• 제목/요약/키워드: RISK FACTORS

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A More Detailed Classification of Mild Head Injury in Adults and Treatment Guidelines

  • Lee, Young-Bae;Kwon, Sun-Ju
    • Journal of Korean Neurosurgical Society
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    • 제46권5호
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    • pp.451-458
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    • 2009
  • Objective : The purpose of this study was to analyze risk factors that are associated with intracranial lesion, and to propose criteria for classification of mild head injury (MHI), and appropriate treatment guidelines. Methods : The study was based on 898 patients who were admitted to our hospital with Glasgow Coma Scale (GCS) score of 13 to 15 between 2003 and 2007. The patients' initial computerized tomography (CT) findings were reviewed and clinical findings that were associated with intracranial lesions were analyzed. Results : GCS score, loss of consciousness (LOC), age and skull fracture were identified as independent risk factors for intracranial lesions. Based on the data ana lysed in this study, MHI patients were divided into four subgroups : very low risk MHI patients are those with a GCS score of 15 and without a history of LOC or headache; low risk MHI patients have a GCS score of 15 and with LOC and/or headache; medium risk MHI patients are those with a GCS score of 15 and with a skull fracture, neurological deficits or with one or more of the risk factors; high risk MHI patients are those with a GCS score of 15 with abnormal CT findings and GCS score of 14 and 13. Conclusion : A more detailed classification of MHI based on brain CT scan findings and clinical risk factors can potentially improve patient diagnosis. In light of our findings, high risk MHI patients should be admitted and treated in same manner as those with moderate head injury.

서울시 소재 한 대학병원 퇴원환자의 재입원 관련요인 (Factors Associated with Unplanned Hospital Readmission)

  • 이은환;유승흠;이해종;김석일
    • 한국병원경영학회지
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    • 제15권4호
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    • pp.125-142
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    • 2010
  • Objective : To determine demographic, clinical, health care utilization factors predicting unplanned readmission(within 28 days) to the hospital. Methods : A case-control study was conducted from January to December 2009. Multiple logistic regression was used to examine risk factors for readmission. 180 patients who had been readmitted within 28 days and 1,784 controls were recruited from an university hospital in Seoul. Results : Six risk factors associated with readmission risk were identified and include mail sex, medical service rather than surgical service, number of comorbid diseases, type of patient's room, lenth of stay, number of admissions in the prior 12 months. Conclusions : One of the association with readmission risk identified was the number of hospital admissions in the previous year. This factor may be the only risk factor necessary for assessing prior risk and has the additional advantage of being easily accessible from computerized medical records without requiring other medical record review. This risk factor may be useful in identifying a group at high readmission risk, which could be targeted in intervention studies. Multiple risk factors intervention approach should be considered in designing future prevention strategies.

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초등학교 저학년 어린이에서의 대사위험요인 군집의 분포와 관련 위험요인 (Clustering of Metabolic Risk Factors and Its Related Risk Factors in Young Schoolchildren)

  • 공경애;박보현;민정원;홍주희;홍영선;이보은;장남수;이선화;하은희;박혜숙
    • Journal of Preventive Medicine and Public Health
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    • 제39권3호
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    • pp.235-242
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    • 2006
  • Objectives: We wanted to determine the distribution of the clustering of the metabolic risk factors and we wanted to evaluate the related factors in young schoolchildren. Methods: A cross-sectional study of metabolic syndrome was conducted in an elementary school in Seoul, Korea. We evaluated fasting glucose, triglyceride, HDL cholesterol, blood pressures and the body mass index, and we used parent-reported questionnaires to assess the potential risk factors in 261 children (136 boys, 125 girls). We defined the metabolic risk factors as obesity or at risk for obesity ($\geqq$ 85th percentile for age and gender), a systolic or diastolic blood pressure at $\geqq90th$ percentile for age and gender, fasting glucose at $\geqq110mg/dl$, triglyceride at $\geqq110mg/dl$ and HDL cholesterol at $\leqq40mg/dl$. Results: There were 15.7% of the subjects who showed clustering of two or more metabolic risk factors, 2.3% of the subjects who showed clustering for three or more risk factors, and 0.8% of the subjects who showed clustering for four or more risk factors. A multivariate analysis revealed that a father smoking more than 20 cigarettes per day, a mother with a body mass index of = $25kg/m^2$, and the child eating precooked or frozen food more than once per day were associated with clustering of two or more components, with the odds ratios of 3.61 (95% CI=1.24-10.48), 5.50 (95% CI=1.39-21.73) and 8.04 (95% CI=1.67-38.81), respectively. Conclusions: This study shows that clustering of the metabolic risk factors is present in young schoolchildren in Korea, with the clustering being associated with parental smoking and obesity as well as the child's eating behavior. These results suggest that evaluation of metabolic risk factors and intervention for lifestyle factors may be needed in both young Korean children and their parents.

Targeting Risk Factors for the Control of Central Line-Associated Bloodstream Infection in the Neonatal Intensive Care Unit: A Single Tertiary Center Experience

  • Jeong, Jiyoon;Kwun, Yoojin;Kim, Min-ju;Choi, Sang-Ho;Jung, Euiseok;Lee, Byong Sop;Kim, Ki-Soo;Kim, Ellen Ai-Rhan
    • Neonatal Medicine
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    • 제28권3호
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    • pp.116-123
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    • 2021
  • Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

Association with Combined Occupational Hazards Exposure and Risk of Metabolic Syndrome: A Workers' Health Examination Cohort 2012-2021

  • Dongmug Kang ;Eun-Soo Lee ;Tae-Kyoung Kim;Yoon-Ji Kim ;Seungho Lee ;Woojoo Lee ;Hyunman Sim ;Se-Yeong Kim
    • Safety and Health at Work
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    • 제14권3호
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    • pp.279-286
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    • 2023
  • Background: This study aimed to evaluate the association between exposure to occupational hazards and the metabolic syndrome. A secondary objective was to analyze the additive and multiplicative effects of exposure to risk factors. Methods: This retrospective cohort was based on 31,615 health examinees at the Pusan National University Yangsan Hospital in Republic of Korea from 2012-2021. Demographic and behavior-related risk factors were treated as confounding factors, whereas three physical factors, 19 organic solvents and aerosols, and 13 metals and dust were considered occupational risk factors. Time-dependent Cox regression analysis was used to calculate hazard ratios. Results: The risk of metabolic syndrome was significantly higher in night shift workers (hazard ratio = 1.45: 95% confidence interval = 1.36-1.54) and workers who were exposed to noise (1.15:1.07-1.24). Exposure to some other risk factors was also significantly associated with a higher risk of metabolic syndrome. They were dimethylformamide, acetonitrile, trichloroethylene, xylene, styrene, toluene, dichloromethane, copper, antimony, lead, copper, iron, welding fume, and manganese. Among the 28 significant pairs, 19 exhibited both positive additive and multiplicative effects. Conclusions: Exposure to single or combined occupational risk factors may increase the risk of developing metabolic syndrome. Working conditions should be monitored and improved to reduce exposure to occupational hazards and prevent the development of the metabolic syndrome.

방문간호를 받는 재가노인의 낙상위험 (Fall Risk in the Community-dwelling Elderly who Received Home Care Services: Focused on Residential Environment and Perception of Fall Risk)

  • 이정미;조복희
    • 근관절건강학회지
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    • 제21권1호
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    • pp.36-45
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    • 2014
  • Purpose: The purpose of this study was to investigate the factors increasing fall risk in the residential environment risk and the perceived fall risk among the older adults who received home care services to provide information for developing a comprehensive falls intervention program. Methods: The subjects were 227 community-dwelling elderly aged 65 years and over who were taken care of by home-visiting nurses of the national health centers. The data were collected from July to August in 2012 using the Choi's residential environmental risk scale (2010) and the Hong's fall risk scale (2011). Results: Requires an assistive devices to walk, modified residential environment, health security, approval certificate of LTC, residential safety perception, residential environment risk, and perception of fall risk were statistically significant risk factors. A multiple logistic regression analysis showed that room & kitchen, physical perception, medication & ADL perception, floor-related environmental perception, and daily living tool-related perception were statistically significant predictors of fall. Conclusion: The results showed that the residential environment and the perceived fall risk were associated with fall experiences among the elderly. It is necessary to develope multifactorial intervention programs considering both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

타워크레인 사고 위험 지각에 영향을 미치는 위험 요인에 관한 연구(타워크레인 업무유형의 조절효과를 중심으로) (A study on risk factors having effect on perception of tower crane incident risk)

  • 은남권;김창은
    • 대한안전경영과학회지
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    • 제18권3호
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    • pp.33-45
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    • 2016
  • Construction sites have gradually become bigger and bigger according to Korea economic growth. Also use of tower crane and other heavy equipment has been increased. The increased use of heavy equipment like tower crane is leading to fatality incident. This study will verify hazards to influence tower crane incident through structural and positive verification and find which hazard influence incident risk. The result of this study is as follows. First, while there is a significant difference between safety managers and tower crane operators for working environment, safety management, personal manage among risk factors, we can not find any evidence on the difference in perception of tower crane incident risk between them. Second, task manage risk and personal manage risk has a significant positive effect on perception of tower crane incident risk. Third, while site environment risk has a significant positive moderating effect of task type between risk factors and perception of tower crane incident risk, personal environment risk has a significant negative moderating effect between them.

치매노인의 낙상위험요인에 관한 메타분석 (A Meta-analysis of the Risk Factors related to Falls among Elderly Patients with Dementia)

  • 홍선영;박희옥
    • 성인간호학회지
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    • 제29권1호
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    • pp.51-62
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    • 2017
  • Purpose: The purpose of this study was to provide data about the risk factors related to falls among elderly patients with dementia using meta-analysis. Methods: Key words used for search through electronic database (CINAHL, PubMed, Ovid-MEDLINE, RISS, KISS, DBPIA, National Assembly Library) included 'dementia', 'Alzheimer', 'fall'. Twenty studies met the inclusion criteria for the meta-analysis and 'R' version 3.2.2 was used to analyze the correlated effect size. Results: Study results showed that risk factors related to falls were identified as the demographic (age, gender, education), dementia-related (disease duration, cognition), physical (body mass index, walking, balance, activity of daily living, use of walking aids, number of medications including psychotropic drugs, musculoskeletal problems, parkinsonism, comorbidity), psychological (neuropsychiatric symptom, depression), environmental (Physical environment), and fall-related (fall history, high risk group of fall) factors. The effect size of risk factors such as high risk group of fall (r=.35), use of walking aids (r=.33), depression (r=.31), psychotropic drugs (r=.27), Musculoskeletal problems (r=.25) were higher than the other risk factors. Conclusion: Based on the findings of this study, strategies to improve elderly patient's depression, intensive care for high risk group of fall, and adequate training with walking aids are needed for prevention of falls in elderly patients with dementia.

유방암의 위험요인 (Risk Factors of Breast Cancer)

  • 정복례;변혜선;김경덕;김경혜
    • 종양간호연구
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    • 제8권2호
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    • pp.120-127
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    • 2008
  • Purpose: The purpose of this study was secondary analysis to explore about risk factors with breast cancer on a basis of primary literature. Methods: This study was searched articles by using CINAHL, MEDLINE, Riss4u, Internet website regarding breast cancer. This study searched for the journal published in Korea and foreign countries from 2000 to 2008, about risk factors of breast cancer. This study was reviewed 42 articles (5 experimental study, 35 survey, 1 qualitative study, 1 report) suitable for the research objectives. Results: Magnitude of risk breast cancer (++) was age, geographic region, family history, mutations in BRCA1, BRCA2 genes and in other penetrance genes, radiation, history of benign breast disease, late age of menopause, early age of menarch, nulliparity and older age at first birth, high mammographic breast density, high insulin-like growth factor 1 level. Magnitude of risk factor (+) was hormone replacement therapy, oral contraceptives use, obesity, tall stature, alcohol consumption, high prolactin level, high saturated fat and well-done meat intake, polymorphisms in low penetrance gene, high socioeconomic status. Conclusion: A breast cancer screening protocol according to magnitude of risk factors is needed for disease prevention. The nurses need to educate and counsel women with risk factors of breast cancer.

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노인집단을 대상으로 한 고혈압의 식이위험요인에 관한 연구 (Dietary Risk Factors of Hypertension in the Elderly)

  • 문현경
    • Journal of Nutrition and Health
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    • 제32권1호
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    • pp.90-100
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    • 1999
  • In order to investigate dietary risk factors for hypertension in th elderly, dietary intakes and dietary habits of 405 elderly subjects, aged 60-94, were assessed by the questionnaire, anthropometric measurement and a 24-hour dietary recall. The prevalence of definite (>95mmHg for diastolic or>160mmHg for systeolic blood pressue) and borderline(90-95mmHg for diastolic or 140-160mmHg for systolic blood pressure) hypertensive subjects 33.3% and 19.3%, respectively. The distribution of the subjects for Body Mass Index(BMI), waist-hip ratio, and alcohol consumption were significantly different among definite, borderline, and normal groups(p<0.05). The distribution of the subjects for smoking, exercise, and preference of salty food were not significantly different among definite, borderline, and normal groups(p>0.05). From the generalized logistic regression analysis of the risk factors for the hypertension, the subjects with over 27 of BMI had significantly higher risk of hypertension. Alcohol consumption and preference of salty food were significant risk factors of hypertension in the elderly. Dietary risk factors for the hypertension that had significant relationship to the hypertension were intakes of potassium, calcium, phosphate, sodium, vitamin B1, niacin, and folate. There was no significant difference of consumption frequencies of food and dish among definite, borderline, and normal groups(p>0.05). The amount of intakes for cereals and grain product, bean and their products, eggs were significantly different among definite, borderline, and normal groups(p<0.05). In summary, the amount of dietary intakes to hypertension in elderly population. Longitudinal studies for dietary risk factors on incidence of hypertension are needed in general population, especially in the elderly.

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