• Journal of muscle and joint health
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• v.27 no.3
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• pp.219-228
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• 2020

Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

• Journal of Chest Surgery
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• v.55 no.3
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• pp.197-205
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• 2022

Background: The integrated design of the HeartMate 3 (Abbott Laboratories, Chicago, IL, USA) affords flexibility to place the pump within the pericardium or thoracic cavity. We sought to determine whether the presence of a left ventricular assist device (LVAD) in either location has a meaningful impact on overall patient outcomes. Methods: A retrospective cohort study was conducted of all 165 patients who received a HeartMate 3 LVAD via a median sternotomy from November 2014 to August 2019 at our center. Based on operative reports and imaging, patients were divided into intrapleural (n=81) and intrapericardial (n=84) cohorts. The primary outcome of interest was in-hospital mortality, while secondary outcomes included postoperative complications, cumulative readmission incidence, and 3-year survival. Results: There were no significant between-group differences in baseline demographics, risk factors, or preoperative hemodynamics. The overall in-hospital mortality rate was 6%, with no significant difference between the cohorts (9% vs. 4%, p=0.20). There were no significant differences in the postoperative rates of right ventricular failure, kidney failure requiring hemodialysis, stroke, tracheostomy, or arrhythmias. Over 3 years, despite similar mortality rates, intrapleural patients had significantly more readmissions (n=180 vs. n=117, p<0.01) with the most common reason being infection (n=68/165), predominantly unrelated to the device. Intrapleural patients had significantly more infection-related readmissions, predominantly driven by non-ventricular assist device-related infections (p=0.02), with 41% of these due to respiratory infections compared with 28% of intrapericardial patients. Conclusion: Compared with intrapericardial placement, insertion of an intrapleural HM3 may be associated with a higher incidence of readmission, especially due to respiratory infection.

• Journal of Chest Surgery
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• v.42 no.3
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• pp.311-316
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• 2009

Background: Clopidogrel is widely used just before coronary artery bypass surgery, yet its pharmacological effect can cause postoperative bleeding-related complications. The purpose of this study was to find the effect of preoperative clopidogrel exposure on the blood transfusion requirement and on the rate of reexploration for bleeding control and the rate of readmission caused by bleeding in patients who undergo off-pump coronary artery bypass surgery (OPCAB). Material and Method: This study included 103 patients who had been on clopidogrel preoperatively and they underwent OPCAB by one surgeon from January, 2005 to November, 2007. We divided the patient into two group. Group 1 consisted of 45 patients who stopped cloidogrel 5 days before surgery and group 2 consisted of 58 patients who were taking clopidogrel within 5 days before surgery. Two groups were compared in terms of the bleeding related reoperation rate and the readmission rate, the amount of postoperative bleeding and the required amount of transfusion. Result: There were no significant differences between the two groups concerning the demographic, echocardiographic and hematologic features. There were no significant differences in the postoperative bleeding amount, but the amount of required transfusion was greater in group 2 (p=0.018). While group 1 showed a 0% reoperation rate for hemostasis and 0% readmission rate as related to postoperative bleeding, group 2 showed a 6.9% reoperation and a 5.2% readmission rate, but three were no statistically significant differences between the two groups. Conclusion: Continuous use of clopidogrel did not cause postoperative major bleeding, but can increase the amount of bleeding and the amount of required transfusion postoperatively. We that discontinuation of clopidogrel for a while before elective OPCAB can help the patient's postoperative recovery.

• Journal of Korean Academy of Nursing
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• v.20 no.2
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• pp.227-248
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• 1990

The study was conceived in relation to a concern over the growing gap between the needs of chronic patients and the availability of care from the current health care system in Korea. Patients with agonizing chronic pain, discomfort, despair and disability are left with helplessly unprepared families with little help from the acute care oriented health care system after discharge from hospital. There is a great need for the development of an alternative means of quality care that is economically feasible and culturally adaptible to our society. Thus, the study was designed to demonstrate the effectiveness of home heath care as an alternative to bridge the existing gap between the patients' needs and the current practice of health care. The study specifically purports to test the effects of home care on health expenditure, readmission, job retention, compliance to health care regime, general conditions, complications, and self-care knowledge and practices. The study was guided by the operations research method advocated by the Primary Health Care Operations Research Institute(PRICOR) which constitutes 3 stages of research : namely, problem analysis solution development, and solution validation. The first step in the operations research was field preparation to develop the necessary consensus and cooperation. This was done through the formation of a consulting body at the hospital and a steering committee among the researchers. For the stage of problem analysis, the Annual Report of Seoul National University Hospital and the patients records for last 5 years were reviewed and selective patient interviews were conducted to find out the magnitude of chronic health problems and areas of unmect health care needs to finally decide on the kinds of health problems to study. On the basis of problem analysis, the solution development stage was devoted to home care program development asa solution alternative. Assessment tools, teaching guidelines and care protocols were developed and tested for their validity. The final stage was the stage of experimentation and evaluation. Patients with liver diseases, hemiplegic and diabetic conditions were selected as study samples. Discharge evaluation, follow up home care, measurement and evaluation were carried out according to the protocols of care and measurement plan for each patient for the period of 6 months after discharge. The study was carried out for the period from Jan. 1987 to Dec. 1989. The following are the results of the study presented according to the hypotheses set forth for the study ; 1. Total expenditures for the period of study were not reduced for the experimental group, however, since the cost per hospital visit is about 4 times as great as the cost per home visit, the effect of cost saving by home care will become a reality as home care replaces part of the hospital visits. 2. The effect on the rate of readmission and job retention was found to be statistically nonsignificant though the number of readmission was less among the experimental group receiving home care. 3. The effect on compliance to the health care regime was found to be statistically significant at the 5% level for hepatopathic and diabetic patients. 4. Education on diet, rest and excise, and medication through home care had an effect on improved liver function test scores, prevention of complications and self - care knowledge in hepatopathic patients at a statistically significant level. 5. In hemiplegic patient, home care had an effect on increased grasping power at a significant level. However. there was no significant difference between the experimental and control groups in the level of compliane, prevention of complications or in self-care practices. 6. In diabetic patients, there was no difference between the experimental and control groups in scores of laboratory tests, appearance of complications, and self-care knowledge or self -care practices. The above findings indicate that a home care program instituted for such short term as 6 months period could not totally demonstrate its effectiveness at a statistically significant level by quantitative analysis however, what was shown in part in this analysis, and in the continuous consultation sought by those who had been in the experimental group, is that home health care has a great potential in retarding or preventing pathological progress, facilitating rehabilitative and productive life, and improving quality of life by adding comfort, confidence and strength to patients and their families. For the further studies of this kind with chronic patients it is recommended that a sample of newly diagnosed patients be followed up for a longer period of time with more frequent observations to demonstrate a more dear- cut picture of the effectiveness of home care.

• Archives of Plastic Surgery
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• v.50 no.5
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• pp.488-491
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• 2023

Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

• International journal of advanced smart convergence
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• v.5 no.1
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• pp.47-50
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• 2016

Big Data is coming rapidly in recent times and keep the vast amount of data was utilized them. These data are utilized in many fields in particular, based on the patient data in the medical field to increase the therapeutic effect, as well as re-incidence to better treatment, lowering the readmission rates increased the quality of life. In this paper it is practiced to report basis of the analysis and verification of data using python. And it can be analyzed the data through a simple formula, from Select reason of Python to how it used; by Press analysis of Agriculture, Forestry and Fisheries research. In this process, a simple formula can be used that expression for analyzing the actual data so it taking advantage of the use of functions in real life.

• Tuberculosis and Respiratory Diseases
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• v.71 no.1
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• pp.1-7
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• 2011

Many findings suggest that chronic obstructive pulmonary disease (COPD) imposes an enormous burden on patients, health-care professionals and society. COPD contributes to morbidity and mortality and to a significant use of health-care resources. In spite of a higher prevalence of COPD in Korea, the result of COPD treatment is not effective. The purpose of this article was to review recent advances in the study of COPD in Korea with the aim of improving effective management. This review highlights articles pertaining to the following topics; prevalence, assessment of COPD, risk factors for hospitalization, co-morbid diseases, phenotypes, and treatment issues.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.243-253
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• 2015

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.36-41
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• 2022

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

• Neonatal Medicine
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• v.25 no.3
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• pp.96-101
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• 2018

Purpose: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. Methods: We reviewed the medical records of preterm infants born at <37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. Results: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants (<34 weeks of gestation) compared to late preterm infants (${\geq}34$ and <37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. Conclusion: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.