• Title/Summary/Keyword: Risk ratio

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A Case-Control Study for Risk Factor Related to Hypertension (고혈압의 위험요인에 대한 환자-대조군 연구)

  • Kam, Sin;Yeh, Min-Hae;Lee, Sung-Kook;Chun, Byung-Yeol
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.2 s.34
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    • pp.221-231
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    • 1991
  • A case-control study was conducted to investigate the risk factors (Part of job, Obesity, Alcohol, Smoking, Milk, Salt. and Family history) for hypertension. We selected 330 hypertension cases (male;247, female;83) and 1,336 controls (male;887, female;449) from employees in Taegu city from 1 May to 30 November, 1908. Data was analysed using a logistic regression model. Statistically significant elevated odds ratio were noted for alcohol (odds ratio=3.23), obesity (odds ratio=2.31), salt(odds ratio=1.75) in male (p<0.05) and those in female were noted for alcohol (odds ratio=16.49), family history(odds ratio=3.70), obesity (odds ratio=1.74) and salt (odds ratio=1.73) (p<0.05). Statistically significant reduced odds ratio was noted for milk in both sexes (odds ratio=0.69 for male and 0.65 for female)(p<0.05) and the dose-response relationship between milk intake and hypertension was confirmed (p<0.05). Therefore, milk seems to be preventive factor for hypertension. Smoking was not significantly associated with hypertension in both sexes. The part of job was significantly associated with hypertension in female by simple analysis (P<0.05) but the relationship was disappeared when multivariate analysis (logistic regression analysis) was done.

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The Relationship of Risk Assessment Using Braden Scale and Development of Pressure Sore in Neurologic Intensive Care Unit (Braden scale을 이용한 신경외과 중환자의 욕창 위험 요인 사정과 욕창 발생과의 관계)

  • Lee, Jong-Kyung
    • Korean Journal of Adult Nursing
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    • v.15 no.2
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    • pp.267-277
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    • 2003
  • Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

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Body Adiposity Index and Metabolic Syndrome Risk Factors in Korean Adults: A Comparison with Body Mass Index and Other Parameters

  • Shin, Kyung-A;Hong, Seung Bok;Shin, Kyeong Seob
    • Biomedical Science Letters
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    • v.23 no.2
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    • pp.57-63
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    • 2017
  • A new body adiposity index (BAI) has been proposed that is expected to replace body mass index (BMI). We evaluated the correlations between metabolic syndrome risk factors and BAI, BMI, and other adiposity indices, such as waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR), by sex in the Korean population. We also evaluated whether BAI would be useful to diagnose metabolic syndrome. A total of 20,961 Korean adults who underwent health examinations were included in this study. The metabolic syndrome diagnostic criteria used in this study were those set by the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI). In men (12,719), BMI and WHtR were more strongly correlated to metabolic syndrome risk than BAI, and in women (8,242), WHtR showed the strongest association with metabolic syndrome risk. BAI (area under the curve [AUC] = 0.678) presented lower discriminatory capacity than that of BMI (AUC = 0.836) for diagnosing metabolic syndrome. Moreover, BAI underestimated fat levels in men and women when considering the ability to discriminate overweight and obese individuals. In conclusion, WHtR and BMI in men, and WHtR in women may be better candidates than BAI to evaluate metabolic risk factors in Korean adults.

Effects of Metformin on Breast Cancer Risk and Mortality in Type 2 Diabetes Mellitus: A Systematic Review and Meta-analysis (제 2형 당뇨병 환자의 유방암 발생 위험 및 사망률에 대한 메트포민의 영향: 체계적 문헌고찰 및 메타분석)

  • Chun, Pusoon
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.3
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    • pp.131-137
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    • 2015
  • Background: The protective effect of metformin against breast cancer is inconclusive. Objective: To evaluate the effect of metformin on breast cancer risk and mortality in patients with type 2 diabetes. Method: A comprehensive literature search was performed for pertinent articles published prior to June 30, 2014, using PubMed and EMBASE. Study heterogeneity was estimated with $I^2$ statistic. The data from the included studies were pooled and weighted by random-effects model. The quality of each included study was assessed on the basis of the 9-star Newcastle-Ottawa Scale and publication bias was evaluated by visual inspection of a funnel plot. Results: Ten studies were included in the meta-analysis of the association of metformin and breast cancer risk. By synthesizing the data from the studies, the pooled odds ratio (OR) was 0.72 (95% CI: 0.59, 0.87) (p = 0.0005). Three cohort studies were included for meta-analysis of the association between metformin and breast cancer-related mortality. Metformin was associated with a significant decrease in mortality (Risk ratio: 0.68; 95% CI: 0.51, 0.90, p = 0.007). Conclusion: The present meta-analysis suggests that metformin appears to be associated with a lower risk of breast cancer incidence and mortality in patients with type 2 diabetes.

Role of the medical claims review (의적클레임검토의 역할 및 기능)

  • Lee, Sin-Hyung
    • The Journal of the Korean life insurance medical association
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    • v.26
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    • pp.31-39
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    • 2007
  • Background and main issue: In the Korean insurance market, an outstanding issue is the decrease of margin of risk ratio. This affects the solvency and profitability of insurance companies. Insurance medicine, which has been developed in Western countries, is so-called medical risk selection or medical underwriting. Medical risk selection is based on clinical follow-up study and mortality analysis methodology. Unfortunately, there have been few clinical follow-up studies, and no intercompany disease analysis system is available in the Korean insurance market. In practice, we use underwriting guidelines, which were developed by some global reinsurance companies. However, these guidelines were developed under clinical follow-up studies performed abroad. So, we cannot rule out underestimation of excess mortality factors such as mortality ratio, excess death rate, and life expectancy. It is necessary to perform medical assessment in claims administration. Comparing the insured's statement by medical records with products' benefit according to this procedure, we can make sound claim decisions and participate in the role of sound underwriting. We can call this scientific procedure as the verification of medical claims review. Another area of medical claims review is medical counsel for claims staff. Result: There is another insurance medicine in addition to medical risk selection. Independent medical assessment by medical records of insured is medical claims review. Medical claims review is composed of verification and counsel.

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Analysis of the Incidence of Macrosomia in Japan by Parental Nationalities at 5-year Intervals From 1995 to 2020

  • Tasuku Okui
    • Journal of Preventive Medicine and Public Health
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    • v.56 no.4
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    • pp.348-356
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    • 2023
  • Objectives: We investigated trends in the incidence rate of macrosomia and its association with parental nationalities using Vital Statistics data in Japan. Methods: We used singleton birth data every 5 years from 1995 to 2020. The incidence rate of macrosomia was calculated according to specific attributes (maternal age, infant's sex, parental nationalities, parity, and household occupation) over time (years). In addition, a log-binomial model was used to investigate the relationship between the incidence of macrosomia and the attributes. This study compared Korea, China, the Philippines, Brazil, and other countries with Japan in terms of parental nationalities. "Other countries" indicates countries except for Japan, Korea, China, the Philippines, and Brazil. Results: The study included 6 180 787 births. The rate of macrosomia in Japan decreased from 1.43% in 1995 to 0.88% in 2020, and the decrease was observed across all parental nationalities. The rates for Japanese parents were the lowest values among parental nationalities during the timespan investigated. Multivariate regression analysis showed that mothers from Korea, China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.91, 2.82, 1.59, 1.74, and 1.64, respectively). Furthermore, fathers from China, the Philippines, Brazil, and other countries had a significantly higher risk of macrosomia than those from Japan (risk ratio, 1.66, 1.38, 1.88, and 3.02, respectively). Conclusions: The rate of macrosomia decreased from 1995 to 2020 in Japan for parents of all nationalities, and the risk of macrosomia incidence was associated with parental nationality.

Assessment of the Optimum LDL : HDL-cholesterol(LDL : HDL-C) Ratio for Predicting CHD (심혈관질환 예측을 위한 저밀도 대 고밀도 지단백 콜레스테롤 비(LDL : HDL-cholesterol ratio)의 적정기준에 관한 연구)

  • Yeoum, Soon-Gyo
    • Korean Journal of Adult Nursing
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    • v.20 no.6
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    • pp.917-931
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    • 2008
  • Purpose: This study was aimed to determine the optimum low-density lipoprotein : high-density lipoprotein-cholesterol (LDL : HDL-C) ratio for predicting coronary heart disease(CHD) in Korean people. Methods: It was analyzed this data of 5,431 adults who had undergone health examinations in a hospital in Gyeonggi-do between January 2006 and December 2007. The covariation of the coronary risk factors such as age, HbA1C, systolic blood pressure(SBP), and waist-to-stature ratio(WSR) were analyzed by using logistic regression analysis. Results: The LDL : HDL-C ratio in the male and female groups was mostly distributed between 1.5 and 4.0. The LDL : HDL-C ratio was the most significant cholesterol-related parameter influencing CHD (male: B = .306, p = .054, female : B = .940, p = .010), followed by LDL-C and total cholesterol. It was observed a sharp increase in the odds ratios for LDL : HDL-C ratios of 2.25 - 2.50(male) and 2.00 - 2.25(female). A significant difference was observed in both male(2.25 : $x^2$ = 2.494, p = .072) and female(2.00 : $x^2$ = 413.742, p = .000) groups. Conclusion: The risk level of CHD was set to 2.25 for males and 2.00 for females. Therefore, the optimum LDL : HDL-C ratio for Koreans should be far lower than that for the people in western countries.

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Study on the Impact of the Private Credit Excess on the Credit Risk under the Massive Capital Inflows

  • Kim, Jong-Hee
    • East Asian Economic Review
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    • v.20 no.3
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    • pp.391-423
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    • 2016
  • By examining the relationship between private credit growth and the possibility of credit risk while focusing on international capital in 21 countries over the period 2000:1Q-2015:2Q, this paper shows that the impact of private credit growth on credit risk is apparent under the high ratio of capital inflows, and its impact on credit risk in the seven Asian countries is even stronger. And the possibility of credit risk caused by private credit is mainly coming from portfolio inflows rather than direct inflows. Finally, portfolio inflows strengthen the positive relationship between credit excess and credit risk in Asian countries, and this trend is seen more in these after the global financial crisis. Taken together, the stronger positive relationship between credit excess and credit risk can be strengthen under the massive portfolio inflows in particular in the seven Asian countries such as Hong Kong, India, Indonesia, Korea, Malaysia, Singapore, and Thailand.

Weight Control and Cardiovascular Risk in Middle-Aged Women (중년여성의 체중관리 실태와 성인병 위험도)

  • Kim, Jeong-Ah;Chaung, Seung-Kyo
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.1
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    • pp.33-47
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    • 2004
  • The purpose of this study was to investigate weight control practices and cardiovascular risk in middle-aged women. 304 middle-aged women were selected as subjects from thirties to fifthies living at J city in Chung-Buk Do. Data were collected using a questionnaire, anthropometric measurements, BP & total cholesterol level in serum from April 1, to June 30, 2003. The results of this study were as follows: The middle-aged woman's age is average $43.95{\pm}7.09yr$ and mean BMI(body mass index) was $23.54{\pm}3.09\;kg/m^2$. Underweight, normal weight, overweight, obese women were 3.0%, 39.5%, 27.9% and 29.6%respectively. Subjects perceived own as 'Slim' 5.9%, 'ordinary' 45.7%, 'Fat' 48.4%. Their weight perception coincide their own actual body weight but as many as 41.8% of overweight and 9.0% of obese perceived themselves as being 'ordinary'. Middle age women with past weight control experience were 55.6%, and only 35.5% was doing weight control at present. Of these subjects, 71.4% reported wanting to lose weight and the primary reason of weight control was to improve their appearance(39.53%). The most frequently reported weight control behavior was 'exercise' followed 'dieting', but 39.6% reported using 'diet food', 12.4% 'behavior modification', 12.4% 'fasting', and 'diet-drug'(3.6%) or 'smoking'(3.6%). Effective weight control methods were thought regular exercise(97.1%) & dieting (79.3%). And behavior modification(71.4%) or diet camp(60%) were effective, too. An average waist circumference was $79.80{\pm}9.47cm$, waist/hip ratio was $86.63{\pm}6.78$, waist/height ratio was $50.43{\pm}6.10$. In the index of abdominal obesity, 79.7 % of middle-aged women was waist/height ratio over 0.46, 65.3% was waist/hip ratio over 0.85, 28.4% was waist circumference over 85cm. There were significant differences in the degree of abdominal obesity according to age and BMI. In the index of cardiovascualr risk, 10.9% of middle aged women was systolic hypertension over 140mmHg, 18.7% was diastolic hypertension over 90mmHg and 10.6% was hypercholesterolemia over 200mg/dl. There was significant difference in systolic hypertension ratio according to age. There was significant difference in diastolic hypertension ratio according to age and obesity. There were significant differences in hypercholesterolemia accorting to obesity. The abdominal obesity indices and the levels of T-cholesterol in the serum, systolic and diastolic BP increased significantly according to age. T-cholesterol in serum was predicted 2.6% by waist/height ratio. And systolic BP was predicted 15.2% by waist/height, add BMI to 16.8%. Subject's diastolic BP was predicted 12.1% by BMI. Therefore waist/height ratio and BMI were significant factors for the predictors of cardiovascular risk. There was significant correlation between index of obesity and cardiovascular risk. T-cholesterol in serum had correlation with waist/eight ratio(r=0.174) and waist circumference(r=0.48). Systolic BP had correlation with waist/height ratio(r=0.387), and BMI(=0.371). diastolic BP correlation had correlation with BMI(r=0.343) and waist/height ratio(r=0.327). In conclusion, The prevalence of obesity was 29.6% in 304 cases, and increased as age after menopause increased. Middle-aged women's weight perception and actual BMI coincide but some of them did not. Trial to reduce weight was attempted. But most of them did not actually. Undesirable weight control method such as using drugs, fasting, smoking was used by some women. It is important to educate about health weight control methods and raise their awareness of exact body figures. High frequency of abdominal obesity in middle-aged women had correlation with hypertension and hypercholesterolemia. Abdominal index such as waist/height ratio, waist circumference, waist/hip ratio was used. Women's hypertension, hypercholesterolemia significantly related to body mass index and abdominal obesity.

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Development and Validation of a Breast Cancer Risk Prediction Model for Thai Women: A Cross-Sectional Study

  • Anothaisintawee, Thunyarat;Teerawattananon, Yot;Wiratkapun, Cholatip;Srinakarin, Jiraporn;Woodtichartpreecha, Piyanoot;Hirunpat, Siriporn;Wongwaisayawan, Sansanee;Lertsithichai, Panuwat;Kasamesup, Vijj;Thakkinstian, Ammarin
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6811-6817
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    • 2014
  • Background: Breast cancer risk prediction models are widely used in clinical practice. They should be useful in identifying high risk women for screening in limited-resource countries. However, previous models showed poor performance in derived and validated settings. Therefore, we aimed to develop and validate a breast cancer risk prediction model for Thai women. Materials and Methods: This cross-sectional study consisted of derived and validation phases. Data collected at Ramathibodi and other two hospitals were used for deriving and externally validating models, respectively. Multiple logistic regression was applied to construct the model. Calibration and discrimination performances were assessed using the observed/expected ratio and concordance statistic (C-statistic), respectively. A bootstrap with 200 repetitions was applied for internal validation. Results: Age, menopausal status, body mass index, and use of oral contraceptives were significantly associated with breast cancer and were included in the model. Observed/expected ratio and C-statistic were 1.00 (95% CI: 0.82, 1.21) and 0.651 (95% CI: 0.595, 0.707), respectively. Internal validation showed good performance with a bias of 0.010 (95% CI: 0.002, 0.018) and C-statistic of 0.646(95% CI: 0.642, 0.650). The observed/expected ratio and C-statistic from external validation were 0.97 (95% CI: 0.68, 1.35) and 0.609 (95% CI: 0.511, 0.706), respectively. Risk scores were created and was stratified as low (0-0.86), low-intermediate (0.87-1.14), intermediate-high (1.15-1.52), and high-risk (1.53-3.40) groups. Conclusions: A Thai breast cancer risk prediction model was created with good calibration and fair discrimination performance. Risk stratification should aid to prioritize high risk women to receive an organized breast cancer screening program in Thailand and other limited-resource countries.