• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.1959-1964
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• 2015

Purpose: To investigate the distribution of liver cancer mortality as well as its developing trend from 1991 to 2012, forecast the future five-year trend, and provide a basis for the comprehensive prevention and management. Materials and Methods: Mortality data for liver cancer in China from 1991 to 2012 were used to describe characteristics and distribution of liver cancer mortality. Trend surface analysis was used to study the geographical distribution of liver cancer mortality. Curve estimation, time series modeling, gray modeling (GM) and joinpoint regression were used to predict and forecast future trends. Results: The mortality rate of liver cancer has constantly increased in China since 1991. Rates in rural areas are higher than in urban areas, and in males are higher than in females. In addition, our data predicted that the trend will continue to increase in the next 5 years. The age-specific mortality of liver cancer increases with age and peaks in the group of 80-84 years old. Geographical analysis showed the liver mortality rate was higher in the southeast provinces, such as Jiangsu, Zhejiang and Guangdong, and southwest regions like Guangxi Province. Conclusions: The standardized mortality rate of liver cancer in China has consistently increased from 1991 to 2012, and the upward trend is predicted to continue in the future. Much better prevention and management of liver cancer is needed in high mortality areas (the southwestern and southeastern parts of China) and high mortality age groups (80- to 84-year-olds), especially in rural areas.

• Asian Pacific Journal of Cancer Prevention
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• 제16권17호
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• pp.7991-7995
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• 2015

Background: To identify the epidemiological characteristics of colorectal cancer mortality in China during the period of 1991-2011, and forecast the future five-year trend. Materials and Methods: Mortality data for colorectal cancer in China from 1991 to 2011 was used to describe epidemiological characteristics in terms of age group, gender, and rural/urban residence. Trend surface analysis was performed to analyze the geographical distribution of colorectal cancer. Four models including curve estimation, time series modeling, gray modeling and joinpoint regression were applied to forecast the trends for the future five years. Results: Since 1991 the colorectal cancer mortality rate increased yearly, and our results showed that the trend would continue to increase in the ensuing 5 years. The mortality rate in males was higher than that of females and the rate in urban areas was higher than in rural areas. The mortality rate was relatively low for individuals less than 60 years of age, but increased dramatically afterwards. People living in the northeastern China provinces or in eastern China had a higher mortality rate for colorectal cancer than those living in middle or western China provinces. Conclusions: The steadily increasing mortality of colorectal cancer in China will become a substantial public health burden in the foreseeable future. For this increasing trend to be controlled, further efforts should concentrate on educating the general public to increase prevention and early detection by screening. More effective prevention and management strategies are needed in higher mortality areas (Eastern parts of China) and high-risk populations (60+ years old).

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1998년도 제50차 추계 학술대회 연제집
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• pp.311-312
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• 1998

• 한국병원경영학회지
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• 제14권1호
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• pp.23-35
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• 2009

The objectives of the present study is to examine the validity of Charlson Comorbidity Index(CCI) based on medical record data; to utilize the index to determine outcome indexes such as mortality, length of stay and cost for the domestic patients whose have received total hip arthroplasty. Based on medical record date, 1-year Mortality was analyzed to be 0.664 of C statistic. The $R^2$ for the predictability for length of stay and the cost was about 0.0181, 0.1842. Fee of national health insurance and total cost including the cost not covered by insurance, also had statistically significance above 3 points of Charlson point score(p=0.0290, 0.0472; $p.{\le}0.05$). The 1-year mortality index, length of stay and cost of the total hip arthroplasty patients which was obtained utilizing CCI have a limitative prediction power and therefore should be carefully analyzed for use.

• 대한간호학회지
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• 제41권1호
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• pp.92-100
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• 2011

Purpose: Mortality Provability Model (MPM) II is a model for predicting mortality probability of patients admitted to ICU. This study was done to test the validity of MPM II for critically ill neurological patients and to determine applicability of MPM II in predicting mortality of neurological ICU patients. Methods: Data were collected from medical records of 187 neurological patients over 18 yr of age who were admitted to the ICU of C University Hospital during the period from January 2008 to May 2009. Collected data were analyzed through $X^2$ test, t-test, Mann-Whiteny test, goodness of fit test, and ROC curve. Results: As to mortality according to patients' general and clinically related characteristics, mortality was statistically significantly different for ICU stay, hospital stay, APACHE III score, APACHE predicted death rate, GCS, endotracheal intubation, and central venous catheter. Results of Hosmer-Lemeshow goodness-of-fit test were MPM $II_0$ ($X^2$=0.02, p=.989), MPM $II_24$ ($X^2$=0.99 p=.805), MPM $II_48$ ($X^2$=0.91, p=.822), and MPM $II_72$ ($X^2$=1.57, p=.457), and results of the discrimination test using the ROC curve were MPM $II_0$, .726 (p<.001), MPM $II_24$, .764 (p<.001), MPM $II_48$, .762 (p<.001), and MPM $II_72$, .809 (p<.001). Conclusion: MPM II was found to be a valid mortality prediction model for neurological ICU patients.

• Korean Circulation Journal
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• 제48권12호
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• pp.1148-1156
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• 2018

Background and Objectives: It is controversial that decreased left ventricular function could predict poststroke outcomes. The purpose of this study is to elucidate whether left ventricular ejection fraction (LVEF) can predict cardiovascular events and mortality in acute ischemic stroke (AIS) without atrial fibrillation (AF) and coronary heart disease (CHD). Methods: Transthoracic echocardiography was conducted consecutively in patients with AIS or transient ischemic attack at Soonchunhyang University Hospital between January 2008 and July 2016. The clinical data and echocardiographic LVEF of 1,465 patients were reviewed after excluding AF and CHD. Poststroke disability, major adverse cardiac events (MACE; nonfatal stroke, nonfatal myocardial infarction, and cardiovascular death) and all-cause mortality during 1 year after index stroke were prospectively captured. Cox proportional hazards regressions analysis were applied adjusting traditional risk factors and potential determinants. Results: The mean follow-up time was $259.9{\pm}148.8days$ with a total of 29 non-fatal strokes, 3 myocardial infarctions, 33 cardiovascular deaths, and 53 all-cause mortality. The cumulative incidence of MACE and all-cause mortality were significantly higher in the lowest LVEF (<55) group compared with the others (p=0.022 and 0.009). In prediction models, LVEF (per 10%) had hazards ratios of 0.54 (95% confidence interval [CI], 0.36-0.80, p=0.002) for MACE and 0.61 (95% CI, 0.39-0.97, p=0.037) for all-cause mortality. Conclusions: LVEF could be an independent predictor of cardiovascular events and mortality after AIS in the absence of AF and CHD.

• 한국대기환경학회지
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• 제22권5호
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• pp.554-563
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• 2006

Numerous epidemiological studies have shown stronger associations between $PM_{2.5}$ and both mortality and morbidity than $PM_{10}$. The association of $PM_{2.5}$ with respiratory mortality was examined in Seoul, during the period of $1996{\sim}2002$. Because $PM_{2.5}$ data were available for only 10% of this time period, a prediction regression model was developed to estimate $PM_{2.5}$ concentration. Death count due to respiratory-related diseases(total respiratory mortality; ICD-10, J00-J98) and death counts(cause-specific mortality) due to pneumonia(ICD-10, J12-J18), COPD(ICD-10, J40-J44) and asthma(ICD-10, J45-J46) were considered in this study. Averaged daily mortality was 5.6 for total respiratory mortality and 1.1 to 1.6 for cause-specific mortality. Generalized additive Poisson models controlling for confounders were used to evaluate the acute effects of particle exposures on total respiratory mortality and cause-specific mortality. An IQR increase in 5-day moving average of $PM_{2.5}(22.6{\mu}g/m^3)$ was associated with an 8.2%(95% CI: 4.5 to 12.1%) increase in total respiratory mortality The association of $PM_{2.5}$ was stronger for the elderly ($\geq$65 years old, 10.1%, 95% CI: 5.8 to 14.5%) and for males(8.9%, 95% CI: 2.1 to 11.3%). A $10{\mu}g/m^3$ increase in 5-day moving average of $PM_{2.5}$ was strongly associated with total respiratory mortality in winter(9.5%, 95% CI: 6.6 to 12.4%), followed by spring(3.1%, 95% CI: -1.2 to 7.5%), which was a different pattern with the finding in North American cities. However, our results are generally consistent with those observed in recent epidemiological studies, and suggest that $PM_{2.5}$ has a stronger effect on respiratory mortality in Seoul.

• 한국의료질향상학회지
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• 제10권2호
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• pp.216-231
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• 2003

Objectives: To develop a model that predicts a death probability of acute myocardial infarction(AMI) patient, and to evaluate a performance of hospital services using the developed model. Methods: Medical records of 861 AMI patients in 7 general hospitals during 1996 and 1997 were reviewed by two trained nurses. Variables studied were risk factors which were measured in terms of severity measures. A risk model was developed by using the logistic regression, and its performance was evaluated using cross-validation and bootstrap techniques. The statistical prediction capability of the model was assessed by using c-statistic, $R^2$ as well as Hosmer-Lemeshow statistic. The model performance was also evaluated using severity-adjusted mortalities of hospitals. Results: Variables included in the model building are age, sex, ejection fraction, systolic BP, congestive heart failure at admission, cardiac arrest, EKG ischemia, arrhythmia, left anterior descending artery occlusion, verbal response within 48 hours after admission, acute neurological change within 48 hours after admission, and 3 interaction terms. The c statistics and $R^2$ were 0.887 and 0.2676. The Hosmer-Lemeshow statistic was 6.3355 (p-value=0.6067). Among 7 hospitals evaluated by the model, two hospitals showed significantly higher mortality rates, while other two hospitals had significantly lower mortality rates, than the average mortality rate of all hospitals. The remaining hospitals did not show any significant difference. Conclusion: The comparison of the qualities of hospital service using risk-adjusted mortality rates indicated significant difference among them. We therefore conclude that risk-adjusted mortality rate of AMI patients can be used as an indicator for evaluating hospital performance in Korea.

• 대한상부위장관⦁헬리코박터학회지
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• 제18권4호
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• pp.225-230
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• 2018

Upper gastrointestinal (GI) bleeding (UGIB) is the most common GI emergency, and it is associated with significant morbidity and mortality. Early identification of low-risk patients suitable for outpatient management has the potential to reduce unnecessary costs, and prompt triage of high-risk patients could allow appropriate intervention and minimize morbidity and mortality. Several risk-scoring systems have been developed to predict the outcomes of UGIB. As each scoring system measures different primary outcome variables, appropriate risk scores must be implemented in clinical practice. The Glasgow-Blatchford score (GBS) should be used to predict the need for interventions such as blood transfusion or endoscopic or surgical treatment. Patients with GBS ${\leq}1$ have a low likelihood of adverse outcomes and can be considered for early discharge. The Rockall score was externally validated and is widely used for prediction of mortality. The recently developed AIMS65 score is easy to calculate and was proposed to predict in-hospital mortality. The Forrest classification is based on endoscopic findings and can be used to stratify patients into high- and low-risk categories in terms of rebleeding and thus is useful in predicting the need for endoscopic hemostasis. Early risk stratification is critical in the management of UGIB and may improve patient outcome and reduce unnecessary health care costs through standardization of care.

• 한국산학기술학회논문지
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• 제19권11호
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• pp.126-136
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• 2018

본 연구는 머신러닝을 활용하여 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발을 목적으로 시행하였다. 전국 단위의 퇴원손상심층조사 2006~2015년 자료 중 한국표준질병사인분류(Korean standard classification of disease-KCD 7)에 따라 뇌졸중 코드 I60-I63에 해당하는 대상자를 추출하여 분석하였다. 동반질환 중증도 보정 도구로는 Charlson comorbidity index(CCI), Elixhauser comorbidity index(ECI), Clinical classification software(CCS)의 3가지 도구를 사용하였고 중증도 보정 모형 예측 개발은 로지스틱회귀분석, 의사결정나무, 신경망, 서포트 벡터 머신 기법을 활용하여 비교해 보았다. 뇌졸중 환자의 동반질환으로는 ECI에서는 합병증을 동반하지 않은 고혈압(hypertension, uncomplicated)이 43.8%로, CCS에서는 본태성고혈압(essential hypertension)이 43.9%로 다른 질환에 비해 가장 월등하게 높은 것으로 나타났다. 동반질환 중중도 보정 도구를 비교해 본 결과 CCI, ECI, CCS 중 CCS가 가장 높은 AUC값으로 분석되어 가장 우수한 중증도 보정 도구인 것으로 확인되었다. 또한 CCS, 주진단, 성, 연령, 입원경로, 수술유무 변수를 포함한 중증도 보정 모형 개발 AUC값은 로지스틱 회귀분석의 경우 0.808, 의사결정나무 0.785, 신경망 0.809, 서포트 벡터 머신 0.830로 분석되어 가장 우수한 예측력을 보인 것은 서포트 벡터머신 기법인 것으로 최종 확인되었고 이러한 결과는 추후 보건의료정책 수립에 활용될 수 있을 것이다.