• 한국의료질향상학회지
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• 제28권1호
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• pp.45-54
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• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• Journal of Chest Surgery
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• 제55권5호
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• pp.388-396
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• 2022

Background: In this study, we present recent trends in heart valve surgery in Korea through analyses of data from the Korea Heart Valve Surgery Registry (KHVSR). Methods: We enrolled 8,981 patients who were registered in the KHVSR from 2017 to 2020. Yearly trends in patients' baseline characteristics, surgical profiles, and early mortality rates were explored. The observed/expected mortality ratio (O/E ratio), calculated from the actual mortality in the KHVSR and the predicted mortality estimated using the EuroSCORE II, was also analyzed. Results: The proportion of aortic valve surgery significantly increased from 56.8% in 2017 to 60.3% in 2020. The proportion of all combined procedures and minimally invasive surgery significantly increased over the 4-year study period. The operative mortality rate was 2.9% in the entire cohort, while mitral valve repair showed the lowest mortality risk (0.9%). The mortality rates of isolated aortic valve replacement (AVR) significantly decreased from 2.1% in 2017 to 0.8% in 2020 (p=0.016). Overall, the O/E ratio was 0.784 (95% confidence interval [CI], 0.677-0.902) demonstrating significantly lower actual mortality risks than expected based on the EuroSCORE II. In particular, the O/E ratios were as low as 0.364 (95% CI, 0.208-0.591) for isolated AVR. Conclusion: The recent data from the KHVSR showed increasing trends for complex procedures and minimally invasive surgery in heart valve surgery in Korea, and demonstrated remarkably low risks of operative mortality.

• 한국수자원학회논문집
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• 제46권12호
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• pp.1235-1247
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• 2013

본 연구에서는 충주댐($2750{\times}10^6m^3$) 및 조정지댐($30{\times}10^6m^3$)을 포함한 유역을 대상으로 미래 기후변화가 댐 저수량에 미치는 영향을 분석하기 위해 SWAT(Soil and Water Assessment Tool) 모형을 활용하였다. 3지점의 9개년(2002~2010)동안의 자료를 이용하여 검보정을 실시한 결과 유출량에 대해서는 Nash-Sutcliffe 모델 효율(NSE)이 0.73으로, 두 댐의 저수위에 대해서는 0.86으로 나타났다. 미래 기후변화 시나리오자료는 IPCC(Intergovernmental Panel on Climate Change)에서 제공하는 GCMs (General Circulation Models) 중 HadCM3 모델의 SRES(Special Report on Emission Scenarios)에 의한 B1과 A2 시나리오를 구축하였다. 미래 월별 기온과 강수자료는 과거 30개년(1977~2006, baseline period) 자료는 편의보정(bias-correction) 기법을 이용하여 오차보정 후, Change Factor (CF) method를 이용하여 상세화 하였다. 미래 연평균 기온은 2040s (2031~2050)에 $0.9^{\circ}C$, 2080s (2071~2099)에는 $4.0^{\circ}C$까지 증가할 것으로 예측되었고, 연평균 강수량은 2040s에 9.6%, 2080s에 20.7% 증가하는 것으로 나타났다. 과거 대비 미래 증발산량은 15.3%까지 증가하고, 토양수분은 최대 2.8% 감소하였다. 과거 9개년 평균 댐 방류스케줄에 따른 미래 댐 연평균 유입량은 가을철을 제외한 대부분 기간에 최대 21.1%까지 증가하는 경향을 보였다. 미래 가을철 댐 유입의 감소로 인해 현재 방류 패턴으로는 연말까지 결국 저수량을 회복하지 못하는 것으로 나타났다. 미래 풍수년과 갈수년에는 댐 저수량의 시간적 변동이 더욱 불안정해지므로 각각 저수량의 상향 및 하향 조정에 주의를 기울여야 한다. 따라서 기후변화 적응을 위한 댐 방류 패턴 조절이 필요하다고 판단된다.