• Title/Summary/Keyword: Operation Outcome

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Clinical Characteristics of Small Bowel Perforation due to Blunt Abdominal Trauma (복부 둔상으로 인한 소장 천공의 임상 양상에 대한 고찰)

  • Bae, Jung-Min
    • Journal of Trauma and Injury
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    • v.24 no.2
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    • pp.125-128
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    • 2011
  • Purpose: Blunt small bowel injury (SBI) is frequently combined other organ injury. So, clinical outcome and characteristics of SBI are influenced by other combined injuries. Thus, we analyzed isolated SBI patients and studied clinical outcome and characteristics. Methods: Between 2005 and 2010, 36 consecutive patients undergoing laparotomy due to isolated SBI were identified in a retrospectively collected. Database. Clinical outcome and characteristics were analyzed. Results: Laparotomy was performed in 36 patients. Primary repair was performed 17 patients. Segmental resection of small bowel was performed 19 patients. Median time gap from trauma to operation was 9 hours. In 24 hours from trauma, operation was performed 31 patients. Post operative death was 5 patients. Mean hospital stay was 18 days and median hospital stay was 12 days. There were significant differences between operation type and minor complication and hospital stay. And there were significant differences between time gap in 24 hours and minor complication. But, there were no significant between time gap and mortality. Conclusion: Although this study had many limitations, some valuable information was produced. When operation above 24 hours was delayed in SBI, minor complications were significantly increased. Segmental resection of small bowel in SBI were significantly increased minor complications and hospital stay. So, preventive measures for surgical site infection was important to reduce wound complication and hospital stay. Further continuous study and multi-center study were should be performed to improve clinical outcome in SBI.

The Effect of the Patient's Characteristics on Nursing Outcomes in Gastrointestinal Surgery Patients (간호결과에 대한 환자 특성의 영향 - 위장관계 수술 환자를 중심으로 -)

  • Lee, Byoung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.3
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    • pp.249-259
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    • 2008
  • Purpose: This study was performed to identify the patient characteristics significantly affecting nursing outcomes and their predictability in gastrointestinal surgery patients. Method: The subjects were 149 abdominal surgery patients from 3 general surgical nursing units of 3 general hospitals. Two instruments were used to measure nursing outcomes and acuity of the subjects. The nursing outcomes were measured at post-operation 4 and 7days using review of patients' records, observation of patients, and interviews with patients by a trained nurse. For data analysis, T-test or ANOVA, Pearson Correlation and Stepwise Multiple Regression were done. Result: Age, severity score, diagnosis, cancer or not, operation site were the subjects' characteristics that were significantly related to the nursing outcomes in both post-operation 4 and 7days. Cancer or not, age, diagnosis and severity score were the significant predictors for the scores of nursing outcome in post-operation 4days and the predictability was 34.9%. The predictability of cancer or not was highest, 22.6%. Age, diagnosis and cancer or not were the significant predictors for the scores of nursing outcome in post-operation 7days and the predictability was 27.8%. The predictability of age was highest, 17.3%. Conclusions: The patient characteristics affecting nursing outcomes should be considered when nursing care is planned and provided. Especially, careful attention should be given to the patients with cancer and older age. And, these patient characteristics should be adjusted for correct estimation of the effectiveness of nursing interventions on nursing outcomes.

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Clinical Analysis of Postoperative Outcome in Elderly Patients with Lumbar Spinal Stenosis

  • Hur, Jin-Woo;Kim, Seung-Hyun;Lee, Jong-Won;Lee, Hyun-Koo
    • Journal of Korean Neurosurgical Society
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    • v.41 no.3
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    • pp.157-160
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    • 2007
  • Objective : The purpose of this study was to evaluate the efficacy and safety of the surgical treatment for lumbar spinal stenosis in elderly patients. Methods : The authors reviewed the medical records of 49 patients older than 65 years of age with lumbar spinal stenosis who underwent surgical treatment from January 2002 to December 2004 in our institute. Results : Average age of patients was 70 years old [32 women, 17 men]. Twenty-four patients had chronic medical disorders. All patients were operated under the general anesthesia of these, 29 patients underwent decompressive laminectomy and decompressive laminectomy with instrumentation and fusion in 20 patients. The mean operation time was 193.5 minutes, mean estimated blood loss was 378cc and mean postoperative hospital stay length was 15.3 days. The mean follow-up duration was 11.9 months. The evaluation of outcome was assessed by Macnab classification. At first month after operation, the outcome showed excellent in 7 [14.3%]. good in 35 [71.4%], fair in 5 [10.2%], and poor in 2 [4.1%]. And at 6 months after operation, 17 patients were lost in follow-up, the outcome showed excellent in 4 [12.5%], good in 25 [78.1%], fair in 3 [9.4%], and no poor cases. There was no significant difference between outcome of laminectomy alone and that of laminectomy with fusion. Six patients [12.2%] experienced postoperative complications which included wound infection [3], nerve root injury [1], disc herniation [1], and reoperation due to insufficient decompression [1]. There were no deaths related to operation. Conclusion : We conclude that the surgical treatment for lumbar spinal stenosis in elderly patients can provide good results with acceptable morbidity when carefully selected. In addition, decision on lumbar spinal fusion should not be against solely on advanced age.

A Study on the Understanding in Results of Arithmetic Operation (연산 결과의 의미 이해에 관한 연구)

  • Roh, EunHwan;Kang, JeongGi;Jeong, SangTae
    • East Asian mathematical journal
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    • v.31 no.2
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    • pp.211-244
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    • 2015
  • The arithmetic operation have double-sided character. One is calculation as a process, the other is understanding in results as an outcome of the operation. We harbored suspicion on students' misunderstanding in an outcome of the operation, because the curriculum has focused on the calculation, as a process of arithmetic operation. This study starts with the presentation of this problem, we tried to find the recognition ability and character in the arithmetic operation. We researched the recognition ability for 7th grade 27 students who have enough experience in arithmetic operation when studying in elementary school. And we had an interview with 3students individually, that has an error in understanding in results of arithmetic operation but has no error in calculation. We focused on 3students' detailed appearance of the ability to understand in results of arithmetic operation and analysed the changing appearance after recommending unit record using operation expression. As a result, we could find the abily to underatanding in results of arithmetic operation and applicability to recommend unit record using operation expression. Through these results, we suggested educational implications in understanding in results of arithmetic operation.

Outcome of Alagille Syndrome Patients Who Had Previously Received Kasai Operation during Infancy: A Single Center Study

  • Lee, Hwa Pyung;Kang, Ben;Choi, So Yoon;Lee, Sanghoon;Lee, Suk-Koo;Choe, Yon Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.18 no.3
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    • pp.175-179
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    • 2015
  • Purpose: Infants with Alagille syndrome (AGS) are occasionally misdiagnosed as biliary atresia and subsequently undergo Kasai operation. The purpose of this study was to investigate the outcome of patients with AGS who had previously received Kasai operation during infancy. Methods: This retrospective study was conducted at the Department of Pediatrics, Samsung Medical Center. We compared the prognosis and mortality between those who had undergone Kasai operation during infancy (Kasai group) and those who had not (non-Kasai group). Results: Among the 15 children with AGS, five had received Kasai operation, while 10 had not. All subjects in the Kasai group revealed neonatal cholestasis, while 70% of the non-Kasai group showed neonatal cholestasis. Liver transplantation was performed in 100% (5/5) among the Kasai group, and 20.0% (2/10) among the non-Kasai group (p=0.007). Mortality was observed in 60.0% (3/5) among the Kasai group, and 10.0% (1/10) among the non-Kasai group (p=0.077). Conclusion: Although overall mortality rate did not significantly differ between the two groups, the proportion of patients receiving liver transplantation was significantly higher in the non-Kasai group. The relatively worse outcome in AGS patients who had received Kasai operation may be due to the unfavorable influences of Kasai operation on the clinical course of AGS, or maybe due to neonatal cholestasis, irrespective of the Kasai operation.

A Study on Development of Operation Evaluation Index for Safety Management System Using AHP (AHP를 이용한 안전관리체제 운영평가지표 개발에 관한 연구)

  • Noh, Chang-Kyun;Lee, Jong-In;Shin, Chul-Ho;Kim, Hyung-Geun;Yim, Jeong-Bin
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.12 no.4 s.27
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    • pp.247-252
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    • 2006
  • In this study, the index for operation evaluation index for safety management system that can be facilitated as the assessment tool for system operation monitoring and operation outcome and the safety management system of shipping companies has been developed. By using this index, this study may provide the instruction or consultation for frequent facilitation by comprehensively recording the required knowledge for each operation stage for the companies that prepares the introduction of the safety management system and companies that already introduced the system to maintain and develop the system. In addition, when working on internal audit and assessing the system operation outcome, it may be facilitated as the assessment tool to contribute in continuous improvement and development. This index is consisted of 11 large categories, 35 items of medium categories and 447 small categories.

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Exploring the Appropriate Operation Ratio on Hospital Revenue Cost and Profit

  • Kim, Yang-Kyun;Sung, Joo-Ho;Kang, Jung-Chul
    • Journal of the Korean Data and Information Science Society
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    • v.18 no.1
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    • pp.31-40
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    • 2007
  • Many previous researchers tried to analysis relationship between financial index of hospitals such as revenue, expenses, and profit and hospital outcome such as number of inpatient and outpatient or, between that financial index and hospital size including number of hospital beds. However, these studies did not find exact relationship between financial index and hospital efficiency and productivity. Therefore, purpose of the study explores exact relationship between hospital financial outcome and hospital efficiency and productivity using adjusted inpatient days concept from American Hospital Association. Through the empirical analysis, the researchers find that hospital profit has the U-shape quadratic function to operation ratio. 66.9% of operation ratio is changing point and hospitals with 55.8% through 75.0% of operation ration have experience deficit situation. Considering the hospital circumstance, Korean hospitals would be to maintain general hospital type with various specialty departments.

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Clinical and Radiological Outcome after Surgical Treatment in Displaced Clavicular Midshaft Fracture

  • Gwak, Heui-Chul;Kim, Jung-Han
    • Clinics in Shoulder and Elbow
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    • v.19 no.2
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    • pp.73-77
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    • 2016
  • Background: The first purpose of this study is to compare the clinical and radiological outcomes of surgical treatment for displaced midshaft clavicle fracture (Robinson type 2B1 vs. 2B2) with 3.5-mm low profile clavicular locking compression plate. The second purpose is to evaluate the difference of the results depending on the presence of accompanying injuries. Methods: Forty-nine patients who underwent an operation for the fractures were reviewed retrospectively. Fracture patterns were classified according to group 2B1 and 2B2 using Robinson's classification. For radiological outcome, time to union after operation was evaluated and for clinical outcome, American Shoulder and Elbow Society (ASES) score, University of California in Los Angeles (UCLA) score, visual analogue scale (VAS), and range of motion (ROM) were evaluated from preoperative period to last follow-up period. Results: The mean time for union was not significantly different in the 2B1 group and 2B2 group (p=0.062). No statistically significant difference in ASES score, UCLA score, and VAS was observed between 2B1 and 2B2 (p=0.619, p=0.896, p=0.856, respectively). In ROM, significant higher mean forward flexion and abduction was observed in 2B2 (p=0.025, p=0.017, respectively) and there was no difference in external rotation and external rotation at shoulder $90^{\circ}$ abduction position (p=0.130, p=0.180, respectively). There was no significant difference in clinical outcomes according to the accompanying injuries. Conclusions: There was no difference in clinical and radiological outcome between Robinson 2B1 and 2B2 type fracture after the operation. Accompanying injuries may not affect the clinical result of displaced midshaft clavicle fractures.

Outcome of Patients Undergoing Kasai Procedure for Biliary Atresia: a Study of Those Surviving More Than 10 Years with Their Native Livers (선천성 담도폐쇄증으로 Kasai 수술 후 장기 치료성적(10년 이상 생존자 대상으로))

  • Yim, Byung-Hun;Song, Young-Tack;Chung, Jae-Hee
    • Advances in pediatric surgery
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    • v.14 no.2
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    • pp.125-133
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    • 2008
  • To evaluate the long-term prognosis of biliary atresia after Kasai operation, a total of 14 patients (of the 41 patients operated upon from 1982 to 1997), who had been followed up for more than 10 years, were included in this retrospective study. Eleven out of 14 patients survived with their native livers, and their data analyzed for age at operation, clearing time of jaundice, histological outcome, postoperative complications, effectiveness after the application of an intussusception anti-reflex valve, and quality of life. Average age at surgery was 62.8 days. Serum bilirubin was normalized within three months in all patients. Six among the eleven long-term survivors had ascending cholangitis as one of the postoperative complications. The application of an intussusception anti-reflux valve did not show any statistical significance in long-term survival. Most of long-term survivors appeared to enjoy good quality of life. Kasai operation might not be the definitive treatment for biliary atresia; however, Kasai operation made it possible to achieve long-term survival for patients with biliary atresia when the patients were detected and treated as early as possible.

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Latarjet operation carries three times the risk of failure in seizure versus non-seizure recurrent anterior dislocation of the shoulder joint: outcome of a systematic review with meta-analysis

  • Alok Rai;Dushyant Chouhan;Sandeep Kumar Nema;Arkesh Madegowda;Rudra Narayan;Bikram K. Kar
    • Clinics in Shoulder and Elbow
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    • v.27 no.2
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    • pp.160-168
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    • 2024
  • Background: Recurrent anterior shoulder dislocation (RASD) in cases of seizure disorders (SDs) total 50%-80% of all SD-associated shoulder instabilities. Based on the extent of bone loss, treatment options include bony and soft-tissue reconstructions, arthroplasty, and arthrodesis. The primary objective of this paper was to review the treatment options for RASD in SDs. Methods: Several bibliographic databases were searched for RASD treatment options in SD patients. The demographic outcome measures, the failure rate (defined as the relative risk of recurrence of dislocation postoperation), and the postoperative seizure recurrence rate were recorded. Results: We pooled 171 cases (187 shoulders) from 11 studies. Of these, one, five, two, two, and one reports studied Bankart's operation with remplissage (27 cases/29 shoulders), the Latarjet procedure (106/118), bone block operation (21/23), arthroplasty (11/11), and arthrodesis (6/6), respectively, in treating SD-associated RASD. The relative risk of failure between SD and non-SD patients was 3.76 (1.36-10.38) after the Latarjet operation. The failure rates were 17% and 13% for Bankart's operation with remplissage and the Latarjet procedure in SD patients, respectively, but 0% each for bone block operation, arthroplasty, and arthrodesis. The total rate of seizure recurrence after operation was 33% of the pooled cases. Conclusions: SD recurrence in the postoperative period, the size of the bone block, and the muscular attachments to a small coracoid autograft are the determinants of failure among various reconstructive operations in SD-associated RASD.