• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.221-228
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• 2023

Background: We assessed the relationship between patient age and remifentanil dosing rate in patients managed under general anesthesia with spontaneous breathing using low-dose remifentanil in sevoflurane. Methods: The participants were patients with an American Society of Anesthesiologists Physical Status of 1 or 2 maintained under general anesthesia with low-dose remifentanil in 1.5-2.0% sevoflurane. The infusion rate of remifentanil was adjusted so that the spontaneous respiratory rate was half the rate prior to the induction of anesthesia, and γ^H (㎍/kg/min) was defined as the infusion rate of remifentanil under stable conditions where the respiratory rate was half the rate prior to the induction of anesthesia for ≥ 15 minutes. The relationship between γ^H and patient age was analyzed statistically by Spearman's correlation analysis. Results: During dental treatment under general anesthesia using low-dose remifentanil in sevoflurane, a significant correlation was detected between γ^H and patient age. The regression line of y = - 0.00079 x + 0.066 (y-axis; γ^H, x-axis; patient's age) was provided. The values of γ^H provide 0.064 ㎍/kg/min at 2 years and 0.0186 ㎍/kg/min at 60 years. Therefore, as age increases, the dosing rate exhibits a declining trend. Furthermore, in the dosing rate of remifentanil when the patient's respiratory rate was reduced by half from the preanesthetic respiratory rate, the dosing rate provided was around 0.88 mL/h in all ages if the remifentanil was diluted as 0.1 mg/mL. EtCO₂ showed 51.0 ± 5.7 mmHg, and SpO₂ was controlled within the normal range by this method. In addition, all dental treatments were performed without major problems, such as awakening and body movement during general anesthesia, and the post-anesthetic recovery process was stable. Conclusion: General anesthesia with spontaneous breathing provides various advantages, and the present method is appropriate for minimally invasive procedures.

• 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.

• Journal of Trauma and Injury
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• 제35권1호
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• pp.3-11
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• 2022

Purpose: The increasing use of electric personal mobility devices (ePMDs) has been accompanied by an increasing incidence of associated accidents. This study aimed to investigate the characteristics of ePMD-related injuries and their associated factors. Methods: This cross-sectional study was conducted using data from the Emergency Department-based Injury In-depth Surveillance database from 2014 to 2018. All patients who were injured while operating an ePMD were eligible. The primary outcome was the rate of severe injury, defined as an excess mortality ratio-adjusted Injury Severity Score of ≥25. We calculated the adjusted odds ratios (AORs) of outcomes associated with ePMD-related injuries. Results: Of 1,391,980 injured patients, 684 (0.05%) were eligible for inclusion in this study. Their median age was 28 years old, and most injuries were sustained by men (68.0%). The rate of ePMD-related injuries increased from 3.1 injuries per 100,000 population in 2014 to 100.3 per 100,000 population in 2018. A majority of the injuries occurred on the street (32.7%). The most commonly injured area was the head and face (49.6%), and the most common diagnosis was superficial injuries or contusions (32.9%). Being aged 55 years or older (AOR, 3.88; 95% confidence interval, 1.33-11.36) and operating an ePMD while intoxicated (AOR, 2.78; 95% confidence interval, 1.52-5.08) were associated with severe injuries. Conclusions: The number of emergency room visits due to ePMD-related injuries is increasing. Old age and drunk driving are both associated with serious injuries. Active traffic enforcement and safety regulations regarding ePMDs should be implemented to prevent severe injuries caused by ePMD-related accidents.

• Journal of Preventive Medicine and Public Health
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• 제20권1호
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• pp.84-96
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• 1987

For the purpose of preparing the basic data for further cancer epidemiologic study and cancer patients control, we conducted the analysis on the degree and structure of deaths from cancer in metropolitan areas of Korea with 7,934 certified cancer deaths records of Seoul, Pusan, Taegu and Incheon in 1982. The analyzed results were as follows: 1) The total number of cancer deaths in metropolitan areas were 7,934 (male: 4,749, female: 3,185) as 14.1% of deaths from all causes in the same area. 2) The rate of physician's certification on cancer deaths was 77.4% and most of cancer deaths (84.4%) occured at their home. 3) Cancer specific death rate was 51.7 per 100.000 population (male: 62.9, female: 41.9) and age-adjusted cancer death rate was 82.4 in male and 51.6 in female per 100,000 population. And the difference was statistically significant (p< 0.01). 4) Age-specific cancer death rate was generally increased with age and most of cancer deaths (male: 75% , female: 65%) occurred from 45 to 74 years old. 5) The first three orders of cancer site were stomach (32.7%), liver (28.8%), lung (11.7%) in male and stomach (30.6%), uterus (18.4%), liver (13.8%) in female. And the relative frequency of these three cancer sites among total cancer deaths was corresponded to 73.2% in male and 62.8% in female. 6) The ratio of male to female cancer death rate was 1.5:1. And the ratio was aboye 3.0 in esophagus, liver, larynx, bladder cancer and the ratio was similar to 1.0 in stomach, pancreas, leukemia, brain, colon cancer, but the ratio was reversed in gall bladder and bile duct, and thyroid cancer.

• 보건행정학회지
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• 제24권2호
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• pp.143-152
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• 2014

Background: Previous studies showed that the characteristics of population and regions were related to the suicide rates. This study purposed to analyze the relationships between regional factors and suicide rates with spatial analysis model. Methods: This is a cross sectional study based on the statistics of 2011 which was extracted from the 229 City Gun Gu administrative districts in Korea. Cause of death statistics on each district was used to produce the age-, sex-adjusted mortality rates resulting from suicide. Regional characteristics were measured by the number of doctors engaged in medical institutions per 1,000 population, divorced people's rate per 1,000 population, number of marriages per 1,000 population, and percent of welfare budget in general accounting. Statistical analysis was performed by using SAS ver. 9.3 and ArcGIS ver. 10.2 was used for geographically weighted regression (GWR). Results: In ordinary least square (OLS) regression, divorced people's rate per 1,000 population had a significant positive relationship with the standardized mortality rate per 100,000 population. Marriages per 1,000 population and the proportion of welfare budget in the general accounting had significant negative relationships with the mortality rates. Meanwhile, GWR provided that the directions of variable, divorced people's rate per 1,000 population, were varied depending on regions. The adjusted $R^2$ was improved from the 0.32 in OLS to the 0.46 in GWR. Conclusion: Results of GWR showed that regional factors had different effects on the suicide rates depending on locations. It suggested that policy interventions for reducing the suicide rate should consider the regional characteristics in obtaining policy objectives.

• 운동영양학회지
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• 제25권1호
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• pp.35-41
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• 2021

[Purpose] This pilot study aimed to develop a regression model to estimate the excess post-exercise oxygen consumption (EPOC) of Korean adults using various easy-to-measure dependent variables. [Methods] The EPOC and dependent variables for its estimation (e.g., sex, age, height, weight, body mass index, fat-free mass [FFM], fat mass, % body fat, and heart rate_sum [HR_sum]) were measured in 75 healthy adults (31 males, 44 females). Statistical analysis was performed to develop an EPOC estimation regression model using the stepwise regression method. [Results] We confirmed that FFM and HR_sum were important variables in the EPOC regression models of various exercise types. The explanatory power and standard errors of estimates (SEE) for EPOC of each exercise type were as follows: the continuous exercise (CEx) regression model was 86.3% (R²) and 85.9% (adjusted R²), and the mean SEE was 11.73 kcal, interval exercise (IEx) regression model was 83.1% (R²) and 82.6% (adjusted R²), while the mean SEE was 13.68 kcal, and the accumulation of short-duration exercise (AEx) regression models was 91.3% (R²) and 91.0% (adjusted R²), while the mean SEE was 27.71 kcal. There was no significant difference between the measured EPOC using a metabolic gas analyzer and the predicted EPOC for each exercise type. [Conclusion] This pilot study developed a regression model to estimate EPOC in healthy Korean adults. The regression model was as follows: CEx = -37.128 + 1.003 × (FFM) + 0.016 × (HR_sum), IEx = -49.265 + 1.442 × (FFM) + 0.013 × (HR_sum), and AEx = -100.942 + 2.209 × (FFM) + 0.020 × (HR_sum).

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7267-7270
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• 2014

Background: The incidence of upper aero-digestive tract (UADT) cancers, including C00-C14, C30-C32, C15 and C16, is increasing rapidly in Kamrup Urban District (KUD) of Assam, North East (NE) India. According to the NCRP (2013) report 37.6% of all cancers in both sexes are UADT cancers in the NE region, accounting for 53.3% in males and about 27.5% in females of the total cases. Materials and Methods: A retrospective study was conducted for patient information from the period of 2008-2011. Age-standardized or age-adjusted rates (ASR or AAR) (per 100,000 person-years) were calculated using the World Standard Population as proposed by Segi and modified by Doll et al. The registry population area at risk was estimated using the 1991 and 2001 census population by sex, as well as the growth rate during that interval using the difference distribution method. Results: There were 5,638 cases registered during the last four years of the study (2008-2011) accounting for 56.7% (3,198/5,638) of the total in males and 43.3% (2,440/5,638) in females. The male: female ratio was 1.31:1.00. The overall age adjusted rates (AAR) were 179.4 and 153.8 per 100 000 males and females respectively. Cancer of the oesophagus was most common in both sexes, with most appreciable gender variation for tongue and hypopharynx, presumably reflecting differential expsoure to risk factors.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.311-320
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• 1993

This study was carried out along with the 1990 6th National Tuberculosis Prevalence Survey in order to estimate the prevalence rate of diabetes mellitus among a representative adult Korean population. Fasting blood glucose was measured by diastix (Ames) using glucometer II for seventy seven percent of the population (30 year old or above) residing in 190 enumeration districts randomly sampled from 146,944 general ED. The prevalence of diabetes mellitus of the population was estimated by projecting the ratio of ${\geq}200mg/dl\;PP_2$ of fasting blood sugar level below 120 mg/dl by sex to the study population. Fasting blood glucose and 2 hr. postprandial blood glucose were measured on about 3000 subsampled individuals, and diabetes mellitus was defined by the WHO criteria-FBG${\geq}120mg/dl\;or\;PP_2{\geq}200mg/dl$ when FBG is below 120mg/dl. The results obtained are as follows : 1. Estimated prevalence(age adjusted) of diabetes mellitus was 4.6% for male and 8.1% for female. The age adjusted mean FBG was $93.9{\pm}26.2mg/dl$ for male and $102.9{\pm}31.5mg/dl$ for female. 2. The prevalence increased as age advanced with peak in $60{\sim}69$ years old age group for both sexes. 3. The mean FBG and estimated prevalence rate of diabetes mellitus varied considerably among the populations of fifteen cities and provinces ; it vaired from $87.0{\pm}17.7\;to\;104.6{\pm}34.5mg/dl$ and 1.2% to 8.9% for males, and from $93.3{\pm}25.3\;to\;116.7{\pm}38.6mg/dl$ and 3.4% to 20.8% for females. 4. The mean FBG and prevalence rates were higher among the rural population than those residing in metropolitan areas. 5. The proportion of the people previously treated among the diabetics was estimated to be a little less than one fifth. 6. Factors strongly associated with FBG were age, sex, family history of D. M., BMI, area and educational level among eleven variables.

• Journal of Trauma and Injury
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• 제35권4호
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• pp.268-276
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• 2022

Purpose: Rib fractures are common injuries that can lead to morbidity and mortality. Methods: Data on all patients with rib fractures admitted to a single trauma center between January 1, 2008 and December 31, 2018 were reviewed. Results: A total of 1,671 admissions for rib fracture were examined. Patients' median age was 57 years, the median Injury Severity Score (ISS) was 14, and the median number of fractured ribs was three. The in-hospital mortality rate was 4%. Age, the number of rib fractures, and Charlson Comorbidity Index scores were poor predictors of mortality, while the ISS was a slightly better predictor, with area under the receiver operating characteristic curve values of 0.60, 0.55, 0.58, and 0.74, respectively. Multivariate regression showed that age, ISS, and Charlson Comorbidity Index score, but not the number of rib fractures, were associated with significantly elevated adjusted odds ratios for mortality (1.03, 1.14, and 1.28, respectively). Conclusions: Age, ISS, and comorbidities were independently associated with the risk of mortality; however, they were not accurate predictors of death. The factors associated with rib fracture mortality are complex and cannot be explained by a single variable. Interventions to improve outcomes must be multifaceted.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.82-88
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• 1988

The main objectives of this study were to know the prevalence of cerebrovascular diseases, to find the important risk factors of cerebrovascular diseases. This study is a part of Eumseong Community Health Project supportes by GTZ(West German Goverment). 116 perceived cases of cerebrovascular diseases were first screened by health interview and examinations and 80 cases were diagnosed as a cerebrovascular group. For comparison, 80 cases were matched with their neighbor controls of the same sex and the similar age. 1. The prevalence rate for cerebrovascular diseases was 476.3 per 100,000 population which is considered to be very high compared with that of other countries. Age adjusted rate for cerebrovascular diseases was 261.6 per 100,000. 2. Among the risk factors examined for the association with cerebrovascular diseases by case-control study, and analysed by paired marginal test(McNemar's $X^2$-test) and odds ratio, only hypertension showed high significant statistical association.