• Title/Summary/Keyword: The Elderly in Ulsan

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Clinical Outcomes of Perioperative Geriatric Intervention in the Elderly Undergoing Hip Fracture Surgery

  • Jang, Il-Young;Lee, Young Soo;Jung, Hee-Won;Chang, Jae-Suk;Kim, Jung Jae;Kim, Hye-Jin;Lee, Eunju
    • Annals of Geriatric Medicine and Research
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    • v.20 no.3
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    • pp.125-130
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    • 2016
  • Background: Conventionally, elderly hip fracture patients are assessed by orthopedists to decide whether they need geriatric intervention. We aimed to evaluate the effect of perioperative geriatric intervention on healthcare outcomes in patients undergoing surgery for hip fractures. Methods: Our care model for hip fracture surgery resembles a combination of a routine geriatric consultation model and a geriatric ward model. We retrospectively reviewed the medical records of patients aged ${\geq}65years$ undergoing surgery for hip fracture at a single tertiary hospital from January 2010 to December 2013. We assessed comorbidity, indwelling status, fracture type, and mode of anesthesia. We also evaluated in-hospital expenditure, duration of admission, disposition at discharge and 1-year mortality as clinical outcomes. We developed a propensity score model using the variables of age, cholesterol, and creatinine and examined the effect of perioperative geriatric intervention on intergroup differences of clinical variables. Results: Among 639 patients, 138 patients received the geriatric intervention and 501 patients received the usual care. Univariate analysis showed that factors such as age; Charlson comorbidity index; and serum levels of cholesterol, albumin, and creatinine differed significantly between these 2 groups. There was no significant difference between the groups in terms of 1-year mortality, disposition at discharge, and in-hospital expenditure in the propensity matched model. However, the duration of hospitalization was shorter in the intervention group ($8.9{\pm}0.8days$) than in the usual care group ($14.2{\pm}3.7days$, p=0.006). Conclusion: This care model of geriatric intervention for patients with hip fracture is associated with reduced hospitalization duration.

The Zinc Nutriture and Effect of Zinc Supplementation on the Elderly Living in Ulsan (울산지역 노인의 아연 영양상태 및 아연 보충의 효과)

  • 정미숙;김혜경
    • Korean Journal of Community Nutrition
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    • v.3 no.3
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    • pp.389-396
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    • 1998
  • This study was intended to examine the zinc status and effect of zinc supplementation on the zinc nutritional status of the elderly living in the Ulsan area. The zinc intake of 207 subjects(male 97, female 110) was measured by a 24-hour dietary recall and food frequency method. Biochemical analysis were conducted from blood and urine samples to evaluate the changes of zinc nutriture with zinc supplementation. The average dietary zinc intake of subjects was $7.7\pm{2.8mg}$ for male and $7.5\pm{2.6mg}$ for female, which were 51.3% and 62.3% of Korean RDA respectively. The first source of zinc was cereal and grain(36%), and the second was eggs and milk group(27%). After 8 weeks of zinc supplementation, the serum zinc content was significantly increased(p<0.01), although the serum copper content was not significantly decrease. Serum HDL- cholesterol level was not significantly decreased with zinc supplementation. Serum alkaline phosphatase(ALP) activity and urinary zinc excretion were significantly increased(p<0.05). The urinary Zn/Cr was not significantly increased. It is suggested from the results that the daily zinc supplementation can be effective to improve zinc nutriture.

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Subjective Oral Health Status of the Elderly and Social Impact Efficacy (노인의 주관적 구강건강상태가 사회적 효능감에 미치는 영향)

  • Noh, Eun-Mi;Back, Jong-Uk
    • Journal of dental hygiene science
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    • v.10 no.4
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    • pp.233-239
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    • 2010
  • The study of the elderly and poor oral status interpersonal relationships and smooth social life limited to give is the social alienation and isolation, promoting to having problems with a sense of the elderly subjective oral health status and social efficacy affects whether analyzed. 1. Subjective oral health status authoring feel healthy food disorders, toothache, periodontal problems, tmj pain, dry mouth, bad breath symptoms such as 'sometimes' 'often' than a 'no' if you appear to be a highly subjective and social efficacy Efficacy of oral health status and social influence were more (p<0.01). 2. Subjective oral health status of the seven kinds of sub-variable that oral health status, food authoring disorders, toothache, gum disease, jaw joint or more, dry mouth, bad breath instantly and look at the relationship between social efficacy oral health status, ability of mastication, pain in oral, gum disease, tmj pain, dry mouth, presence of halitosis than positive (+) was correlated.

The Effect of Preoperative Nutritional Status on Postoperative Outcome in Elderly Patients (노인 환자의 수술 전 영양상태가 수술 후 임상경과에 미치는 영향)

  • Kim, Min Young
    • Journal of Korean Biological Nursing Science
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    • v.21 no.4
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    • pp.292-299
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    • 2019
  • Purpose: The purpose of this study was to determine whether poor preoperative nutritional status in elderly patients exhibited a negative influence on postoperative clinical outcomes. Methods: The medical records of 645 elderly patients were examined retrospectively. The patients had undergone major surgery between January 2017 and January 2018. Their nutritional status was measured using the Nutritional Risk Screening 2002. The data were analyzed using the chi-squared test, the Mann-Whitney U test, logistic regression, linear regression, Cox proportional hazards regression, and the Kaplan-Meier analysis. Results: Preoperative malnutrition was found in 73 patients (11.3%). Poor preoperative nutritional status was significantly associated with pressure ulcers, length of hospitalization, discharge to patient care facilities rather than home, and mortality rate at three months. Conclusion: Preoperative malnutrition in elderly patients was associated with negative postoperative clinical outcomes. These results indicate that an effective nutritional program before surgery can lead to a more rapid postoperative recovery.

Effects of the Elderly's Health Statuses, Health Behavior, and Social Relations on Their Health-related Quality of Life: Focusing on Family Types (노인의 건강상태, 건강행위, 사회관계가 건강 관련 삶의 질에 미치는 영향: 가구유형별 분석)

  • Kim, Young Bum;Lee, Seung-Hee
    • Research in Community and Public Health Nursing
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    • v.29 no.3
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    • pp.310-321
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    • 2018
  • Purpose: The purpose of this study is to identify the effects of the elderly's health statuses, health behavior, and social relations on their health-related quality of life (HRQoL) according to their family types. Methods: The subjects of this study were 1000 elderly persons (298 living alone, 420 living with their spouses, and 282 living with their family)living in C city in Gangwon Province. Data were collected through structured questionnaires from July 20 to September 30, 2015. The SPSS/WIN program was used for data analysis. Results: The HRQoL of the elderly living alone was much lower than the other groups. The most influential factors on the HRQoL include self-rated health and depressive symptoms in all three groups. Social activities and skipping meals were associated with the HRQoL of the elderly living alone and living with their spouses, while marital status, number of chronic disease, and instrumental activities of daily living were associated with the HRQoL of the elderly living with their family. Conclusion: Nurses should take into account family types when designing interventions for improving the HRQoL of the elderly.

Nutritional and Health Status of Korean Elderly Living in America

  • Hye-Kyung Kim
    • Korean Journal of Community Nutrition
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    • v.3 no.5
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    • pp.707-714
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    • 1998
  • This cross-sectional study was designed to describe in nutritional and health status of the Korean elderly residing in America using demographic variables, dietary, anthropometric and functional status indicators, and to investigate possible relationships among these variables. Sixty elderly persons aged 61-91 years were assessed in their homes. Dietary intake was estimated by the 24-hour recall and brief dietary questionnaire. The following anthropometric measures were taken : weight, height, knee height, triceps skinfold, and midarm circumference. Functional status was measured by activities of daily living(ADLs), instrumental activities of daily living(IADLs) questionnaires, and a measure of psychosocial status as "happiness score"(a life satisfaction questionnaire). Intakes of energy, calcium, magnesium, folacin, vitamin B6, and zinc were low in this elderly sample. Females 75 years of age and older had extremely low energy intakes. A large percentage of subjects reported difficulty with both activities of daily living and instrumental activities of daily living. Subjects over 75 years of age reported more difficulty than younger subjects for most activities. Gender differnces were seen in anthropometric variables and energy intake. Happiness scores were similar in subjects, regardless of age or gender, however, happiness score was significantly correlated with the energy and protein intake(p<0.05). Several difficulties were encountered during the assessment of this elderly sample. The conditions in the home were unpredictable and often inadequate for the anthropometric measures in particular. Further research is needed to improve current methodologies so that they may be more adaptable to the conditions found in homes. in homes.

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Modified Trajectory of C2 Laminar Screw-Double Bicortical Purchase of the Inferiorly Crossing Screw

  • Rhee, Woo-Tack;You, Seung-Hoon;Jang, Yeon-Gyu;Lee, Sang-Youl
    • Journal of Korean Neurosurgical Society
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    • v.43 no.2
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    • pp.119-122
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    • 2008
  • The crossing laminar screw fixation might be the most recently developed approach among various fixation techniques for C2. The new construct has stability comparable to transarticular or transpedicular screw fixation without risk of vertebral artery injury. Quantitative anatomical studies about C2 vertebra suggest significant variation in the thickness of C2 lamina as well as cross sectional area of junction of lamina and spinous process. We present an elderly patient who underwent an occipito-cervical stabilization incorporating crossed C2 laminar screw fixation. We preoperatively recognized that she had low profiles of C2 lamina, and thus made a modification of trajectory for the inferiorly crossing screw. We introduce a simple modification of crossing C2 laminar screw technique to improve stability in patients with low laminar profiles.

A Case of Severe Bleomycin-Induced Pneumonitis at Non-Hodgkin's Lymphoma (비호즈킨 림프종 환자에서 저용량의 Bleomycin에 의해 발생한 급성 중증 폐독성 1예)

  • Han, Dong-Ha;Min, Young-Joo;Yoon, Je-Hyun;Park, Jong-Ho;Ahn, Jong-Joon;Lee, Ki-Man;Park, Jae-Hoo
    • Tuberculosis and Respiratory Diseases
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    • v.52 no.3
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    • pp.260-264
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    • 2002
  • Bleomycin-induced pulmonary toxicity usually occurs in the elderly patients (greater than 70 years old), patients with a cumulative dose above 400 units, previous chest radiotherapy, oxygen therapy, and renal failure. However, there are some reports of severe pneumonitis that developed after administering low bleomycin doses(less than 100 units). In severe bleomycin-induced pneumonitis in non-Hodgkin's lymphoma patients, the response to corticosteroid is poor and the mortality rate is very high, approximately 83%. Therefore, clinicians should have a low threshold for investigating and treating bleomycin-induced pneumonitis. Here, we report a case of severe bleomycin-induced pneumonitis as a complication of a non-Hodgkin's lymphoma treatment.

Coronary Artery Bypass Grafting in Elderly Patients Older Than 75 Years (75세 이상 고령환자의 관상동맥우회로술)

  • Yoo Dong Gon;Kim Chong Wook;Park Chong Bin;Choo Suk Jung;Lee Jae Won;Song Meong Gun;Song Hyun
    • Journal of Chest Surgery
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    • v.38 no.2 s.247
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    • pp.123-131
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    • 2005
  • Background: The number of elderly patients undergoing coronary artery bypass grafting (CABG) is increasing. Elderly patients are at increased risk for a variety of perioperative complications and mortality. We identified determinants of operative complications and mortality in elderly patients undergoing CABG. Material and Method: Between January 1995 and July 2003, 91 patients older than 75 years underwent isolated CABG at Asan Medical Center. There were 67 men and 24 women with mean age of $77.0\pm2.4$ years. Thirty clinical or hemodynamic variables hypothesized as predictors of operative mortality were evaluated. Result: CABG was performed under emergency conditions in 5 patients. The internal thoracic artery was used in 85 patients and 10 patients received both internal thoracic arteries. The mean number of distal anastomosis was 3.7 per patient. Operative mortality was $3.3\%$. Twenty-two patients had at least one major postoperative complication. Low cardiac output syndrome was the most common complication, followed by reoperation for bleeding, pulmonary dysfunction, perioperative myocardial infarction, stroke, acute renal failure, ventricular arrhythmia, upper gastrointestinal bleeding, infection, and delayed sternal closure. None were the predictors of mortality. Renal failure, peripheral vascular disease, emergency operation, recent myocardial infarction, congestive heart failure, New York Heart Association (HYHA) class III or IV, Canadian Cardiovascular Society (CCS) angina scale III or IV, and low left ventricle ejection fraction below $40\%$ were univariate predictors of overall complications. Actuarial probability of survival was $94.9\%,\;89.8\%,\;and\;83.5\%$ at postoperative 1, 3 and 5 years respectively. During the follow-up period $93.3\%$ of patients were in NYHA class I, or II and $91.1\%$ were free from angina. Conclusion: Although operative complication is increased, CABG can be performed with an acceptable operative mortality and excellent late results in patients older than 75 years.

Daily Life Perspectives on Living Arrangements of the Elderly after the Modernization Era (근대 이후 노인의 생활과 생활공간 변화에 대한 일상사적 고찰)

  • Hong, Hyung-Ock;Jun, Nam-Il;Yang, Se-Hwa;Eun, Nan-Soon
    • Journal of the Korean Home Economics Association
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    • v.44 no.8
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    • pp.47-61
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    • 2006
  • The study analyzed the characteristics of the daily life and the living arrangements use of the elderly with literature review after the modernization period based on the daily life perspectives. The changes in the ideology, social system, and family system, which influenced the society and families, also affected the status of the elderly and their daily lives. Consequently, they had been facing conflicts, acceptance, and internal differentiations. The characteristics of the changes in the daily lives of the elderly in different periods were as follows. The contents were written from three different perspectives, phenomenological, symbolic interaction, and Marxist. During the modernization period, the family system and the hierarchy within a family had been reformed. However, the elderly were still considered as the symbolic leader and the respected figure of the family. From a phenomenological perspective, elderlies teach the next generations and influence the family's lives. On the other hand, from a perspective of symbolic interactions, spatial adjustment behaviors toward the largest room between the elderly and the next generation were detected. The actual authority was given to the next generation. However, the elderly were still treated as the symbolic authority. Yet, as the society became more industrialized, conflicts aroused about the support of the elderly. Those, who were neglected from the family, even spent their daily time at the elderly center or the community center. The daily lives from the Marxist perspectives suggested that modernization caused the young generations, who were well-educated and had financial powers, to have initiatives. The role of the elderly was reduced and they became negligible people, who spend meaningless daily lives. The interested the Third Ages is a new perspective on the elderly, who were neglected from the industrialized society. From a phenomenological perspective, the Third Ages are the generations that seek and demand for new housing.