respectively. FPT was 13.1%(34/258) when the cutoff point of SSPT was 1+ and among them the morbidity and mortality were 67.6% and 23.5%, respectively. FPT was 19.7%(51/258) when the cutoff point of IgG with sRID was $1,000mg/d{\ell}$ and among them the morbidity and mortality were 41.1% and 11.7%, respectively. In addition, mean concentration of IgG with sRID tested was $2,150mg/d{\ell}$ at 3-day old but $1,100mg/d{\ell}$ at 9-days with $1,100mg/d{\ell}$. The results of the study were suggested that SSPT for FPT was the relatively reliable and convinient method for evaluating the immune status of calves(P<0.05).

Benefits of Surgical Treatment for Unruptured Intracranial Aneurysms in Elderly Patients

  • Jang, E-Wook;Jung, Jin-Young;Hong, Chang-Ki;Joo, Jin-Yang
    • Journal of Korean Neurosurgical Society
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    • v.49 no.1
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    • pp.20-25
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    • 2011
  • Objective: Due to longer life spans, patients newly diagnosed with unruptured intracranial aneurysms (UIAs) are increasing in number. This study aimed to evaluate how management of UIAs in patients age 65 years and older affects the clinical outcomes and post-procedural morbidity rates in these patients. Methods: We retrospectively reviewed 109 patients harboring 136 aneurysms across 12 years, between 1997 and 2009, at our institute. We obtained the following data from all patients: age, sex, location and size of the aneurysm(s), presence of symptoms, risk factors for stroke, treatment modality, and postoperative 1-year morbidity and mortality. We classified these patients into three groups: Group A (surgical clipping), Group B (coil embolization), and Group C (observation only). Results: Among the 109 patients, 56 (51.4%) underwent clipping treatment, 25 (23%) patients were treated with coiling, and 28 observation only. The overall morbidity and mortality rates were 2.46% and 0%, respectively. The morbidity rate was 1.78% for Clipping and 4% for coiling. Factors such as hypertension, diabetes mellitus, hypercholesterolemia, smoking, and family history of stroke were correlated with unfavorable outcomes. Two in the observation group refused follow-up and died of intracranial ruptured aneurysms. The observation group had a 7% mortality rate. Conclusion: Our results show acceptable favorable outcome of treatment-related morbidity comparing with the natural history of unruptured cerebral aneurysm. Surgical clipping did not lead to inferior outcomes in our study, although coil embolization is generally more popular for treating elderly patients, In the treatment of patients more than 65 years old, age is not the limiting factor.

Predictors of Intensive Care Unit Morbidity and Midterm Follow-up after Primary Repair of Tetralogy of Fallot

  • Egbe, Alexander C.;Nguyen, Khanh;Mittnacht, Alexander J.C.;Joashi, Umesh
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.211-219
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    • 2014
  • Background: Our objectives were to review our institutional early and midterm experience with primary tetralogy of Fallot (TOF) repair, and identify predictors of intensive care unit (ICU) morbidity. Methods: We analyzed perioperative and midterm follow-up data for all cases of primary TOF repair from 2001 to 2012. The primary endpoint was early mortality and morbidity, and the secondary endpoint was survival and functional status at follow-up. Results: Ninety-seven patients underwent primary repair. The median age was 4.9 months (range, 1 to 9 months), and the median weight was 5.3 kg (range, 3.1 to 9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median length of ICU stay was 6 days (range, 2 to 21 days), and the median duration of mechanical ventilation was 19 hours (range, 0 to 136 hours). By multiple regression analysis, age and weight were independent predictors of the length of ICU stay, while the surgical era was an independent predictor of the duration of mechanical ventilation. At the 8-year follow-up, freedom from death and re-intervention was 97% and 90%, respectively. Conclusion: Primary TOF repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery remain significant predictors of morbidity.

Surgical Treatment of Boerhaave Syndrome Using Mesentery (장간막을 이용한 Boerhaave 증후군의 치료)

  • 김형준
    • Journal of Chest Surgery
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    • v.23 no.5
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    • pp.1040-1046
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    • 1990
  • Despite the improved diagnostic and treatment modalities recently introduced for a variety of esophageal disorders, a perforation or leak from the esophagus remains a sources of morbidity and mortality regardless of the cause of leak. After the perforation of esophagus, the contamination of mediastinum and pleural cavity with food, bacteria and corrosive gastric juice leads to sepsis and cardiopulmonary dysfunction. The early diagnosis and early treatment are very important, and the delayed treatment leads to high risk of morbidity and mortality. We experienced one case of esophageal perforation, after forced vomiting in 48 years old male patient. We used omentum on the treatment of ruptured esophagus, and it was successfully managed.

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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.

A Retrospective Study on the Comparison of Outbreaks of Food Poisoning for Food Hygiene in Korea and Japan

  • Lee, Won-Chang;Chung, Choog-Il
    • Journal of Food Hygiene and Safety
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    • v.11 no.4
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    • pp.277-285
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    • 1996
  • Retrospective study on the comparison of outbreaks of food poisoning for food hygiene in Korea and Japan. The average value of morbidity rate by year in Korea during the period of 1971 to 1992 was 2.9 per 100,000 population, and that of Japan was 29.1. The mean value of mortality rates in case of food poisoning by year in Korea was 2.33%, and that of Japan was 0.07%. When compared the rates of morbidity and mortality between Korea and Japan during the same period, the morbidity rates of Japan were much higher than those of Korea (p<0.01). However, mortality rate of patients in Korea were much higher then those of Japan(p<0.01). Resulting from comparative observation of food poisoning by preparing facilities between Korea and Japan. The highest list the places where the outbreaks occurred was home-made foods accounted for 48.8% of the total cases in Korea and that of Japan was restaurants accounted for 33.0%. Causative foods in Korea, the most common incrimination vehicles were seafood, meat and animal products and grain and vegetables, including mushroom. However, in the case of the common incrimination vehicles Japan were unknown and other foods, seafood, vegetables and meat and animal products etc.. Food poisoning of pathogenic substance in Korea were 60.9% of bacterial food poisoning of the total cases showing that Vibrio species, Salmonella spp., Staphylococcus spp., pathogenic E. coli, Clostridium spp. and other spp. were 33.3%, 26.2%, 16.3%, 5.3%, 0.4% and 18.5%, respectively. On the other hand, in Japan, major causes were Vibrio spp. (45.7%), Staphylococcus spp. (23.7%), Salmonella spp. (16.8%), pathogenic E. coli (3.8%), Clostridium spp. (0.2%) and other spp. (9.6%).

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Risk Factors for Complications Following Resection of Gastric Cancer

  • Kim, Min-Soo;Park, Joong-Min;Choi, Yoo-Shin;Cha, Sung-Jae;Kim, Beom-Gyu;Chi, Kyong-Choun
    • Journal of Gastric Cancer
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    • v.10 no.3
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    • pp.118-125
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    • 2010
  • Purpose: Operative morbidity and mortality from gastric cancer have decreased in recent years, but many studies have demonstrated that its prevalence is still high. Therefore, we investigated the risk factors for morbidity and mortality considering the type of complication in patients with gastric cancer. Materials and Methods: A total of 259 gastrectomies between 2004 and 2008 were retrospectively reviewed. Results: Overall morbidity and mortality rates were 26.6% and 1.9%, respectively. A major risk factor for morbidity was combined resection (especially more than two organs) (P=0.005). The risk factors for major complications in which a re-operation or intervention were required were type of gastrectomy, upper location of lesion, combined resection, and respiratory comorbidity (P=0.042, P=0.002, P=0.031). Mortality was associated with preexisting neurologic disease such as cerebral stroke (P=0.016). In the analysis of differen complication's risk factors, a wound complication was not associated with any risk factor, but combined resection was associated with bleeding (P=0.007). Combined resection was an independent risk factor for a major complication, surgical complication, and anastomotic leakage (P=0.01, P=0.003, P=0.011, respectively). Palliative resection was an independent risk factor for major complications and a previous surgery for malignant disease was significantly related to anastomosis site leakage (P=0.033, P=0.007, respectively). Conclusions: The risk factors for gastrectomy complications of gastric cancer were combined resection, palliative resection, and a previous surgery for a malignant disease. To decrease post-gastrectomy complications, we should make an effort to minimize the range of combined resection, if a palliative gastrectomy is needed for advanced gastric cancer.

Clinical Outcomes and Risk Factors of Traumatic Pancreatic Injuries (외상성 췌장 손상의 임상 결과 및 예후인자)

  • Lee, Hong-Tae;Kim, Jae-Il;Choi, Pyong-Wha;Park, Je-Hoon;Heo, Tae-Gil;Lee, Myung-Soo;Kim, Chul-Nam;Chang, Surk-Hyo
    • Journal of Trauma and Injury
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    • v.24 no.1
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    • pp.1-6
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    • 2011
  • Purpose: Even though traumatic pancreatic injuries occur in only 0.2% to 4% of all abdominal injuries, the morbidity and the mortality rates associated with pancreatic injuries remain high. The aim of this study was to evaluate the clinical outcomes of traumatic pancreatic injuries and to identify predictors of mortality and morbidity. Methods: We retrospectively reviewed the medical records of 26 consecutive patients with a pancreatic injury who underwent a laparotomy from January 2000 to December 2010. The data collected included demographic data, the mechanism of injury, the initial vital signs, the grade of pancreatic injury, the injury severity score (ISS), the revised trauma score (RTS), the Glasgow Coma Scale (GCS), the number of abbreviated injury scales (AIS), the number of associated injuries, the initial laboratory findings, the amount of blood transfusion, the type of operation, the mortality, the morbidity, and others. Results: The overall mortality rate in our series was 23.0%, and the morbidity rate was 76.9%. Twenty patients (76.9%) had associated injuries to either intra-abdominal organs or extra-abdominal organs. Two patients (7.7%) underwent external drainage, and 18 patients (69.3%) underwent a distal pancreatectomy. Pancreaticoduodenectomies were performed in 6 patients (23.0%). Three patients underwent a re-laparotomy due to anastomosis leakage or postoperative bleeding, and all patients died. The univariate analysis revealed 11 factors (amount of transfusion, AAST grade, re-laparotomy, associated duodenal injury, base excess, APACHE 11 score, type of operation, operation time, RTS, associated colon injury, GCS) to be significantly associated with mortality (p<0.05). Conclusion: Whenever a surgeon manages a patient with traumatic pancreatic injury, the surgeon needs to consider the predictive risk factors. And, if possible, the patient should undergo a proper and meticulous, less invasive surgical procedure.

Five-year follow-up after pancreatoduodenectomy performed for malignancy: A single-centre study

  • Thomas Brendon Russell;Peter Lawrence Zaki Labib;Somaiah Aroori
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.27 no.1
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    • pp.76-86
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    • 2023
  • Backgrounds/Aims: The aim of this study was to describe short- and long-term outcomes of patients who underwent pancreatoduodenectomy (PD) at a typical United Kingdom hepatopancreatobiliary unit. Methods: A retrospective analysis of all PD patients with histologically-confirmed pancreatic ductal adenocarcinoma (PDAC), ampullary adenocarcinoma (AA), or distal cholangiocarcinoma (CC) from September 1st, 2006 to May 31st, 2015 was carried out. The following information was obtained: demographics, comorbidities, preoperative investigations, neoadjuvant treatment, operative details, postoperative management, complications, adjuvant treatment, five-year recurrence, and five-year survival. Effects of selected preoperative variables on short- and long-term outcomes were investigated. Results: Of 271 included patients, 57.9% had PDAC, 25.8% had AA, and 16.2% had CC. In total, 67.9% experienced morbidity and 17.3% developed a Clavien-Dindo grade ≥ III complication. The 90-day mortality was 3.3%. Clinically-relevant postoperative pancreatic fistula, bile leak, gastrojejunal leak, postpancreatectomy haemorrhage and delayed gastric emptying affected 8.1%, 4.1%, 0.0%, 9.2%, and 19.9% of patients, respectively. American Society of Anesthesiologists grade III-VI correlated with overall morbidity (p = 0.002) and major morbidity (p = 0.009), but not 90-day mortality or five-year survival. The same pattern was observed in patients with a preoperative serum bilirubin > 29 µmol/L and/or a neutrophil/lymphocyte ratio > 3.1. Five-year cancer recurrence and five-year survival were 68.3% and 22.5%, respectively. PDAC patients had higher five-year recurrence but lower five-year survival rates (both p = 0.001). Conclusions: In our series, the majority of patients experienced a complication. However, few patients experienced major morbidity. Surgical risk factors did not affect five-year survival.

Management of Preterm Labor (조기 진통의 처치)

  • Park, Yoon-Ki
    • Journal of Yeungnam Medical Science
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    • v.16 no.2
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    • pp.141-154
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    • 1999
  • Premature birth is the single largest cause of perinatal mortality and morbidity nonanomalous infants in developing countries. Advances in neonatal care have lead to increase survival and reduced short and long term morbidity for preterm infants, but the rate of preter birth has actually increased. This review provides recent multifactorial approaches to treatme and prevention of preterm birth.

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