• Title/Summary/Keyword: Risk Assessment Index

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Comparison of Hospital Standardized Mortality Ratio Using National Hospital Discharge Injury Data (퇴원손상심층조사 자료를 이용한 의료기관 중증도 보정 사망비 비교)

  • Park, Jong-Ho;Kim, Yoo-Mi;Kim, Sung-Soo;Kim, Won-Joong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.4
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    • pp.1739-1750
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    • 2012
  • This study was to develop the assessment of medical service outcome using administration data through compared with hospital standardized mortality ratios(HSMR) in various hospitals. This study analyzed 63,664 cases of Hospital Discharge Injury Data of 2007 and 2008, provided by Korea Centers for Disease Control and Prevention. We used data mining technique and compared decision tree and logistic regression for developing risk-adjustment model of in-hospital mortality. Our Analysis shows that gender, length of stay, Elixhauser comorbidity index, hospitalization path, and primary diagnosis are main variables which influence mortality ratio. By comparing hospital standardized mortality ratios(HSMR) with standardized variables, we found concrete differences (55.6-201.6) of hospital standardized mortality ratios(HSMR) among hospitals. This proves that there are quality-gaps of medical service among hospitals. This study outcome should be utilized more to achieve the improvement of the quality of medical service.

Impact of Sarcopenia on Early Postoperative Complications in Early-Stage Non-Small-Cell Lung Cancer

  • Lee, Jiyun;Moon, Seok Whan;Choi, Jung Suk;Hyun, Kwanyong;Moon, Young Kyu;Moon, Mi Hyoung
    • Journal of Chest Surgery
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    • v.53 no.3
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    • pp.93-103
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    • 2020
  • Background: Risk assessment for pulmonary resection in patients with early-stage non-small-cell lung cancer (NSCLC) is important for minimizing postoperative morbidity. Depletion of skeletal muscle mass is closely associated with impaired nutritional status and limited physical ability. We evaluated the relationship between skeletal muscle depletion and early postoperative complications in patients with early-stage NSCLC. Methods: Patients who underwent curative lung resection between 2016 and 2018 and who were diagnosed with pathological stage I/II NSCLC were included, and their records were retrospectively analyzed. The psoas volume index (PVI, ㎤/㎥) was calculated based on computed tomography images from routine preoperative positron emission tomography-computed tomography. Early postoperative complications, defined as those occurring within 90 days of surgery, were compared between the lowest sex-specific quartile for PVI and the remaining quartiles. Results: A strong correlation was found between the volume and the cross-sectional area of the psoas muscle (R2=0.816). The overall rate of complications was 57.6% among patients with a low PVI and 32.8% among those with a normal-to-high PVI. The most common complication was prolonged air leak (low PVI, 16.9%; normal-to-high PVI, 9.6%), followed by pneumonia (low PVI, 13.6%; normal-to-high PVI, 7.9%) and recurrent pleural effusion (low PVI, 11.9%; normal-to-high PVI, 6.8%). The predictors of overall complications were low PVI (odds ratio [OR], 2.18; 95% confidence interval [CI], 1.07-4.09; p=0.03), low hemoglobin level (OR, 0.686; 95% CI, 0.54-0.87; p=0.002), and smoking history (OR, 3.93; 95% CI, 2.03-7.58; p<0.001). Conclusion: Low PVI was associated with a higher rate of early postoperative complications in patients with early-stage NSCLC.

Impact Assessment of Climate Change on Drought Risk (기후변화가 가뭄 위험성에 미치는 영향 평가)

  • Kim, Byung-Sik;Kwon, Hyun-Han;Kim, Hung-Soo
    • Journal of Wetlands Research
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    • v.13 no.1
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    • pp.1-11
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    • 2011
  • A chronic drought stress has been imposed during non-rainy season(from winter to spring) since 1990s. We faced the most significant water crisis in 2001, and the drought was characterized by sultry weather and severe drought on a national scale. It has been widely acknowledged that the drought related damage is 2-3 times serious than floods. In the list of the world's largest natural disaster compiled by NOAA, 4 of the top 5 disasters are droughts. And according to the analysis from the NDMC report, the drought has the highest annual average damage among all the disasters. There was a very serious impact on the economic such as rising consumer price during the 2001 spring drought in Korea. There has been flood prevention measures implemented at national-level but for mitigation of droughts, there are only plans aimed at emergency (short-term) restoration rather than the comprehensive preventive measures. In addition, there is a lack of a clear set of indicators to express drought situation objectively, and therefore it is important and urgent to begin a systematic study. In this study, a nonstationary downscaling model using RCM based climate change scenario was first applied to simulate precipitation, and the simulated precipitation data was used to derive Standardized Precipitation Index (SPI). The SPI under climate change was used to evaluate the spatio-temporal variability of drought through principal component analysis at three different time scales which are 2015, 2045 and 2075. It was found that spatio-temporal variability is likely to modulate with climate change.

Risk Assessment of the Road Cut Slopes in Gyeoungnam based on Multiple Regression Analysis (다중회귀분석을 통한 경남 지방도로 절취사면의 안정성평가)

  • Kang, Tae-Seung;Um, Jeong-Gi
    • The Journal of Engineering Geology
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    • v.17 no.3
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    • pp.393-404
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    • 2007
  • The purpose of this study is to capture the essentials in survey and evaluation scheme which are able to assess the hazard of a rock slope systematically. Statistical analysis are performed on slope instability parameters related to failure of the rock slope. As the slope instability parameters, twelve survey items are considered such as tension crack, surface deformation, deformation of retaining structures, volume of existing failures, angles between strike of discontinuity and strike of cut slope face, angles between dip of discontinuity and dip of cut slope face, discontinuity condition, cut slope angle, rainfall or ground water level, excavation condition, drainage condition, reinforcement. A total of 233 road cut slopes located in Gyeongnam were considered. The stability of the road cut slopes were evaluated by estimating the slope instability index(SII) and corresponding stability rank. 126 rock slopes were selected to analyze statistical relation between SII and slope instability parameters. The multiple regression analysis was applied to derive statistical models which are able to predict the SII and corresponding slope stability rank. Also, its applicability was explored to predict the slope failures using the variables of slope instability parameters. The results obtained in this study clearly show that the methodology given in this paper have strong capabilities to evaluate the failures of the road cut slope effectively.

Toxicological Effect of Samultang (Herbal Medicine) Administration in the Pregnant Rats and Fetuses - Focusing on dose-response Relationship - (사물탕의 용량별 투여가 임신 랫드와 태자에 미치는 독성학적 연구)

  • Jeon, Sung-Jin;Shin, Heon-Tae;Kim, Kyung-Tae;Park, Hae-Mo;Lee, Sun-Dong
    • Journal of Society of Preventive Korean Medicine
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    • v.14 no.3
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    • pp.1-12
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    • 2010
  • Objective : Samulatang (herbal description) is much used for women's disease in Korean Traditional Medicine. The aim of this study is to evaluate reproductive toxic effect by Samultang in pregnant rats and fetuses, and ascertain a dose-response relationship Method : Pregnant Sprague-Dawley rats were administered with the Samultang at single, double and quadruple dose for 20 days, orally. Pregnant rats were sacrificed at 20th day of gestation, and observed internal and reproductive organs. Live fetuses of gestation were randomly selected and fixed in 95% ethanol. Fetuses were stained with alcian blue and alizarin red S. We observe maternal body weight,, index associated pregnancy, and skeletal malformations in fetus Result : Maternal body weight of Samultang treated group has increased, side effect was not found in maternal body compared to that of control group. There were no significant difference in internal and reproductive organs. Double concentration administered group had lowest value in number of implantation, live fetuses, implantation rate and delivery rate, Also double concentration administered group showed higher early and late resorption rate than the other group. But, these are not significant. In the sex ratio, number of females, bigger than number of males in all Samultang administered groups. The fetuses of dams treated with Samultang didn't showed external and skeletal malformation. Vertebral and sternal variations were observed in single, double and quadruple concentration administered group but, compared to the control, those variations were insignificant. There were no significant changes in number of ribs, cervical, thoracic, lumber, sacral and caudal vertebrae Conclusion : Samultang is not expected to affect on pregnant rats and fetus about maternal body weight and number of live fetuses. There were no significant changes in organ weight, reproductive organs. Although skeletal variations were showed in vertebrae and sternum, treated groups were shown insignificant changes in skeletal variation

Exposure Characteristics of Construction Painters to Organic Solvents

  • Park, Hyunhee;Park, Hae Dong;Jang, Jae-Kil
    • Safety and Health at Work
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    • v.7 no.1
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    • pp.63-71
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    • 2016
  • Background: Construction painters have not been studied well in terms of their hazards exposure. The objective of this study was to evaluate the exposure levels of total volatile organic compounds (TVOCs) for painters in the construction industry. Methods: Activity-specific personal air samplings were carried out in three waterproofing activities [polyurethane (PU), asphalt, and cement mortar] and three painting activities (epoxy, oil based, and water based) by using organic-vapor-monitor passive-sampling devices. Gas chromatograph with flame ionization detector could be used for identifying and quantifying individual organic chemicals. The levels of TVOCs, by summing up 15 targeted substances, were expressed in exposure-index (EI) values. Results: As arithmetic means in the order of concentration levels, the EIs of TVOCs in waterproofing works were 10.77, 2.42, 1.78, 1.68, 0.47, 0.07, and none detected (ND) for indoor PU-primer task, outdoor PU-primer task, outdoor PU-resin task, indoor PU-resin task, asphalt-primer task, asphalt-adhesive task, and cement-mortar task, respectively. The highest EI for painting works was 5.61 for indoor epoxyprimer task, followed by indoor epoxy-resin task (2.03), outdoor oil-based-spray-paint task (1.65), outdoor water-based-paint task (0.66), and indoor oil-based-paint task (0.15). Assuming that the operations were carried out continuously for 8 hours without breaks and by using the arithmetic means of EIs for each of the 12 tasks in this study, 58.3% (7 out of 12) exceeded the exposure limit of 100% (EI > 1.0), while 8.3% (1 out of 12) was in 50e100% of exposure limit (0.5 > EI > 1.0), and 4 tasks out of 12 were located in less than 50% of the limit range (EI < 0.5). Conclusion: From this study, we recognized that construction painters are exposed to various solvents, including carcinogens and reproductive toxins, and the levels of TVOC concentration in many of the painting tasks exceeded the exposure limits. Construction workers need to be protected from chemical agents during their painting works by using personal protective devices and/or work practice measures. Additional studies should focus on the exposure assessment of other hazards for construction workers, in order to identify high-risk tasks and to improve hazardous work environments.

Improved Socio-Economic Status of a Community Population Following Schistosomiasis and Intestinal Worm Control Interventions on Kome Island, North-Western Tanzania

  • Mwanga, Joseph R.;Kaatano, Godfrey M.;Siza, Julius E.;Chang, Su Young;Ko, Yunsuk;Kullaya, Cyril M.;Nsabo, Jackson;Eom, Keeseon S.;Yong, Tai-Soon;Chai, Jong-Yil;Min, Duk-Young;Rim, Han-Jong;Changalucha, John M.
    • Parasites, Hosts and Diseases
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    • v.53 no.5
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    • pp.553-559
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    • 2015
  • Research on micro-level assessment of the changes of socio-economic status following health interventions is very scarce. The use of household asset data to determine wealth indices is a common procedure for estimating socio-economic position in resource poor settings. In such settings information about income is usually lacking, and the collection of individual consumption or expenditure data would require in-depth interviews, posing a considerable risk of bias. In this study, we determined the socio-economic status of 213 households in a community population in an island in the north-western Tanzania before and 3 year after implementation of a participatory hygiene and sanitation transformation (PHAST) intervention to control schistosomiasis and intestinal worm infections. We constructed a household 'wealth index' based housing construction features (e.g., type of roof, walls, and floor) and durable assets ownership (e.g., bicycle, radio, etc.). We employed principal components analysis and classified households into wealth quintiles. The study revealed that asset variables with positive factor scores were associated with higher socio-economic status, whereas asset variables with negative factor scores were associated with lower socio-economic status. Overall, households which were rated as the poorest and very poor were on the decrease, whereas those rated as poor, less poor, and the least poor were on the increase after PHAST intervention. This decrease/increase was significant. The median shifted from -0.4376677 to 0.5001073, and the mean from -0.2605787 (SD; 2.005688) to 0.2605787 (SD; 1.831199). The difference in socio-economic status of the people between the 2 phases was highly statistically significant (P<0.001). We argue that finding of this study should be treated with caution as there were other interventions to control schistosomiasis and intestinal worm infections which were running concurrently on Kome Island apart from PHAST intervention.

A Study on the Eco-Toxicity of Silicone-Based Antifoaming Agents Discharging into Marine Environments (해양으로 배출되는 실리콘계 소포제의 생태독성 연구)

  • Kim, Tae Won;Kim, Young Ryun;Park, MiOk;Jeon, MiHae;Son, Min Ho
    • Journal of the Korean Society of Marine Environment & Safety
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    • v.25 no.1
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    • pp.81-88
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    • 2019
  • In order to understand the effects of the main components of antifoaming agents on the marine benthic ecosystem when silicone-based antifoaming agents are discharged into marine environments, eco-toxicity testing was performed on silicone and alcohol-based antifoaming agent by using benthic amphipod (Monocorophium acherusicum) and luminescent bacteria (Vibrio fischeri). The toxic effects of Polydimethylsiloxane (PDMS) as a main component of silicone-based antifoaming agents on aquatic organisms were also researched. In the results of the eco-toxicity test, luminescent bacteria showed a maximum of 9 times more toxic effects than benthic amphipod for alcohol-based antifoaming agents, and silicone-based antifoaming agents showed a maximum of 400 times more toxic effects than alcohol-based. The $LC_{50}$ and $EC_{50}$ values of PDMS ranged from 10 to $44,500{\mu}g/L$ in phytoplankton, invertebrate, and fish. In the results of applying PBT (P: persistency, B: bioaccumulation, T: toxicity) characteristics as an index showing the qualitative characteristics of PDMS, persistency (P) and bioaccumulation (B) were confirmed. Thus, when PDMS is discharged to marine environments, it could accumulate in the upper trophic level through bioaccumulation and the food chain, which could have negative effects on benthic organisms. The results of this study may be used for objective and scientific risk assessment, considering the major components of antifoaming agents when investigating the effects of various discharged antifoaming agents in marine ecosystem.

Hepatic and Renal Safety of Concurrent Use of Conventional and Herbal Medications for Musculoskeletal Disorders: A Retrospective Observational Study (근골격계 질환에 대한 양약 및 한약 병용의 간과 신장에 대한 안전성: 후향적 관찰 연구)

  • Kim, Se-Yoon;Kim, Hyungsuk;Kang, Doyoung;Ko, Junhyuk;Kim, Jongyeon;Kim, Koh-Woon;Kim, Bo-Hyung;Cho, Jae-Heung;Song, Mi-Yeon;Chung, Won-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.131-140
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    • 2022
  • Objectives This study aimed to investigate whether the concurrent use of conventional and herbal medications affects liver and kidney function, by examining blood test data. Methods We retrospectively reviewed the electronic medical records of 590 inpatients with musculoskeletal diseases between 2013 and 2017. We investigated cases of drug-induced liver injury (DILI) according to the Roussel Uclaf Causality Assessment Method criteria and cases of drug-induced kidney injury (DIKI) based on the Kidney Disease Improving Global Outcomes definition. Results One case (0.17%) of DILI and one case (0.17%) of DIKI were identified. Significant improvements in serum laboratory data were observed after the concurrent use of both types of medications (p<0.05). The kappa coefficients ranged from 0.26 to 0.72, indicating that the values after the concurrent use of conventional and herbal medications showed a fair similarity to the baseline values of the patients. The linear regression test showed that female sex and high body mass index (BMI) were risk factors for an increase in the serum blood levels of liver function parameters. Conclusions The concurrent use of conventional and herbal medications for musculoskeletal disorders is relatively safe; however, clinicians should exercise caution when prescribing these medications to female patients and patients with a high BMI because of their potential effect on hepatic function.

Decision Making of Seismic Performance Management for the Aged Road Facilities Based on Road-Network and Fragility Curve (취약도곡선을 이용한 도로망기반 노후도로시설물 내진성능관리 의사결정)

  • Kim, Dong-Joo;Choi, Ji-Hae
    • Journal of the Korea institute for structural maintenance and inspection
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    • v.25 no.5
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    • pp.94-101
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    • 2021
  • According to the Facility Management System (FMS) operated by the Korea Authority of Land & Infrastructure Safety, it is expected that the number of aging facilities that have been in use for more than 30 years will increase rapidly to 13.9% in 2019 and 34.5% in 2929, and end up with a social problem. In addition, with the revision of "Common Application of Seismic Design Criteria" by the Ministry of Public Administration and Security in 2017, it is mandatory to re-evaluate all existing road facilities and if necessary seismic reinforcement should be done to minimize the magnitude of earthquake damage and perform normal road functions. The seismic performance management-decision support technology currently used in seismic performance management practice in Korea only determines the earthquake-resistance reinforcement priority based on the qualitative index value for the seismic performance of individual facilities. However with this practice, normal traffic functions cannot be guaranteed. A new seismic performance management decision support technology that can provide various judgment data required for decision making is needed to overcome these shortcomings and better perform seismic performance management from a road network perspective.