• The Korean Journal of Health Service Management
• /
• v.9 no.2
• /
• pp.81-88
• /
• 2015

The purpose of this study was to compare the risk-adjusted in-hospital mortality for craniotomies between logistic regression and multilevel analysis. By using patient sample data from the Health Insurance Review & Assessment Service, in-patients with a craniotomy were selected as the survey target. The sample data were collected from a total number of 2,335 patients from 90 hospitals. The sample data were analyzed with SAS 9.3. From the results of the existing logistic regression analysis and multilevel analysis, the values from the multilevel analysis represented a better model than that of logistic regression. The intra-class correlation (ICC) was 18.0%. It was found that risk-adjusted in-hospital mortality for craniotomies may vary in every hospital. The agreement by kappa coefficient between the two methods was good for the risk-adjusted in-hospital mortality for craniotomies, but the factors influencing the outcome for that were different.

• Korean Journal of Clinical Pharmacy
• /
• v.25 no.3
• /
• pp.131-137
• /
• 2015

Background: The protective effect of metformin against breast cancer is inconclusive. Objective: To evaluate the effect of metformin on breast cancer risk and mortality in patients with type 2 diabetes. Method: A comprehensive literature search was performed for pertinent articles published prior to June 30, 2014, using PubMed and EMBASE. Study heterogeneity was estimated with $I^2$ statistic. The data from the included studies were pooled and weighted by random-effects model. The quality of each included study was assessed on the basis of the 9-star Newcastle-Ottawa Scale and publication bias was evaluated by visual inspection of a funnel plot. Results: Ten studies were included in the meta-analysis of the association of metformin and breast cancer risk. By synthesizing the data from the studies, the pooled odds ratio (OR) was 0.72 (95% CI: 0.59, 0.87) (p = 0.0005). Three cohort studies were included for meta-analysis of the association between metformin and breast cancer-related mortality. Metformin was associated with a significant decrease in mortality (Risk ratio: 0.68; 95% CI: 0.51, 0.90, p = 0.007). Conclusion: The present meta-analysis suggests that metformin appears to be associated with a lower risk of breast cancer incidence and mortality in patients with type 2 diabetes.

• Journal of the Korean Data and Information Science Society
• /
• v.24 no.3
• /
• pp.571-584
• /
• 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.

• Journal of Chest Surgery
• /
• v.30 no.1
• /
• pp.17-26
• /
• 1997

Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.

• Environmental and Resource Economics Review
• /
• v.12 no.1
• /
• pp.49-74
• /
• 2003

This study used a slightly modified version of contingent valuation questionnaire designed and developed by Krupnick et al.(2000) to estimate the value of mortality risk reduction for environmental policy. Because that environmental policy, especially air pollution policy with some latency main effect on mortality risk reduction of old people with some latency period, respondents were asked about their current WTP for 5/1,000 mortality risk reduction being to take place beginning at 70 over the course of ten years. The annual mean WTP is 233,370 won (standard error 32,570 won) in spike/continuous/interval data model. The implied VSL is 466 million won. The 95% confidence interval is 339 million won~594 million won.

• Communications for Statistical Applications and Methods
• /
• v.28 no.2
• /
• pp.171-188
• /
• 2021

Due to an increased demand for longevity risk analysis, various stochastic models have been suggested to evaluate uncertainly in estimated life expectancy and the associated value of future annuity payments. Recently updated data allow us to analyze mortality for a longer historical period and extended age ranges. This study followed up previous case studies using up-to-date empirical data on Korean mortality and the recently developed R package StMoMo for stochastic mortality models analysis. The suitability of stochastic mortality models, focusing on retirement ages, was investigated with goodness-of-fit, validity of models, and ability of generating reasonable sets of simulation paths of future mortality. Comparisons were made across various types of models. Based on the selected models, the variability of important estimated measures associated with pension, annuity, and reverse mortgage were quantified using simulations.

• Tuberculosis and Respiratory Diseases
• /
• v.68 no.3
• /
• pp.140-145
• /
• 2010

Background: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. Methods: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. Results: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). Conclusion: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.

• Journal of Digital Convergence
• /
• v.18 no.9
• /
• pp.249-256
• /
• 2020

This study was to identify differences in mortality risk by living arrangements among older adults. We analyzed data from 3,827 older adults who took part in the 2014 Korean Longitudinal Study of Aging. Cox proportional hazards regression was used for data analysis. The significant factors associated with mortality risk in living with others were male, education level, self-rated health, limitation of instrumental activities of daily living, cognitive dysfunction, and depression. The significant factors associated with mortality risk in living alone were regular exercise, limitation of instrumental activities of daily living, and cognitive dysfunction. This study is significant in that it examined whether there are differences between mortality risk by living arrangements. According to the results of this study, nursing intervention should be developed to decrease mortality by living arrangements.

• Clinical Nutrition Research
• /
• v.13 no.2
• /
• pp.96-107
• /
• 2024

Malnutrition affect clinical outcomes in hospitalized old age patients, but the data on the related outcomes on the basis of different age categories are still limited. We aimed to investigate the interplay of associations among body mass index (BMI), falls risk, and mortality rate in different older adult patient age categories. This retrospective study included hospitalized patients aged ≥ 65 years who received artificial nutrition. Demographic, biochemical, and survival data were collected. BMI was evaluated using the World Health Organization BMI cutoffs for Asians, and patients were classified into high (≥ 23.0 kg/m²), normal (18.5-22.9 kg/m²), and low (< 18.5 kg/m²) BMI groups. The Morse Fall Scale was used to assess falls risk. By age categories, all patients (n = 4,642) were divided into the 65-74 (n = 2,649) and ≥ 75 (n = 1,993) years age groups. We found that the proportion of low-BMI and high risk of falls increased with age. Further, low-BMI was associated with increased falls risk in both age groups. Overall survival rate tended to be lower in the low-BMI and ≥ 75 years group than that in other patient groups, but did not differ significantly compared with the low-BMI and 65-74 years group. Low-BMI was associated with increased falls risk and mortality; however, the association depended on specific patient age groups.

• Journal of Korean Medical Science
• /
• v.33 no.48
• /
• pp.312.1-312.10
• /
• 2018

Background: Obesity is related to several comorbidities and mortality, but its relationship with acute kidney injury (AKI) and long-term mortality remain undetermined in patients undergoing coronary artery bypass grafting. Methods: Data from 3,018 patients (age ${\geq}18$ years) who underwent coronary artery bypass graft surgery from two tertiary referral centers were retrospectively reviewed between 2004 and 2015. Obesity was defined using the body mass index, according to the World Health Organization's recommendation. The odds and hazard ratios in post-surgical, AKI, and all-cause mortality were calculated after adjustment for multiple covariates. Patients were followed for $90{\pm}40.9$ months (maximum: 13 years). Results: Among the cohort, 37.4%, 2.4%, 21.1%, 35.1%, and 4.0% of patients were classified as normal weight, underweight, overweight-at-risk, obese I, and obese II, respectively. Post-surgical AKI developed in 799 patients (26.5%). Patients in the obese groups (overweight-at-risk to obese II) had a higher risk of AKI than did those in the normal-weight group. During the follow-up period, 787 patients (26.1%) died. Underweight patients had a higher risk of mortality than did normal-weight patients, whereas overweight-at-risk, obese I, and obese II patients showed better survival rates. Conclusion: After coronary artery bypass graft surgery, obese patients encountered a high risk of AKI, and underweight patients exhibited a low chance of survival. Awareness of both obese and underweight statuses should be raised in these patients.