• Title/Summary/Keyword: Severity Score

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Why do Multiple-trauma Patients Stay Longer in the Intensive Care Unit?; - A Comparison of Injury Severity Score and The Number of Injured Regions - (어떤 다발성 외상환자가 중환자실에 오래 있게 되는가?; Injury severity score와 손상부위 수의 비교)

  • Jo, Mu Jin;Lee, Seong Hwa;Cho, Seok Ju;Yeom, Seok Ran;Han, Sang Kyoon;Park, Sung Wook;Lee, Dae Seop
    • Journal of Trauma and Injury
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    • v.26 no.2
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    • pp.47-52
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    • 2013
  • Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

Classify the Acute Drug Intoxication Patients with Poisoning Severity Score(PSS) and Calculate the Optimal Cutoff Value of PSS, PSSsum to Predict Poor Prognosis (급성 약물 중독 환자에서 Poisoning Severity Score (PSS)를 이용한 중증도 분류와 중증도 분류에 있어 PSS 값과 PSSsum 값의 Optimal Cutoff Value)

  • Park, Hyun Woo;Park, Ha Young;Kim, Han Byeol;Park, Keon Woo;Lee, Sang Hun;Lee, Hyun Wook;Lee, Je Won;Hwang, Tae Sik
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.75-85
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    • 2018
  • Purpose: This study examined the Poisoning Severity Score (PSS) from acute poisoning patients, to determine the relationships among the PSS, PSSsum, the primary outcome (prolonged stay at the ER over 24 hours, general ward and ICU admission and the application of intubation and mechanical ventilator, and the administration of inotropes). Methods: A retrospective study was conducted through the EMR for 15 months. The PSS grade was classified according to the evidence of symptoms and signs. The differences in the primary outcomes between the PSS of when a single organ was damaged, and the PSS, PSSsum combined with the grade of when multiple organs were damaged, were studied. The cutoff value was calculated using the receiving operating characteristics (ROC) curve. Results: Of the 284 patients; 85 (29.9%) were men with a mean age of 48.8 years, and their average arrival time to the ER was $4.4{\pm}6.7\;hours$. The most frequently used drug was hypnotics. The number of patients with PSS grade 0, 1, 2, 3, and 4 was 17, 129, 122, 24, and one, respectively. No ICU admissions, application of intubation and mechanical ventilators, administration of inotropes were observed among the patients with PSS grades 0 and 1 but only on patients with PSS grades 2 to 4. At PSS, when separating the patients according to the number of damaged organs, 17 had no symptoms, 133 had one organ damaged, 75 had two organs damaged, 36 had three organs damaged, and 23 had four organs damaged. Significant differences were observed between increasing number of damaged organs and the primary outcome. Conclusion: Among the acute poisoning patients, the PSS was higher in severity when the grade was higher. The number of damaged organs and the primary outcome showed meaningful statistical differences. This study confirmed that when the patients' PSS>2 and PSSsum>5, the frequency of ICU admission was higher, and they were considered to be severe with an increased prescription risk of application of intubation and mechanical ventilator, and the administration of inotropes.

The Effectiveness of Acupuncture for Fatigue Severity in Lung Cancer Patients: Pilot Study (침치료가 폐암 환자의 피로도에 미치는 영향: Pilot Study)

  • Hyun, Dae-Sung;Kim, Jong-Dae;Kwon, Hyo-Jung;Jung, Hyun-Jung
    • Korean Journal of Acupuncture
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    • v.29 no.4
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    • pp.623-633
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    • 2012
  • Objectives : Fatigue is a common and distressing symptom that is a concern for cancer patients. It has a decisive effect on quality of life. The purpose of this study was to examine the feasibility of clinical trial to evaluate of efficacy and safety of acupuncture on cancer related fatigue of lung cancer patients. Methods : Total lung cancer 9 patients complained of fatigue were treated by acupuncture twice a week for four weeks(8 times in total). Evaluation of the severity of fatigue was measured by FSS(Fatigue Severity Score). In visit 1, 10, we checked FSS. For check safety of acupuncture treatment, we did blood test. Results : After 4 weeks of acupuncture treatment, the FSS was significantly decreased from $4.92{\pm}1.06$ to $3.74{\pm}1.37$(p=0.008). And the level of hemoglobin was significantly increased from 10.87 g/dl to 12.01 g/dl(p=0.014). No other lab measures indicated any significant differences between before and after acupuncture treatment. Conclusions : This study suggests that acupuncture treatment will be beneficial for lung cancer patients to improve the fatigue severity. And acupuncture treatment is safe method for lung cancer patients. A large-scale study to confirm efficacy and safety of acupuncture is needed.

A Composite Trend Test with Symptom Occurrence and Severity Symptom Scores (증상 발현과 증상 심각성을 병합한 추세검정법)

  • Choi, Se-Mi;Yang, Soo;Song, Hae-Hiang
    • The Korean Journal of Applied Statistics
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    • v.24 no.6
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    • pp.1045-1054
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    • 2011
  • During clinical trials a researcher is frequently able to observe a disease symptom in a subject as well as a severity score for those who experienced a symptom after a fixed length of treatment. The traditional method to evaluate a decreasing trend in proportion, when there is an intrinsic order in the treatment groups (for example control and two or more treatment groups) is a Cochran-Armitage test, while the method to evaluate a decreasing trend in continuous non-normal data is a Jonckheere-Tersptra test. The Cochran-Armitage test emphasizes the dichotomous data of symptom occurrence and the Jonckheere-Tersptra test emphasizes the continuous non-normal data of severity symptom scores. In this paper we propose new test statistics that consider the combined evidence from a symptom occurrence and disease severity score. We illustrate these methods with example data of schizophrenic inpatients that demonstrated antipsychotic-drug induced constipation. A small-scale simulation is conducted to compare the new trend tests with other trend tests.

Injury Analysis of a 12-passenger Van Rollover Accident (12인승 밴 전복사고의 상해 분석)

  • Kim, S.C.;Choi, H.Y.;Kim, B.W.;Park, G.J.;An, S.M.;Lee, K.H.
    • Journal of Auto-vehicle Safety Association
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    • v.10 no.1
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    • pp.20-26
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    • 2018
  • The fatality of rollover accidents in motor vehicle crashes is high despite their low incidence. Through the investigation of a 12-passenger van rollover accident in which 10 passengers were involved, we intend to analyze the correlation between the severity of the injury and the position of the occupants. We collected accident information from medical records, interviews, photo-images of the damaged van, field surveys, and the results of the Korean New Car Assessment Program (KNCAP). Based on the occupants' position, we classified injury sites and estimated injury severity. Passenger injury severity was evaluated by trauma score calculation. The initiation type of the rollover accident was passenger side 'fall-over' and the Collision Deformation Classification (CDC) code for the damaged van was 00TDZO3. The crash of the van involved 10 passengers, with an average age of $16.3{\pm}4.2years$. Few of the occupants had fastened seat belts at the time of the incident, and there was no airbag installed. One patient sustained severe liver injury and another was diagnosed with a fracture of the right humerus. The most common injuries were at the upper extremities and the neck. The average of Injury Severity Score (ISS) was $4.8{\pm}5.9$, and the average ISS of right-seated, mid-seated and left-seated occupants was $7.5{\pm}9.3$, $1.5{\pm}0.7$, and $3.3{\pm}2.1$ respectively (p>0.05). In the rollover (to-passenger side) accident of occupant unfastened, the average ISS of right-seated occupants (near side) was higher, but there was no statistically significant difference.

Association between Thyroid Dysfunction and Severity, Treatment Response in Schizophrenic Inpatients (조현병 입원 환자에서의 갑상샘 기능이상과 증상 심각도, 치료 반응과의 관계)

  • Jung, Mee-Jool;Hwang, Hyun-Kuk;Seo, Yung-Eun;Choi, Jong-Hyuk
    • Korean Journal of Biological Psychiatry
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    • v.26 no.1
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    • pp.14-21
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    • 2019
  • Objectives Thyroid hormone deficiency during the neurodevelopmental period can impair brain development and induce psychiatric symptoms. This study examined the association between thyroid dysfunction and the severity of symptoms in schizophrenia patients, and the treatment response of patients with schizophrenia. Methods Three hundred thirty-eight schizophrenia patients, with no prior history of thyroid disease or taking medication associated with it, were studied. We assessed the blood thyroid hormone level, the Brief Psychiatric Rating Scale (BPRS) scores on the day of admission and discharge, admission period, dose of administered antipsychotics, and the number of antipsychotic combinations. The collected data were subsequently analyzed using the Kruskal-Wallis test and Pearson's chi-square test. Results The percentage of schizophrenia patients who presented with abnormal thyroid hormone level was 24.6%. High total triiodothyronine (TT3) (p = 0.003), low TT3 (p = 0.001), and high free thyroxine (fT4) (p < 0.001) groups showed a higher BPRS score on admission than did the normal thyroid hormone group, while thyroid stimulating hormone (TSH) levels were not significantly correlated with the severity of symptoms. Furthermore, thyroid hormone was not associated with the treatment response assessed by the rate of BPRS score reduction, admission days, use of clozapine, and dose of antipsychotics. Conclusions The TT3 and fT4 hormone levels were significantly associated with the severity of symptoms in schizophrenia patients. These relations suggested that thyroid dysfunction may be associated with the severity of schizophrenia. And hence, further analysis of the results of the thyroid function test, which is commonly used in cases of psychiatric admission, is required.

Impact of obesity on the severity of trauma in patients injured in pedestrian traffic accidents

  • Pillsung, Oh;Jin-Seong, Cho;Jae Ho, Jang;Jae Yeon, Choi;Woo Sung, Choi;Byungchul, Yu
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.240-247
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    • 2022
  • Purpose: Studies on the relationship between obesity and injuries, especially those sustained in pedestrian traffic accidents, are lacking. We aimed to assess the effects of obesity on the severity of injury at the time of admission to the emergency room in patients who experienced pedestrian traffic accidents. Methods: This study included trauma patients registered in the Korean Trauma Database from July 1, 2018 to December 31, 2020, whose mechanism of injury was pedestrian traffic accidents and who were treated at a single institution. Those aged below 15 years were excluded. Patients were assigned to nonobese and obese groups based on a body mass index of 25 kg/m2. An Injury Severity Score of 25 or greater was considered to indicate a critical injury. Results: In total, 679 cases of pedestrian traffic accidents were registered during the study period, and 543 patients were included in the final analysis. Of them, 360 patients (66.3%) and 183 patients (33.7%) were categorized as nonobese and obese, respectively. The median age was significantly higher in the nonobese group than in the obese group (60 vs. 58 years). Multivariate analysis demonstrated that the odds ratio for critical injury in obese patients was 1.59 (95% confidence interval, 1.01-2.48) compared with nonobese patients. Conclusions: Obesity affected the likelihood of sustaining severe injuries in pedestrian traffic accidents. Future studies should analyze the effects of body mass index on the pattern and severity of injuries in patients with more diverse injury mechanisms using large-scale data.

Comparative Study of PSO-ANN in Estimating Traffic Accident Severity

  • Md. Ashikuzzaman;Wasim Akram;Md. Mydul Islam Anik;Taskeed Jabid;Mahamudul Hasan;Md. Sawkat Ali
    • International Journal of Computer Science & Network Security
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    • v.23 no.8
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    • pp.95-100
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    • 2023
  • Due to Traffic accidents people faces health and economical casualties around the world. As the population increases vehicles on road increase which leads to congestion in cities. Congestion can lead to increasing accident risks due to the expansion in transportation systems. Modern cities are adopting various technologies to minimize traffic accidents by predicting mathematically. Traffic accidents cause economical casualties and potential death. Therefore, to ensure people's safety, the concept of the smart city makes sense. In a smart city, traffic accident factors like road condition, light condition, weather condition etcetera are important to consider to predict traffic accident severity. Several machine learning models can significantly be employed to determine and predict traffic accident severity. This research paper illustrated the performance of a hybridized neural network and compared it with other machine learning models in order to measure the accuracy of predicting traffic accident severity. Dataset of city Leeds, UK is being used to train and test the model. Then the results are being compared with each other. Particle Swarm optimization with artificial neural network (PSO-ANN) gave promising results compared to other machine learning models like Random Forest, Naïve Bayes, Nearest Centroid, K Nearest Neighbor Classification. PSO- ANN model can be adopted in the transportation system to counter traffic accident issues. The nearest centroid model gave the lowest accuracy score whereas PSO-ANN gave the highest accuracy score. All the test results and findings obtained in our study can provide valuable information on reducing traffic accidents.

Comparison of Vessel Disease and Gensini Score according to Ankle-Brachial Index in Patients with Cardiovascular Disease (심혈관 질환자의 발목-상완 지수에 따른 Vessel disease 및 Gensini score 비교 융복합 연구)

  • Choi, Suk-Kyeong;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.15 no.1
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    • pp.267-275
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    • 2017
  • The purpose of this study was to evaluate the clinical availability of ankle-brachial index(ABI) according to severity of cardiovascular disease. The subjects of this study were the patients who had ABI in a general hospital. In this study, total 441 patients were enrolled for analysis. Electric medical records were reviewed to investigate the result of ABI and severity of cardiovascular disease measured vessel disease and Gensini score. Collected data were analyzed using SPSS 21.0 program. Subjects with $ABI{\leq}0.90$ and > 0.90 were classified as having abnormal and normal ABI. There were significant differences in vessel disease categorization($x^2=4.731$, p=.030) and Gensini score(t=2.351, p=.019) between two groups. Therefore, ABI is an effective and non-invasive tool for the diagnosis of cardiovascular disease with high severity. ABI is a valuable predictive index of ischemic heart disease.

Anti-atopic Activity of Sargassum micracanthum Ethanol Extracts (잔가시 모자반 에탄올 추출물의 항아토피 효과)

  • Jeong, Da-Hyun;Kim, Koth-Bong-Woo-Ri;Kim, Min-Ji;Kang, Bo-Kyeong;Bark, Si-Woo;Pak, Won-Min;Kim, Bo-Ram;Park, Hong-Min;Im, Moo-Hyeog;Ahn, Dong-Hyun
    • Microbiology and Biotechnology Letters
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    • v.42 no.1
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    • pp.82-88
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    • 2014
  • Atopic dermatitis (AD) is a common chronic inflammatory disease preceding the development of allergic disorders. The aim of this study was to evaluate the effect of Sargassum micracanthum ethanol extract (SMEE) on AD. AD was induced by spreading 2,4-dinitrochlorobenzen (DNCB) on the back sides of BALB/c mice. The efficacy of SMEE was tested by observing the skin clinical severity score, proliferations of Raw 264.7 cells and the secretion of cytokines and IgE. The secretion of IL-4, and IgE was significantly decreased by SMEE in a dose dependent manner, while IFN-${\gamma}$ was increased. In addition, SMEE alleviated the AD symptoms better when compared to the positive controls. In conclusion, these results suggest that SMEE has an inhibitory effect on AD, and may serve as a useful biomaterial for the development of cosmeceuticals.