• Title/Summary/Keyword: Risk Sensitivity

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Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit (외상중환자의 욕창 위험사정 도구의 타당도 비교)

  • Choi, Ja Eun;Hwang, Sun-Kyung
    • Journal of Korean Critical Care Nursing
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    • v.12 no.2
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    • pp.26-38
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    • 2019
  • Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

Association between obesity and high-sensitivity C-reactive protein in Korean adults without cardiovascular disease

  • Heashoon, Lee
    • Journal of Korean Biological Nursing Science
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    • v.25 no.1
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    • pp.32-42
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    • 2023
  • Purpose: This study aimed to investigate the association between obesity and high-sensitivity C-reactive protein (hs-CRP) levels in Korean adults without cardiovascular disease (CVD). Methods: The subjects were 3,634 adults, and data were extracted from the seventh Korea National Health and Nutrition Examination Survey (KNHANES VII-3). A complex sampling design analysis was applied to reflect the stratified and clustered weights. The data were analyzed using the complex sample Rao-Scott chi-square test and multiple logistic regression analysis (in SPSS for Windows version 26.0). Obesity, according to body mass index (BMI), was defined as obesity (BMI = 25-29.9 kg/m2), high obesity (BMI = 30-34.9 kg/m2), and super-high obesity (BMI ≥ 35 kg/m2), and abdominal obesity (AO) was defined as a waist circumference (WC) ≥ 90 cm in males and WC ≥ 85 cm in females. Results: The odds ratios for moderate CVD risk (hs-CRP; 1-3 mg/dL) were 2.21, 4.16, and 7.13 in the obesity, high obesity, and super-high obesity groups, respectively, compared to the normal BMI group. The odds ratio for moderate CVD risk was 2.18 in males with AO and 1.88 in females with AO. The odds ratios for high CVD risk (hs-CRP > 3 mg/L) were 4.40 and 17.55 in the high obesity and super-high obesity groups, respectively, compared to the normal BMI group. Conclusion: This study provides evidence that early detection and prevention programs for CVD should include obesity-related interventions aiming to modulate hs-CRP.

Microbial Modeling in Quantitative Risk Assessment for the Hazard Analysis and Critical Control Point (HACCP) System: A Review

  • Min, Sea-Cheol;Choi, Young-Jin
    • Food Science and Biotechnology
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    • v.18 no.2
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    • pp.279-293
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    • 2009
  • Quantitative risk assessments are related to implementing hazard analysis and critical control points (HACCP) by its potential involvement in identifying critical control points (CCPs), validating critical limits at a CCP, enabling rational designs of new processes, and products to meet required level of safety, and evaluating processing operations for verification procedures. The quantitative risk assessment is becoming a standard research tool which provides useful predictions and analyses on microbial risks and, thus, a valuable aid in implementing a HACCP system. This paper provides a review of microbial modeling in quantitative risk assessments, which can be applied to HACCP systems.

Study on the Inundation Risk Evaluation by the Relationship Analysis (다양한 침수인자간의 상관관계 분석을 통한 침수위험지역 예측)

  • Choi, Sung-Wook;Jun, Hwan-Don;Park, Moo-Jong
    • 한국방재학회:학술대회논문집
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    • 2008.02a
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    • pp.115-118
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    • 2008
  • In this study, PROMETHEE(Preference Ranking Organization METHod for Enrichment Evaluations) which is one of the multi criteria decision making methods is applied to estimate the relative inundation risk of the urban subcatchment. For this purpose, five factors which have an effect on the inundation risk are selected and used to perform PROMETHEE. Those are elevation average, slope average, density of conduit, population and sediment yields per unit area of each subcatchment. Based on them, PROMETHEE is performed and the relative inundation risk for each subcatchment is estimated. Sensitivity anlysis is conducted to evaluate each factor's effect on subcatchment and it is found that suggested method can be used to establish a practical guide to mitigate the inundation.

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The Relationship Between Lumbar Spine Bone Mineral Density and Cardiovascular Risk Factors in Premenopausal and Postmenopausal Women (폐경 전후 여성의 요추 골밀도와 심혈관 위험인자와의 연관성)

  • Kim, Mi-Young
    • Journal of radiological science and technology
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    • v.30 no.4
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    • pp.365-371
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    • 2007
  • Recent studies suggest a possible pathogenic linkage between the osteoporosis and atherosclerosis. We investigated the relationship between cardiovascular risk factors, including high sensitivity C-reactive (hs-CRP), hs-CRP and bone metabolism in females. Anthropometric measurements were performed on 300 women, and cardiovascular risk factors, including fasting blood glucose, lipid profiles and hs-CRP. An atherogenic index was calculated using the serum total cholesterol level divided by the high-density lipoprotein cholesterol level. The lumbar spine bone mineral density was measured using dual X-ray abosorptiometry. By bivariate analysis, the lumbar spine BMD showed negative correlations with age, systolic and diastolic blood pressures, serum total cholesterol, high-density lipoprotein cholesterol. The Age, BMI and high-density lipoprotein cholesterol showed significant correlations with the lumbar spine BMD. From linear regression analyses of all the study subjects, age, high-density lipoprotein cholesterol were found to be determinants of the lumbar spine BMD($R^2=0.272$).

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The Effects of Driving Behavior Determinants on Dangerous Driving and Traffic Accidents in the Reckless Drivers Group: A Path Analysis Study (사고 및 음주운전자들의 운전행동결정요인 특성이 위험행동 및 교통사고에 미치는 영향: 경로분석 연구)

  • O, Ju-Seok;Lee, Sun-Cheol
    • Journal of Korean Society of Transportation
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    • v.25 no.2 s.95
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    • pp.95-105
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    • 2007
  • Speeding and drunken driving make drivers fail to detect hazards and cope with various driving situations. These behaviors also raise the possibility of being involved in traffic accidents and tend to increase the number of fatalities. The authors compared the driving behavior determinants of a rockless drivers group, consisting of individuals who have committed traffic accidents or offended regulations through drunken driving, with a normal drivers group. In the results, the reckless drivers group showed high scores of 'speeding' and 'drunken driving', and they also stated that they had more experiences of speeding, drunken driving and traffic accidents. In the path analysis study, it was found that the impacts of the rockless drivers group's 'risk sensitivity' and 'situational adaptability' on traffic accidents were stronger than those of normal drivers. This means 'risk sensitivity' and 'situational adaptability' can explain the origins of traffic accidents better in the reckless drivers group than accidents of the normal drivers group.

External Validation of Carbapenem-Resistant Enterobacteriaceae Acquisition Risk Prediction Model in a Medium Sized Hospital (중규모 종합병원 대상 카바페넴 내성 장내세균속균종(Carbapenem-resistant Enterobacteriaceae) 획득위험 예측모형의 외적타당도 평가)

  • Seo, Su Min;Jeong, Ihn Sook
    • Journal of Korean Academy of Nursing
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    • v.50 no.4
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    • pp.621-630
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    • 2020
  • Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

Comparison of the Predictive Validity of the Pressure Injury Risk Assessment in Pediatric Patients: Braden, Braden Q and Braden QD Scale (소아 환자에서 욕창 위험도 사정 도구의 예측타당도 비교: Braden, Braden Q 및 Braden QD 도구)

  • Kang, Ji Hyeon;Lim, Eun Young;Lee, Nam Ju;Yu, Hye Min
    • Journal of Korean Clinical Nursing Research
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    • v.30 no.1
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    • pp.35-44
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    • 2024
  • Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.