• Journal of Korean Neurosurgical Society
• /
• 제64권5호
• /
• pp.791-798
• /
• 2021

Objective : The period of mechanical ventilator (MV)-dependent respiratory failure after cervical spinal cord injury (CSCI) varies from patient to patient. This study aimed to identify predictors of MV at hospital discharge (MVDC) due to prolonged respiratory failure among patients with MV after CSCI. Methods : Two hundred forty-three patients with CSCI were admitted to our institution between May 2006 and April 2018. Their medical records and radiographic data were retrospectively reviewed. Level and completeness of injury were defined according to the American Spinal Injury Association (ASIA) standards. Respiratory failure was defined as the requirement for definitive airway and assistance of MV. We also evaluated magnetic resonance imaging characteristics of the cervical spine. These characteristics included : maximum canal compromise (MCC); intramedullary hematoma or cord transection; and integrity of the disco-ligamentous complex for assessment of the Subaxial Cervical Spine Injury Classification (SLIC) scoring. The inclusion criteria were patients with CSCI who underwent decompression surgery within 48 hours after trauma with respiratory failure during hospital stay. Patients with Glasgow coma scale 12 or lower, major fatal trauma of vital organs, or stroke caused by vertebral artery injury were excluded from the study. Results : Out of 243 patients with CSCI, 30 required MV during their hospital stay, and 27 met the inclusion criteria. Among them, 48.1% (13/27) of patients had MVDC with greater than 30 days MV or death caused by aspiration pneumonia. In total, 51.9% (14/27) of patients could be weaned from MV during 30 days or less of hospital stay (MV days : MVDC 38.23±20.79 vs. MV weaning, 13.57±8.40; p<0.001). Vital signs at hospital arrival, smoking, the American Society of Anesthesiologists classification, Associated injury with Injury Severity Score, SLIC score, and length of cord edema did not differ between the MVDC and MV weaning groups. The ASIA impairment scale, level of injury within C3 to C6, and MCC significantly affected MVDC. The MCC significantly correlated with MVDC, and the optimal cutoff value was 51.40%, with 76.9% sensitivity and 78.6% specificity. In multivariate logistic regression analysis, MCC >51.4% was a significant risk factor for MVDC (odds ratio, 7.574; p=0.039). Conclusion : As a method of predicting which patients would be able to undergo weaning from MV early, the MCC is a valid factor. If the MCC exceeds 51.4%, prognosis of respiratory function becomes poor and the probability of MVDC is increased.

• 대한원격탐사학회지
• /
• 제37권2호
• /
• pp.257-274
• /
• 2021

고해상도 원격탐사 영상의 객체기반 분석에서 영상분할의 결과는 매우 중요한 부분이지만, 영상분할품질의 평가는 간과되고 있다. 본 연구에서는 영상분할의 최적 매개변수를 구하기 위한 실용적이고 효율적인 방법을 제시하고자 한다. 영상분할 평가는 크게 무감독 평가, 감독 평가, 그리고 시각적 판독에 의한 정성적 평가로 나눈다. 인천대공원 무인기 다중분광영상에서 추출한 도시 지역과 산림을 대상으로 세 가지 영상분할 평가 방법을 비교하였다. 영상분할 평가 방법은 계산 및 적용의 효율성에 따라 차이가 있지만, 표본영상에 대한 평가 결과 도출된 최적의 매개변수는 세 평가 방법에서 거의 동일하게 나타났다. 영상분할 평가를 통하여 도출된 최적의 매개변수는 도시영상과 산림영상에서 다르게 나타났다. 세 가지 조각 내부변이 척도(V, WV, COV)와 세 가지 조각간 이질성 척도(MI, BSH, DTNP)의 조합을 적용한 무감독 평가로 선정한 최적의 매개변수는 거의 같았다. 무감독 평가를 위한 척도마다 처리 과정의 난이도는 다르지만, 실험에 적용된 여러 종류의 척도는 대부분 동일한 성능을 보여주었다. 감독 평가 방법은 참조자료를 구성하는 과정에서 분석자의 주관으로 편향될 가능성이 있지만, 특정 공간객체를 탐지하는 데 간편하게 적용할 수 있다. 정성적 평가는 무감독 및 감독 평가 결과와 일치했다.