• Journal of Yeungnam Medical Science
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• v.38 no.4
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• pp.337-343
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• 2021

Background: Chromogranin A (CgA) levels have been reported to predict mortality in patients with heart failure. However, information on the prognostic value and clinical availability of CgA is limited. We compared the prognostic value of CgA to that of previously proven natriuretic peptide biomarkers in patients with acute heart failure. Methods: We retrospectively evaluated 272 patients (mean age, 68.5±15.6 years; 62.9% male) who underwent CgA test in the acute stage of heart failure hospitalization between June 2017 and June 2018. The median follow-up period was 348 days. Prognosis was assessed using the composite events of 1-year death and heart failure hospitalization. Results: In-hospital mortality rate during index admission was 7.0% (n=19). During the 1-year follow-up, a composite event rate was observed in 12.1% (n=33) of the patients. The areas under the receiver-operating characteristic curves for predicting 1-year adverse events were 0.737 and 0.697 for N-terminal pro-B-type natriuretic peptide (NT-proBNP) and CgA, respectively. During follow-up, patients with high CgA levels (>158 pmol/L) had worse outcomes than those with low CgA levels (≤158 pmol/L) (85.2% vs. 58.6%, p<0.001). When stratifying the patients into four subgroups based on CgA and NT-proBNP levels, patients with high NT-proBNP and high CgA had the worst outcome. CgA had an incremental prognostic value when added to the combination of NT-proBNP and clinically relevant risk factors. Conclusion: The prognostic power of CgA was comparable to that of NT-proBNP in patients with acute heart failure. The combination of CgA and NT-proBNP can improve prognosis prediction in these patients.

• Childhood Kidney Diseases
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• v.17 no.2
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• pp.149-153
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• 2013

We report the case of a 14-year-old girl, diagnosed with atypical thrombotic microangiopathy (TMA). The patient presented with persistent fever, nausea, and newly developed peripheral edema. Her laboratory findings indicated chronic anemia with no evidence of hemolysis, thrombocytopenia, or elevated serum creatinine level. A few days after hospitalization, acute renal failure and fever worsened, and proteinuria developed. On day 40 of hospitalization, she experienced a generalized tonic seizure for 5 min, accompanied by renal hypertension. Brain magnetic resonance imaging revealed posterior reversible leukoencephalopathy syndrome. After steroid pulse therapy, a renal biopsy was performed because of delayed recovery from thrombocytopenia. The biopsy findings showed features of thrombotic microangiopathic hemolysis with fibrinoid change restricted. Current diagnostic criteria for TMA have focused on thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, and diagnosis is based on the clinical presentation and etiology, with the consequence that idiopathic and atypical forms of TMA can be overlooked. Developing effective tools to diagnose TMA, such as studying levels of ADAMTS13 or testing for abnormalities in the complement system, will be the first step to improving patient outcomes.

• Journal of Korean Medicine Rehabilitation
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• v.33 no.4
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• pp.109-124
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• 2023

Objectives This study aims to find out effect of Korean medicine treatment on managing thoracolumbar compression fractures through retrospective observational study. Methods Among hospitalized patients at the Department of Korean Medicine Rehabilitation from January 1st, 2018 to February 28th, 2023, a total of 24 inpatients who were diagnosed with thoracolumbar compression fractures and received Korean medicine treatment were included in this study. Numeric rating scale (NRS) was used for pain assessment and clinical variables such as sex, symptoms, age, thoracolumbar injury classification and severity (TLICS) scores were collected. For subgroup analysis to analyze factors affecting treatment response, we divided patients into responders and non-responders according to NRS change. For statistical analysis, we compared before/after hospitalization and analyzed distinct features between two groups. Results Most of the patients were in their 70s and 83.33% were female. Average hospitalization period was 24.54±11.91 days. All patients had back pain as their chief complaint and only 2 patients received surgeries. In TLICS, only 1 patient got score 6, which represented surgery indication. After Korean medicine treatment, NRS of almost every patient got lower significantly at the time of discharge (3.02±1.93) than admission (5.52±1.95). Comparing two groups, responders had lower NRS at the time of discharge and TLICS score of them were lower than non-responders. Conclusions Our results show that Korean medicine treatment for thoracolumbar compression fractures was effective in reducing pain. There were distinct clinical features such as age, past history, surgeries between those with significant improvement in pain scores and those who did not.

• The Journal of the Korea Contents Association
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• v.17 no.11
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• pp.435-445
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• 2017

This study was conducted to overcome the limitations of prior research on the equity of medical care performed by identifying simple differences in the use of medical care or using limited medical needs and medical utilization indicators. Specifically, we used activity limits, chronic diseases, and subjective health status as medical needs, and used outpatient, inpatient, and emergency services as medical uses. In addition, we used concentration index, concentration curve, and Le Grand factor to analyze the equity of medical use considering medical needs. The main results are as follows. First, the amount of medical care for the low-income class is higher than that of the high-income class when considering the concentration of medical use. In particular, the number of hospitalization days for low-income households and hospitalization fees were higher than the fees of outpatient medical consultation and emergency room usage. Second, medical needs were concentrated in the low income class. In other words, low-income group is not as healthy as the high-income group. Third, the Le Grand factor was calculated in order to confirm the fairness of the medical uses considering the medical needs. Even if medical needs are taken into consideration, the high-income earners will have a large amount of medical care. In addition, when considering the limitation of activity and the number of chronic diseases, the medical use of the high income class was more frequent. However, when the subjective health condition and the chronic illness were considered, medical use of the low income class was more frequent. This may be due to the underestimation of the medical needs of the low-income earners by neglecting their own health status and perception of chronic diseases.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.11 no.9
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• pp.3336-3340
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• 2010

This study has been carried out against hospitals with less than 100 beds, which were excluded from the previous study on the discharged patients from January 1 to December 31, 2007. To analyze the discharged patients, the general characteristics of discharged patients, means of payment for medical costs, type of disease and surgery and current status of the use of medical services have been investigated based on the medical records. During the year of 2007, the number of discharged patients from the hospitals with less than 100 beds reached 4,697,095 (9.7% of total population). In other words, 9,693 people were discharged from a hospital per 100,000 populations with 9.8 days in terms of annual mean length of hospitalization. The number of patients who returned home after hospitalization reached 4,538,861 (male: 1,784,041, female: 2,754,821) while 119,378 patients were evacuated to other hospitals. Among them, 8,970 patients were returned back to the original hospital. Based on the results of this study, they could be used in could be used in planning a project which is aimed to reduce public health costs by investigating high-risk groups with particular injuries and preventing damage. In addition, the injury monitoring data which are continuously collected could be useful in monitoring and evaluating the efficiency of an injury prevention program.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.11
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• pp.324-334
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• 2019

This study investigates the characteristics of patients hospitalized at a convalescent hospital, by considering patient groups based on their medical record information. It further analyzes and correlates the factors, thus providing basic data required to improve the patient classification system at convalescent hospitals. The data includes total information of 213 medical records of patients discharged from a convalescent hospital in the Jeonbuk region during a period of one year, from January to December 2016. The study examines and correlates the days of hospitalization and the number of diseases, revealing a positive correlation having a correlation coefficient, thereby indicating that infliction with a greater number of diseases results in longer hospitalization. Based on these findings, the study raises the need to revise and supplement items on the patient assessment report to help determine the patient groups and identify medical efforts to be actually provided to patients. In addition, a proper care service system for each patient group based on their respective problems that are intensively managed according to the patient groups will be an essential element in the efficient management of convalescent hospitals. Furthermore, an important task addressed will be in managing the health of the elderly population at the national level.

• Quality Improvement in Health Care
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• v.10 no.1
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• pp.28-41
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• 2003

Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

• The Journal of Internal Korean Medicine
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• v.40 no.5
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• pp.743-751
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• 2019

This case report suggests the potential effects of Korean medicine for the gait disturbance and posture instability of Multiple System Atrophy-Parkinsonism (MSA-P). A patient with MSA-P who had gait disturbance and posture instability was given a series of Korean medicine, including acupuncture, pharmacopuncture, electro-acupuncture, moxibustion, and herbal medicine, for 15 days of hospitalization. During the hospitalization period, the severity and progression of the disease was measured with the Unified Multiple System Atrophy Rating Scale (UMSARS) and a video recording of a 20-meter round timed walking test. The UMSARS Part I and II scores decreased from 14 to 5 and 9 to 5, respectively. An improvement was also noted in standing and walking posture, and the walking time was shortened from 30 to 25 seconds in the 20-meter round-trip walking test. Dysarthria, dysphagia, and non-motoring symptoms like sleep behavioral disorders and constipation were also improved. The findings of this case study suggest that this series of Korean medicine has potential therapeutic effects for patients with MSA-P with motor and non-motor symptoms.

• Journal of Industrial Convergence
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• v.20 no.10
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• pp.51-59
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• 2022

This study aims to investigate the changes in health status of inpatients before and after a fall accident, and it is a retrospective study using data from 328 inpatients who fell from January 1, 2016 to December 31, 2020, reported to the patient safety reporting system. The average age of the study subjects was 68.57(±14.13), and those in their 70s accounted for the most at 30.49%. Falls occurred on average 13.86(±25.03) days after hospitalization, and the time when the most falls occurred was between 22:30 and 06:59 with 42.99%. Before and after a fall during hospitalization, bowel problems (x²=314.0, p<.001), urination problems (x²=284.0, p<.001), intravenous fluid therapy (x²=85.16, p<.001), and walking (x²=69.77. p<.001), bedridden state (x²=51.60, p< .001), mental state and performance (x²=17.52, p<.001) patient's attitude (x²=220.17, p<.001), there was a statistically significant difference. It is necessary to develop an appropriate method and education program for fall prevention in hospital by considering the individual characteristics of inpatient.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.99-111
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• 2019

Purpose: Respiratory syncytial virus (RSV) and human rhinovirus (hRV) are the most common causes of child respiratory viral infections. We aimed to investigate epidemiological and clinical characteristics of RSV and hRV single infections and coinfections. Methods: Nasopharyngeal aspirates of hospitalized children aged <5 years were tested using multiplex reverse transcription polymerase chain reaction (RT-PCR) from October 2014 to April 2017. Their medical records were retrospectively reviewed. Results: RSV or hRV was detected in 384 patients who divided into 3 groups: patients with RSV (R group, n=258); patients with hRV (H group, n=99); and patients with both (RH group, n=27). The R group (median age, 6 months) consisted of 248 (96.1%) patients with lower respiratory tract infection (LRTI), and 14 (5.4%) needed oxygen inhalation. Infants aged <12 months (63.2%) had respiratory difficulty and were supplied oxygen more often. The H group (median age, 16 months) consisted of 56 (56.6%) patients with LRTI, 4 (4%) required oxygen inhalation, and 1 (1.0%) required mechanical ventilation. Infants (40.4%) showed longer hospitalization compared to patients aged ${\geq}12$ months (5 vs. 4 days, P<0.05). The RH group consisted of 24 (88.9%) patients with LRTI, and 2 (7.4%) needed oxygen inhalation. Hospitalization days and oxygen inhalation and mechanical ventilation rates did not differ between single infections (R and H groups) and coinfections (RH group). Conclusions: RSV was detected more often in younger patients and showed higher LRTI rates compared to hRV. Single infections and coinfections of RSV and hRV showed no difference in severity.