• Title/Summary/Keyword: Severity Score

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The Assessment of Severity Adjustment Measures for AMI Patients in Korea (급성심근경색증 환자를 대상으로 한 중증도 보정 방법의 평가)

  • Park, Hyeung-Keun
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.164-175
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    • 2003
  • Objectives: To evaluate the performance of models to predict AMI patients death using severity adjustment measures in Korea. Methods: Medical records of 861 patients treated by AMI in 7 general hospitals during 1996 and 1997 were reviewed by trained nurses. We measured the severity of patients by APACHE III, MedisGroups, CSI and DS. Using each severity method a predictive mortality for each patient was calculated from a logistic regression model including the severity score. The statistical performance of each severity method model was evaluated by using c-statistics and R2. For each hospital, z scores compared actual and expected mortality rates. Results: The overall in-hospital mortality was 14.5%, ranged from 10.0% to 22.2%. The distributions of severity scores for each method was significantly different by hospitals. The four severity-adjusted models to predict AMI patients death varied in their statistical performance for discrimination power of patients death. Order of Severity-adjusted mortality rates and z scores by four severity measures was different. Conclusion: Severity-adjusted mortality rates of AMI patients might be applied as an indicator for hospital performance evaluation in Korea. Because different severity methods frequently produce different impressions about relative hospital performance, more studies has to be done to use it as quality indicator and more attention should be paid to select appropriate severity measures.

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CORRELATION BETWEEN DEPRESSION OF MOTHERS WITH AUTISTIC CHILDREN AND SEVERITY OF AUTISTIC SYMPTOMS OF THEIR CHILDREN (자폐장애아 어머니의 우울정도와 그들 자녀의 자폐증상간의 상관관계)

  • Kwak, Young-Sook;Lee, Soo-Kyung;Kang, Kyung-Mi
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.9 no.2
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    • pp.148-153
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    • 1998
  • Objectives:This study investigated the severity and frequency of depression in mothers with autistic children and the correlation between K-BDI score of mothers with autism and severity of autistic symptoms of their children. Methods:The subjects for this study consisted of 45 autistic children and their mothers. The severity of autistic symptoms of children were evaluated by K-CARS and severity of depressive symptoms of mothers with autistic children evaluated by the K-BDI. Results:1) Total K-BDI scores of mothers with autistic children were $17.3{\pm}10.9$ and this score was belonged to subclinical depression on the K-BDI STEN score. There were significant differences of total KBDI score between in mothers with autistic children and in those of normal control. The 26.7% of 45 mothers with autistic children were depression. 2) There was no correlation between total K-BDI score and each factor of mothers with autistic children and K-CARS score of the their children. Conclusion:There were many depression in mothers with autistic children than in those of normal control. This result suggested that the education and the supportive psychotherapy for mothers with autistic children is as important as the treatment for autism.

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A Study on the Differentiation of Women with Perimenstrual Symptom Severity and Perimenstrual Distress Patterns (월경 전후기 증상 정도 및 월경고통 유형 판별요인)

  • Park, Young-Joo;Ryu, Ho-Shin
    • Women's Health Nursing
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    • v.4 no.1
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    • pp.123-138
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    • 1998
  • The purpose of this study was to describe perimenstrual symptom severity levels and perimenstrual distress patterns of women. The study performed the discriminant analysis in which included seven factors : age, pariety, social support, menstrual socialization(mother's symptom, sister's symptom, and menstrual effect), attitude of sex role and depression. The subjects were 283 women that they were not pregnant or lactating, had at least one period in past three months, would understand the purpose of study and willingly accepted the participation. The data analysis was done by pc-SAS program after data collection from Nov. 20, 1997 to Dec. 18, 1997. The descriptive analysis was done to explore general characteristics of the subjects and the stepwise discriminant analysis was done to verify factors in relation to perimenstrual symptom severity levels(severe vs mild menstrual symptom group) and perimenstrual distress patterns(spasmodic vs congestive menstrual symptom group). The instruments were selected for this study from Interpersonal Support Evaluation List(ISEL) by Cohen and Hoberman(1983), Center for Epidemic Studies Depression(CES-D) by Radloff(1977), and Sex Role Attitude Scale by Yunok Suh(1995), Mother's symptom and sister's symptom measurements by Woods, Mitchell & Lentz(1995), and menstrual effect by Brooks-Gun & Ruble(1980). The major findings of this study are as follows : 1. Of the 283 women, 93 women(32.9%) were assessed to severe perimenstrual symptom group and 190 women(67.1%) were assessed to mild perimenstrual symptom group. Results from the stepwise discriminant analysis showed three factors, such as depression, menstrual effect, and age, significantly related to perimenstrual symptom severity and they explained 20% of the total variance. The linear discriminant equation included three factors related to perimenstrual symptom groups was showed(Z=1.445 depression+0.174 menstrual effect-0.054 age). The cutting score(Z) was 2.809. We classified the severe perimenstrual symptom group by more than the cutting score 2.809 and the mild perimenstrual symptom by less or equal than the cutting score 2.809. The correctedness of posterior probability from discriminant equation was 72% as two perimenstrual symptom group classifications. 2. Of the 264 women, 139 women(52.7%) were assessed to spasmodic perimenstrual distress group and women(47.3%) were assessed to congestive perimenstrual distress group. Results from the stepwise discriminant analysis showed two factors, such as depression, age, significantly related to perimenstrual distress groups and they explained 8% of the total variance. The linear discriminant equation included two factors related to perimenstrual distress group was showed(Z=-0.084 age-0.776 depression). The cutting score(Z) was -3.759. We classified the spasmodic perimenstrual distress group by more than cutting score -3.759 and the congestive perimenstrual distress group by less or equal than cutting score -3.759. The correctedness of posterior probability from discriminant equation was 65% as two perimenstrual distress group classifications.

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Working Conditions Related to Cumulative Trauma Disorder and Symptoms of Cumulative Trauma Disorder in Furniture Company Employees (가구회사 근무자들의 누적외상성장애 관련 작업조건과 누적외상성장애 증상)

  • Moon Jung Soon;Kwon Eun Ha
    • Journal of Korean Public Health Nursing
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    • v.17 no.2
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    • pp.266-277
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    • 2003
  • In order to investigate the working conditions related to cumulative trauma disorder(CTD) and symptoms of CTD, a survey was conducted covering 305 employees who were working in three furniture manufacturing companies in Kyungin area. Data were collected by using questionnaire of the Personal Ergonomics Profiles. The results were as follows : 1. The mean score of working conditions related to CTD was 0.95. The mean score of working conditions for labor workers were significantly higher than that of clerical workers. Among 4 factors of working conditions, the higher score were shown in the working and environment factors with 1.22 and 1.18, respectively. 2. Symptom prevalence rate of CTD for workers was $81.0\%\;{;}\;82.9\%$ for labor workers and $77.0\%$ for clerical workers. As for symptom of CTD in body part, higher rate were shown in lower back with $50.2\%$, shoulder and neck with $38.4\%\;and\;36.4\%$ respectively. 3. The score of symptom severity of CTD were 3.45. Significant difference was shown in symptom severity of forearm and wrist/hand part between labor and clerical workers. As for symptom severity of CTD in body part the higher score were shown in shoulder, ankle/foot, forearm. lower leg and elbow. and the highest score for labor workers were shoulder and ankle/foot and for clerical workers was lower back. 4. As a whole, symptom of CTD for workers positively correlated to working conditions. 5. Symptom of CTD for workers seemed to be significantly influenced by working factor, sex, working duration and working area factor.

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Validity of the scoring system for traumatic liver injury: a generalized estimating equation analysis

  • Lee, Kangho;Ryu, Dongyeon;Kim, Hohyun;Jeon, Chang Ho;Kim, Jae Hun;Park, Chan Yong;Yeom, Seok Ran
    • Journal of Trauma and Injury
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    • v.35 no.1
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    • pp.25-33
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    • 2022
  • Purpose: The scoring system for traumatic liver injury (SSTLI) was developed in 2015 to predict mortality in patients with polytraumatic liver injury. This study aimed to validate the SSTLI as a prognostic factor in patients with polytrauma and liver injury through a generalized estimating equation analysis. Methods: The medical records of 521 patients with traumatic liver injury from January 2015 to December 2019 were reviewed. The primary outcome variable was in-hospital mortality. All the risk factors were analyzed using multivariate logistic regression analysis. The SSTLI has five clinical measures (age, Injury Severity Score, serum total bilirubin level, prothrombin time, and creatinine level) chosen based on their predictive power. Each measure is scored as 0-1 (age and Injury Severity Score) or 0-3 (serum total bilirubin level, prothrombin time, and creatinine level). The SSTLI score corresponds to the total points for each item (0-11 points). Results: The areas under the curve of the SSTLI to predict mortality on post-traumatic days 0, 1, 3, and 5 were 0.736, 0.783, 0.830, and 0.824, respectively. A very good to excellent positive correlation was observed between the probability of mortality and the SSTLI score (γ=0.997, P<0.001). A value of 5 points was used as the threshold to distinguish low-risk (<5) from high-risk (≥5) patients. Multivariate analysis using the generalized estimating equation in the logistic regression model indicated that the SSTLI score was an independent predictor of mortality (odds ratio, 1.027; 95% confidence interval, 1.018-1.036; P<0.001). Conclusions: The SSTLI was verified to predict mortality in patients with polytrauma and liver injury. A score of ≥5 on the SSTLI indicated a high-risk of post-traumatic mortality.

Case Report of Acute Bronchitis Treated with Dojukgangki-tang (도적강기탕(導赤降氣湯)을 투여한 급성기관지염 치험 3례)

  • Kim, Kitae
    • The Journal of Internal Korean Medicine
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    • v.39 no.5
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    • pp.1068-1074
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    • 2018
  • Objectives: Acute bronchitis is a common inflammatory disease with symptoms related to temporary inflammation of the airways. It is caused by a viral infections in over 95% of cases. A small minority of cases are caused by bacteria; however, there is little evidence that antibiotics are effective in the treatment of the condition. This report is a case of administering Dojukgangki-tang to three patients with acute bronchitis. Methods: Patients diagnosed with acute bronchitis were treated with Dojukgangki-tang, and the effects were studied using the bronchitis severity scale (BSS) and acute bronchitis severity scale (ABBS). Results: After treatment with Dojukgangki-tang for 2 weeks, average BSS score changed from $11.33{\pm}2.08$ to $1.67{\pm}1.15$. Average ABSS score decreased from $9.00{\pm}3.00$ to $2.00{\pm}1.00$. Conclusions: This study suggests that Dojukgangki-tang is effective in relieving coughs and sputum related to acute bronchitis.

Comparative Analysis of the Accuracy of Severity Scoring Systems for the Prediction of Healthcare Outcomes of Intensive Care Unit Patients (중환자실 환자의 건강결과 예측을 위한 중증도 평가도구의 정확도 비교분석)

  • Seong, Ji-Suk;So, HeeYoung
    • Journal of Korean Critical Care Nursing
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    • v.8 no.1
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    • pp.71-79
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    • 2015
  • Purpose: The purpose of this study was to compare the applicability of the Charlson Comorbidity Index (CCI) and Acute Physiology, Age, Chronic Health Evaluation III (APACHE III) to the prediction of the healthcare outcomes of intensive care unit (ICU) patients. Methods: This research was performed with 136 adult patients (age>18 years) who were admitted to the ICU between May and June 2012. Data were measured using the CCI score with a comorbidity index of 19 and the APACHE III score on the standard of the worst result with vital signs and laboratory results. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under an ROC curve (AUC). Calibration was performed using logistic regression. Results: The overall mortality was 25.7%. The mean CCI and APACHE III scores for survivors were found to be significantly lower than those of non-survivors. The AUC was 0.835 for the APACHE III score and remained high, at 0.688, for the CCI score. The rate of concordance according to the CCI and the APACHE III score was 69.1%. Conclusion: The route of admission, days in ICU, CCI, and APACHE III score are associated with an increased mortality risk in ICU patients.

Self-Management and Its Predictors for Patients with Poorly Controlled Type 2 Diabetes (혈당조절이 잘 안되는 당뇨 환자의 자기관리 정도와 관련요인 연구)

  • Lee, Jong-Kyung
    • Korean Journal of Adult Nursing
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    • v.21 no.5
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    • pp.447-457
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    • 2009
  • Purpose: The purpose of this study was to investigate the level of self management of patients with poorly controlled type 2 diabetes, and to investigate the factors influencing self management. Methods: The subjects consisted of 117 diabetes patients who visited the outpatient department of a university hospital from March to August 2008. Data were collected by asking the subjects to answer a 54-item questionnaire and were analyzed using the SPSS/WIN 14.0 program. Results: The total mean score of the patients in self -management was 4.38 out of 7. Medication adherence obtained the highest score under self-management, and the self-monitoring of blood glucose obtained the lowest score. Family support, self-efficacy, severity, and depression were found to be significantly correlated with self-management. In stepwise multiple regression analysis a total of 44.5% of the variance in self management was accounted for by family support, self-efficacy, severity, and depression. Conclusion: Therefore, a diabetic intervention program should be designed and provided for increasing family support, self efficacy, and severity and for reducing depression of patients with poorly controlled type 2 diabetes.

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Time to Surgery and Injury Severity Score

  • Oh, Chang Seon;Lee, Jae Gil;Kim, Seung Hyun
    • Journal of Trauma and Injury
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    • v.29 no.4
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    • pp.151-154
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    • 2016
  • Purpose: To evaluate the association between time to surgery and injury severity score (ISS). Methods: Medical charts and records were reviewed for polytrauma patients who underwent trauma surgery from November 2014 to March 2016. The patients were divided into two groups based on the ISS. Results: Among the 217 operated patients, 22 patients underwent first and second surgery. The patients with an ISS over 17 (mean 13.0 days) had a longer interval between surgeries than patients with an ISS of 17 or less (mean 7.5 days) (p=0.031). One hundred and twenty-one patients only underwent elective surgery and there is a positive correlation between ISS and time to elective surgery (p<0.028, Pearson's correlation coefficient=0.224). Seventy-four patients underwent emergent surgery only. Among these, the patients with an ISS of 17 or less underwent general surgery (86%) but the patients with an ISS more than 17 underwent neurological surgery (47%). Conclusion: Patients with high ISS need critical care during the preoperative and postoperative period.

One Case Report of Chronic Motor Tic Disorder Patient with Extreme Headache and Insomnia. (극심한 두통과 불면을 호소하는 만성 운동 틱 장애 환자1례 보고)

  • Kim, Ja-Young;Kang, Hyun-Sun;Lee, Jin-Hwan;Sung, Woo-Yong;Jeong, Da-Un
    • Journal of Oriental Neuropsychiatry
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    • v.19 no.3
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    • pp.219-229
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    • 2008
  • Tics are sudden, painless, nonrhythmic behaviors that are either motor or vocal. As to DSM- VI diagnostic criteria, chronic tic disorder is either single or multiple motor or phonic tics, but not both, which are present for more than a year. In this case, a male patient was diagnosed tics disorder at 8 years old. He has suffered for 15 years and his symptom was simple motor tics of neck, both arms and both legs, not vocal tics. So we diagnosed him as the chronic tic disorder. The severity score headache was assessed using the Visual Analog Scales. The severity score tics was assessed at baseline using the Yale Global Tic Severity Scale (YGTSS) and we compared score of before with after treatment. We treated him with oriental medication( herbal medicine, acupuncture, cry cupping) and progressive muscle relaxation. After this treatment, chronic insomnia and extreme headache were disappeard and the symptoms of tics were mildly decreased.

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