• 제목/요약/키워드: Severity Score

검색결과 1,044건 처리시간 0.031초

CT Quantitative Analysis and Its Relationship with Clinical Features for Assessing the Severity of Patients with COVID-19

  • Dong Sun;Xiang Li;Dajing Guo;Lan Wu;Ting Chen;Zheng Fang;Linli Chen;Wenbing Zeng;Ran Yang
    • Korean Journal of Radiology
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    • 제21권7호
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    • pp.859-868
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    • 2020
  • Objective: To investigate the value of initial CT quantitative analysis of ground-glass opacity (GGO), consolidation, and total lesion volume and its relationship with clinical features for assessing the severity of coronavirus disease 2019 (COVID-19). Materials and Methods: A total of 84 patients with COVID-19 were retrospectively reviewed from January 23, 2020 to February 19, 2020. Patients were divided into two groups: severe group (n = 23) and non-severe group (n = 61). Clinical symptoms, laboratory data, and CT findings on admission were analyzed. CT quantitative parameters, including GGO, consolidation, total lesion score, percentage GGO, and percentage consolidation (both relative to total lesion volume) were calculated. Relationships between the CT findings and laboratory data were estimated. Finally, a discrimination model was established to assess the severity of COVID-19. Results: Patients in the severe group had higher baseline neutrophil percentage, increased high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and lower baseline lymphocyte count and lymphocyte percentage (p < 0.001). The severe group also had higher GGO score (p < 0.001), consolidation score (p < 0.001), total lesion score (p < 0.001), and percentage consolidation (p = 0.002), but had a lower percentage GGO (p = 0.008). These CT quantitative parameters were significantly correlated with laboratory inflammatory marker levels, including neutrophil percentage, lymphocyte count, lymphocyte percentage, hs-CRP level, and procalcitonin level (p < 0.05). The total lesion score demonstrated the best performance when the data cut-off was 8.2%. Furthermore, the area under the curve, sensitivity, and specificity were 93.8% (confidence interval [CI]: 86.8-100%), 91.3% (CI: 69.6-100%), and 91.8% (CI: 23.0-98.4%), respectively. Conclusion: CT quantitative parameters showed strong correlations with laboratory inflammatory markers, suggesting that CT quantitative analysis might be an effective and important method for assessing the severity of COVID-19, and may provide additional guidance for planning clinical treatment strategies.

환자분류체계를 이용한 NICU 입원 환아의 중증도 (The Severity of the Pediatric Patients admitted at NICU using Therapeutic Intervention Scoring System)

  • 김문실;문선영;이경숙;정유경;김신정
    • 간호행정학회지
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    • 제8권1호
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    • pp.5-15
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    • 2002
  • This study was attempted to help in explore new direction about classification of the severity of the pediatric patients admitted at NICU. Data were collected from 230 patients who admitted at Neonatal Intensive Care Unit of 3 University hospitals and 1 General hospital during 7 months period from september 1, 2000 to April 30, 2001. The results were as follows: 1. The degree of severity of the pediatric patients admitted at NICU shown ranged 1-102 and averaged 17.7. 2. With the respect to the severity of the pediatric patients admitted at NICU, there were statistically significant relation in passing day(s) to admission(r=-.153, p=.020), hospital day(s)(r-.501, p=.000), gestational age(r=-.354, p=.000), birth weight(r=-.280, p=.000), Apgar score at 1 min and at 5 min(4=-.340, p=.000; r=-.322, p=.000), present body weight(r=-.151, p=.023). 3. The severity of the pediatric patients according to general characteristics, there were significant difference in admitting day of the patients(t=2.339, p=.020), Apgar score at 1min and 5min(F=7.893, p=.000; t=3.568, p=.001).

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칠제향부환(七製香附丸)이 원발성(原發性) 월경통(月經痛) 환자(患者)의 복부(腹部) 온도(溫度)에 미치는 영향(影響) (The effect of Chiljehyangbuhwan on the abdominal temperature in the primary dysmenorrhea patients)

  • 이창훈;조정훈;장준복;이경섭;윤영진
    • 대한한방체열의학회지
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    • 제4권1호
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    • pp.29-38
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    • 2005
  • Purpose: We intended to observe the relations between Chiljehyangbuhwan and abdominal temperature according to primary dysmenorrhea severity. Methods: We selected the 100 primary dysmenorrhea patients by the screening tests (first screening test-inquiry, second screening test-clinical test, additionally WHR (Waist-to-Hip ratio) by Inbody 2.0). By the fixed blocked randomization and double blind method, Chiljehyangbuhwan or placebo was administered for 1 menstration period. Finally, 69 patients remainded. Before and after administration, we measured 4 points abdominal temperature (Chon-jung(CV17), Chung-wan(CV12), Kwan-won(CV4), Chung-guk(CV3)) by DITI (DOREX Inc., USA). And then we checked the difference of temperature $({\Delta}T)$ between CV17 and CV12 / CV17 and CV4 / CV17 and CV3 / CV12 and CV4 / CV12 and CV3. After that, we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by VRS (verbal rating scale) and MVRS (multidimensional verbal rating scale). In dysmenorrhea severity, we standardized scale score and 3-group-severity by score (mild, moderate, severe). For statistics, we used Pearson correlations and Spearman's rho correlations, SPSS 11.0 for windows. Results: In case of MVRS, Chiljehyangbuhwan was correlated to ${\Delta}T$ (CV12 and CV3 / CV12 and CV4). In case of VRS, Chiljehyangbuhwan was not correlated to ${\Delta}T$. Statistically they showed significant result (p<0.05). Conclusion: The primary dysmenorrhea patients showed that severity by MVRS was connected with ${\Delta}T$ (CV12 and CV3 / CV12 and CV4) after Chiljehyangbuhwan administration. So we can consider Chiljehyangbuhwan effects the abdominal temperature according primary dysmenorrhea severity.

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응급의료센터 성과 평가 기준개발과 적용 (Performance Evaluation of Emergency Medical Center)

  • 강철환;김윤;이평수;권영대;김창엽;신영수
    • Journal of Preventive Medicine and Public Health
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    • 제30권4호
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구 (The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion)

  • 정호형;한상균;이성화;박성욱;박순창;염석란;민문기;김용인;류지호
    • Journal of Trauma and Injury
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    • 제27권4호
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    • pp.108-114
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    • 2014
  • Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.

체간 안정화 운동과 고관절 운동이 만성 요통 환자의 허리가동범위, 통증, 장애정도에 미치는 영향 (Effects of Trunk Stability Exercise and Hip Exercise on Lumbar Range of Motion, VAS, Disability Chronic Low Back Pain Patients)

  • 박찬호;양영식;정용식
    • 대한정형도수물리치료학회지
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    • 제28권2호
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    • pp.45-55
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    • 2022
  • Background: This study compared the effects of trunk stabilization exercise and hip joint exercises on the range of motion of the lumbar spine, pain severity, and severity of disability in patients with chronic lower back pain. Methods: A total of 30 participants were enrolled and divided into group 1 (n=10), group 2 (n=10), and group 3 (n=10) were performed by each group thrice a week for a total of 8 weeks. Group 1 performed warm-up exercise (15 min), trunk stabilization exercise (25 min), finish-up exercise (15mins). Group 2 performed warm-up exercise (15 min), hip exercise (25 mins, finish-up exercise (15mins). Group 3 warm-up exercise (15 min), trunk stabilization and hip exercise (25 min), Finish-up exercise (15 min). Participants were assessed for the range of motion of the lumbar spine, pain severity (visual analog scale score; VAS), and severity of disability (Oswestry disability index score; ODI) before and after the interventions. Results: All three groups showed a significant increase in the range of motion of the lumbar spine, but there was no significant difference among the groups. Moreover, the severity of pain and ODI were significantly decreased in all groups; however, the intergroup differences were non-significant. Conclusion: The results from this study confirmed the effectiveness of trunk stabilization and hip joint exercise in improving the lumbar range of motion, pain severity, and chronic lower back pain in patients. Thus, trunk and pelvic stabilization exercises and hip joint exercise can be used as clinical practices to treat and prevent chronic lower back pain.

혈청 콜린에스테라제 활성도를 이용하여 유기인계 농약 음독 환자의 증증도를 예측할 수 있는가? (Is it Meaningful to Use the Serum Cholinesterase Level as a Predictive Value in Acute Organophosphate Poisoning?)

  • 이상진;정진희;정구영
    • 대한임상독성학회지
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    • 제2권2호
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    • pp.72-76
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    • 2004
  • Purpose: Dealing patients with organophosphate poisoning, cholinesterase level has been used as a diagnostic and prognostic value. But there are some controversies that the cholinesterase level is significantly related to the severity or prognosis of acute organophosphate poisoning. We evaluated the correlation between initial serum level of cholinesterase and APACHE II score as an index for severity, and we assessed cholinesterase levels for predicting value of weaning from mechanical ventilation. Method: From August 1996 to March 2003, 23 patients with organophosphate poisoning who needed ventilatory care were enrolled. Retrospective review was done for the serum level of cholinesterase, APACHE II score, and the duration of ventilatory care. The percentage of measured serum cholinesterase to median normal value was used to standardize cholinesterase levels from different laboratories. Result: There were tendencies that the lower initial serum of cholinesterase, the higher the APACHE II score (r=0.297) and the longer the duration of mechanical ventilation (r=-0.204), but they were not significant (p=0.264 and p=0.351 respectively). In 9 patients whose serum cholinesterase level were checked at the time of weaning, mean of measured cholinesterase level was $10.3\pm7.60\%$ of normal value. Conclusion: There was no significant relationship between initial level of serum cholinesterase and severity or duration of mechanical ventilation. General health status of patient, amount of ingestion, toxicity of agent should be considered as important factors for severity of poisoning. And the decision of weaning should be based not solely on the cholinesterase level but on the consideration of general and respiratory state of individual patients.

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아토피 피부염에 대한 임상적 연구 (A Clinical Study on Atopic Dermatitis)

  • 남봉수;조재훈;김윤범;채병윤
    • 대한한의학회지
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    • 제21권4호
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    • pp.204-215
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    • 2000
  • Objectives: This study was conducted to establish the study form of atopic dermatitis in oriental medicine, to find out the effect of herbal medicine and to compare Bangpungtongsungsan group with symptom-complexes prescription group. Methods: We gave scores(1-3) to the 37 outpatients who visited the dept. of Ophthalmotolaryngology & Dermatosurgery of the Kyunghee Oriental Medical Center from June 1,2000 to September 30, 2000. According to transformed the G. Rajka, T. Langeland and Jon M. Hanifin standard. We checked the Eosinophil count, IgE and the scores (intensity: the degree of itching, course: the degree of itching during a year, extent: erythema, lichenification, scaling. dryness, erosion' oozing). After herbal treatment for 6 weeks, we checked the above factors again in the same way. In treatment, we divided the patients into Bangpungtongsungsan group and Symptom-complexes group for cross-comparison. Results: There were 19 patients we could check by score and 14 patients by laboratory. 1. In the 14 lab cases, the number of abnormal value of Eosinophil count and IgE was decreased but it was not significant. 2. In the 19 cases by score, clinical severity of the intensity of itching, lichenification, scaling' dryness was significantly decreased between the before- and after-herbal treatment periods (P<0.01, P<0.01, P<0.05). 3. In 19 cases, clinical severity of erythema, erosion. oozing was decreased after herbal treatment but it was not significant(p>0.05). 4. In point of total score, clinical severity of atopic dermatitis was significantly decreased after herbal treatment(p<0.01). 5. There was no significant difference between Bangpungtongsungsan group and Symptom-complexes group(P<0.05). Conclusions: Although more study is needed, these results indicate that herbal treatment is effective on atopic dermatitis.

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30-40대 여성의 미병상태에 따른 월경양상 비교연구 (A Study on comparison of menstrual pattern according to Mibyeong Index of Korean women in their thirties and forties)

  • 박민영;오현주;황민우
    • 대한예방한의학회지
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    • 제23권1호
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    • pp.61-72
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    • 2019
  • Introduction : The aim of this study was to investigate menstrual pattern according to Mibyeong Index(MBI) and compare Mibyeong symptom score according to severity of menstrual pain. Mibyeong Index was designed to measure inconvenience and resilience of subject's complains including four physical symptoms(fatigue, pain, low sleep quality, indigestion) and mental distress including anxiety, anger, depression. Method : We used the clinical data of Korean medicine Date Center(KDC) for subjects who participated in the study of 'Clinical research for collecting of clinical cases based on the personal type of Mibyeng' conducted in Seoul, from June 26, 2015 to June 26, 2017. A total of 566 fertile women aged 30 to 50 who completed the questionnaires were included in this study. In this study, we used items of Mibyeong Index and the menstrual pattern by self-report questionnaires. The date were analyzed through Kruskal Wallis test, Pearson's chi-square test, and one-way ANOVA using SPSS statistics 19.0. Results : Mibyeong status was significantly associated with severity of menstrual pain(p<0.001), worst day of menstrual pain(p<0.05), and type of menstrual pain(low back pain, nausea, depression, and none (respectively, p<0.05)). In addition, The 7-subtype score (fatigue (p<0.001), pain(p<0.001), low sleep quality(p<0.001), indigestion(p<0.001), anxiety(p<0.05), anger(p<0.05) and depression(p<0.05)) of Mibyeong index and total score of Mibyeong Index (p<0.001) showed significant difference for severity of menstrual pain. Conclusion : This result indicates that a close relationship between Mibyeong status and severity of menstrual pain. Further studies are needed but, we hope that this results will be used as the basic data to improve mibyeong status through health care to alleviate dysmenorrhea.

관상동맥우회술의 중증도 측정과 병원 사망률 비교에 관한 연구 (Severity Measurement Methods and Comparing Hospital Death Rates for Coronary Artery Bypass Graft Surgery)

  • 안형식;신영수;권영대
    • Journal of Preventive Medicine and Public Health
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    • 제34권3호
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    • pp.244-252
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    • 2001
  • Objective : Health insurers and policy makers are increasingly examining the hospital mortality rate as an indicator of hospital quality and performance. To be meaningful, a risk-adjustment of the death rates must be implemented. This study reviewed 5 severity measurement methods and applied them to the same data set to determine whether judgments regarding the severity-adjusted hospital mortality rates were sensitive to the specific severity measure. Methods : The medical records of 584 patients who underwent coronary artery bypass graft surgery in 6 general hospitals during 1996 and 1997 were reviewed by trained nurses. The MedisGroups, Disease Staging, Computerized Severity Index, APACHE III and KDRG were used to quantify severity of the patients. The predictive probability of death was calculated for each patient in the sample from a multivariate logistic regression model including the severity score, age and sex to evaluate the hospitals' performance, the ratio of the observed number of deaths to the expected number for each hospital was calculated. Results : The overall in-hospital mortality rate was 7.0%, ranging from 2.7% to 15.7% depending on the particular hospital. After the severity adjustment, the mortality rates for each hospital showed little difference according to the severity measure. The 5 severity measurement methods varied in their statistical performance. All had a higher c statistic and $R^2$ than the model containing only age and sex. There was a little difference in the relative hospital performance evaluation by the severity measure. Conclusion : These results suggest that judgments regarding a hospital's performance based on severity adjusted mortality can be sensitive to the severity measurement method. Although the 5 severity measures regarding hospital performance concurred, more often than would be expected by chance, the assessment of an individual hospital mortality rates varied by the different severity measurement method used.

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