• 제목/요약/키워드: days of hospitalization

검색결과 529건 처리시간 0.025초

A Study on the Effectiveness of Korean Medicine Treatment for Patients' Involved in Traffic Accidents and the Analysis of Factors Affecting the Effectiveness of Korean Medicine Treatment - A Retrospective Review

  • Kim, Seon-Hye;Kim, Hye-Ryeon;Sung, Won-Suk;Cho, Hyun-Seok;Moon, So-Ri;Keum, Dong-Ho;Lee, Seung-Deok;Kim, Eun-Jung
    • Journal of Acupuncture Research
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    • 제36권1호
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    • pp.12-20
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    • 2019
  • Background: This study was conducted to verify the effectiveness and effectiveness-related factors of Korean medicine (KM) treatment for patients who have been involved in traffic accidents (TA). Methods: The medical records of 150 TA patients hospitalized in Dongguk University Bundang Oriental Medicine Hospital from September 2017 to May 2018 were reviewed. Medical records included information on patient demographic characteristics, TA situations, use of KM treatment, clinical characteristics, 4 scales [numeric rating scale (NRS), visual analogue scale (VAS), EuroQol-visual analogue scale (EQ-VAS) and neck disability index (NDI)]. Statistical analyses were performed to determine the effectiveness and effectiveness-related factors of treatment. Results: The 150 patients (almost 1:1 gender ratio) were typically in their 40's (26.67%), had rear impact to their vehicle (37.33%), were in the driver's seat (70.00%), and without head trauma and loss of consciousness (83.33%). The main symptoms were neck pain (60.66%) and lower back pain (54.00%). All 150 patients showed significant improvement after KM treatment. 4 scales significantly improved when the treatment started within 3 days from the accident and patients were hospitalized longer and took more diverse treatments. The patients experiencing a higher initial pain level (NRS 8-10, $VAS{\geq}70$) showed significant improvement of NRS and VAS scores with faster and longer inpatient treatments than the other patients. The patients with higher initial pain levels ($VAS{\geq}70$) also showed significant improvement in EQ-VAS scores. Conclusion: KM treatment was effective for TA patients in this study. Treatment initiation time, hospitalization period, treatment diversity and initial pain level are related to the degree of improvement of a patient's symptoms.

Morbidity and Mortality Trends in Preterm Infants of <32 Weeks Gestational Age with Severe Intraventricular Hemorrhage : A 14-Year Single-Center Retrospective Study

  • Eui Kyung Choi;Hyo-jeong Kim;Bo-Kyung Je;Byung Min Choi;Sang-Dae Kim
    • Journal of Korean Neurosurgical Society
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    • 제66권3호
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    • pp.316-323
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    • 2023
  • Objective : Owing to advances in critical care treatment, the overall survival rate of preterm infants born at a gestational age (GA) <32 weeks has consistently improved. However, the incidence of severe intraventricular hemorrhage (IVH) has persisted, and there are few reports on in-hospital morbidity and mortality. Therefore, the aim of the present study was to investigate trends surrounding in-hospital morbidity and mortality of preterm infants with severe IVH over a 14-year period. Methods : This single-center retrospective study included 620 infants born at a GA <32 weeks, admitted between January 2007 and December 2020. After applying exclusion criteria, 596 patients were included in this study. Infants were grouped based on the most severe IVH grade documented on brain ultrasonography during their admission, with grades 3 and 4 defined as severe. We compared in-hospital mortality and clinical outcomes of preterm infants with severe IVH for two time periods : 2007-2013 (phase I) and 2014-2020 (phase II). Baseline characteristics of infants who died and survived during hospitalization were analyzed. Results : A total of 54 infants (9.0%) were diagnosed with severe IVH over a 14-year period; overall in-hospital mortality rate was 29.6%. Late in-hospital mortality rate (>7 days after birth) for infants with severe IVH significantly improved over time, decreasing from 39.1% in phase I to 14.3% in phase II (p=0.043). A history of hypotension treated with vasoactive medication within 1 week after birth (adjusted odds ratio, 7.39; p=0.025) was found to be an independent risk factor for mortality. When comparing major morbidities of surviving infants, those in phase II were significantly more likely to have undergone surgery for necrotizing enterocolitis (NEC) (29.2% vs. 0.0%; p=0.027). Additionally, rates of late-onset sepsis (45.8% vs. 14.3%; p=0.049) and central nervous system infection (25.0% vs. 0.0%; p=0.049) were significantly higher in phase II survivors than in phase I survivors. Conclusion : In-hospital mortality in preterm infants with severe IVH decreased over the last decade, whereas major neonatal morbidities increased, particularly surgical NEC and sepsis. This study suggests the importance of multidisciplinary specialized medical and surgical neonatal intensive care in preterm infants with severe IVH.

입원환자의 비공식적 의료비용 부담에 관한 연구 (A Study on the Informal Cost Burden of the Patients Admitted to the Hospital)

  • 한미현
    • 간호행정학회지
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    • 제7권1호
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    • pp.5-14
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    • 2001
  • To estimate total burden of hospital admission over patient of gamily, we need to know the unofficial private expenses in addition to explicit hospital admission fees. This study was conducted from June 29, 2,000 to August 10, 2,000. Subjects were 104 patient at university hospital located at chungnam province. After thorough explanation of purpose and procedures, notebooks are given to each patient or guardian. They are requested to recorded all relevant expenditures occurred during hospital stay. Incomplete records were filled-up by direct personal contact or phones. Datas were summarized and analyzed using SAS statistical package. P-value less than 0.05 was considered significant. The results of the study are as follows: 1. In 96.1% of the patient, guardians stayed at hospital to take care of patients. In 38,8% one of the family members get work-leave or temporary resting from job. Average date of leave was 7.5days. 2. Average informal cost burden per patient was 204,467 won (14,330 won${\sim}$1,594,870 won). Average hospital cost paid by the patient was 1,061,807 won. The ratio of informal cost burden to hospital cost paid by the patient was 0.327. 3. According to the regression analysis, the relevant factors affection informal cost burdens were distance from home to hospital(p=0.018), and duration of hospitalization(p=0.0001). 4. Informal cost burden was composed of expenses for personal expense of care giver (126, 720 won/patient), meal (86,924 won/patient), transportation (77,648 won/patient), necessaries of life (18,789 won/patient), tests and treatments not covered by insurance (17,289 won/patient), medical supplies not covered by insurance (15,280 won/patient), treat for visitors (14,757 won/patient), TV coin (8,247 won/patient), and others (7,582 won/patient). In addition to the hospital cost paid by the patient for hospital admission, the informal cost burdens should be recognised explicitly because it is not small. Significant proportion of informal cost burden is composed of care-giver's personal expense, transportation, meal. It is suggested that some polices are to be devised and implemented enabling that this portion of informal expenses be directed to formal professional nursing care. Thus we can improve the quality of care and decrease discomfort of patient's relatives.

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소아기 류마티스모양 관절염 환자에서 etanercept 사용 후 발생한 뇌염 1예 (A case of encephalitis in a juvenile rheumatoid arthritis patient treated with etanercept)

  • 권아름;;김기환;김동수
    • Clinical and Experimental Pediatrics
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    • 제53권2호
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    • pp.262-266
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    • 2010
  • $TNF-{\alpha}$ 는 소아기 류마티스모양 관절염의 병태생리학에 관여하는 주요 cytokine 이다. Etanercept 는 $TNF-{\alpha}$ 억제제 중 하나로 소아기 류마티스모양 관절염에 효과적인 약물로 각광받고 있다. Etanercept의 주요 부작용은 면역력 저하에 의한 감염으로, 대게 중등도의 상기도 감염이 대부분으로 알려져 있으나, 최근 중증의 감염도 보고되고 있다. 저자들은 소아기 류마티스모양 관절염 환자가 etanercept를 14개월간 투약 후 발생한 뇌염 1예를 경험하였기에 보고하는 바이다.

급성기 뇌경색 발생 환자의 1년 후 삶의 질 관련요인 (A Study on Factors in Quality of Life of Patients with Acute Cerebral Infarction One Year after Diagnosis)

  • 신승옥;류소연
    • 한국산학기술학회논문지
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    • 제15권1호
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    • pp.274-282
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    • 2014
  • 본 연구는 급성기 뇌경색 환자의 일반적인 특성, 치료관련 특성 및 뇌졸중 평가척도와의 관련성을 파악하고, 뇌졸중 환자의 삶의 질 영향요인을 분석하였다. 연구대상은 한 대학병원에서 7일 이내 발생한 뇌경색으로 진단받고 퇴원한 환자이며 1년 후까지 생존한 576명을 대상으로 전화인터뷰를 통한 삶의 질을 조사하였다. 연구결과 평균연령은 $65.8{\pm}12.4$세로 남성이 62.0%이었으며, 삶의 질 평균은 $0.77{\pm}0.29$점이었다. 뇌졸중 환자의 성별, 연령, 고혈압, 심방세동, 뇌졸중 과거력, 흡연에서 통계적으로 유의한 차이가 있었다. 삶의 질에 영향을 주는 요인을 위해 다중회귀분석한 결과 여성이 남성에 비해 삶의 질이 낮았고, 뇌졸중 과거력이 있거나 연령이 높을수록 삶의 질이 유의하게 낮았다. 뇌졸중 평가 척도가 높을수록 삶의 질이 유의하게 낮았다. 따라서 뇌졸중으로 입원중과 퇴원이후에는 환자에게 적합한 프로그램의 중재가 이루어져야 하며 재발방지를 위한 프로그램 개발이 필요할 것이다.

요양병원에 내원한 경도인지장애환자의 진료특성에 관한 연구 (A Study on Clinical Characteristics of Patients with Mild Cognitive Impairment at Convalescent Hospitals)

  • 김윤종;김두리;김광환
    • 한국융합학회논문지
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    • 제9권8호
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    • pp.77-85
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    • 2018
  • 본 연구는 일 지역 내 요양병원의 경도인지장애환자의 일반적 특성, 입원 및 진료특성을 분석하여 경도인지장애 환자에 대한 효율적 관리에 필요한 자료를 제공하고자 시행하였다. 연구대상은 2016년 일 지역에 소재하는 요양병원에서 경도인지장애(F067)를 주진단으로 하는 입원환자 303명의 명세서 건이다. 본 연구결과, 재원일수는 계절별로는 ADL 6~12점, ADL 13~20점 그룹 모두 겨울이 가장 긴 것으로 나타났다. 진료결과는 ADL 6~12점, ADL 13~20점 그룹 모두 퇴원일 때 재원일수가 긴 것으로 나타났다. 총 진료비는 계절별로는 ADL 6~12점, ADL 13~20점 그룹에서 겨울이 높았다. 환자 분류군는 ADL 4~5점 그룹에서는 인지장애군의 진료비가 가장 높았고, ADL 6~12점, ADL 13~20점 그룹 모두 문제행동군이 가장 높은 것으로 나타났다. 이와 같은 결과 경도인지장애에 대한 조기발견과 치료는 잠재적인 치매환자 발생과 그에 따른 사회적 비용 감소에 효과적인 방안이자 대단히 중요한 과제임을 알 수 있다.

한의학적 복합치료에 의해 호전된 척추수술실패증후군(Failed Back Surgery Syndrome)환자 10례: 후향적 증례연구 (Korean Medicinal Combination Treatments for Failed Back Surgery Syndrome: A Retrospective Case Series)

  • 서영우;박한솔;김민철;김세영;서영훈;이상민;김유종;홍제락;김지수;김기옥;김태훈
    • Journal of Acupuncture Research
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    • 제32권2호
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    • pp.217-227
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    • 2015
  • Objectives : This study is an evaluation of the effectiveness of treatments combined with Korean medical methods, such as relaxative Chuna and Gangchuk herbal medicines, for patients with failed back surgery syndrome. Methods : In this study, medical records of ten patients who experienced failed back surgery syndrome and participated in intensive Korean medical treatment were reviewed. All patients received relaxative Chuna and acupuncture along with Gangchuk herbal medicines during hospitalization. Numeric rating scale(NRS) in the degree of 0 to 10, pain-free walking distance(PFWD) and oswestry disability index(ODI) were measured before and after treatments. Results : The patients were hospitalized for an average of 22 days. The average NRS of lumbar pain in all patients decreased from $7.7{\pm}1.6$ to $3.2{\pm}2.2$ and the average NRS decline of leg pain was from $7.7{\pm}1.7$ to $3.2{\pm}2.2$, both of which indicate statistical significance(p < 0.05). PFWD in all patients increased from 113.3 m to 798.1 m on average. The average ODI in all patients significantly improved from $63.9{\pm}7.0$ to $43.9{\pm}6.9$(p < 0.05). Conclusions : The treatments combined with Korean medical methods for failed back surgery syndrome patients are clinically effective and viable.

코로나 19 후 폐섬유화(Post COVID-19 pulmonary fibrosis)에 대한 복합 한의치험 1례 (Korean Medicine Treatment for a Patient with Post-COVID-19 Pulmonary Fibrosis: A Case Report)

  • 신정원;박지원;진수현;김관일;정희재;이범준
    • 대한한방내과학회지
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    • 제44권6호
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    • pp.1294-1317
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    • 2023
  • Background: Post-COVID-19 pulmonary fibrosis (PCPF) is a common complication in severe COVID-19 cases, often associated with acute respiratory distress syndrome or mechanical ventilation. Patients with PCPF frequently experience a decline in their quality of life due to persistent COVID-19 sequelae, including cough and chest pain. However, there is currently no established standard treatment, and the efficacy of existing medications remains uncertain. Case Report: A 65-year-old female patient presenting with cough, dyspnea, chest pain, and fatigue due to PCPF received Korean medicine treatment for 25 days. Symptom evaluation utilized the modified Medical Research Council scale, the Leicester Cough Questionnaire, and the Numeral Rating Scale. Quality of life and functional status were assessed using the Post-COVID-19 Functional Status and the EuroQol 5-Dimensional 5-Level. The extent of pulmonary fibrosis was assessed by comparing chest computed tomography (chest CT) scans before and after hospitalization. Following treatment, the patient demonstrated clinically meaningful improvement in clinical symptoms, enhanced quality of life, and decreased fibrotic lesions on CT scans. Conclusion: This case report suggests that Korean medicine treatment may be effective in improving clinical symptoms, such as cough and dyspnea caused by PCPF, while also enhancing post-COVID-19 quality of life and ameliorating pulmonary fibrotic lesions.

USN을 이용한 산모 모니터링 시스템 모델 설계 (The Design of Maternity Monitoring System Using USN in Maternity Hospital)

  • 이서준;심현진;이아롬;이태로
    • 디지털융복합연구
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    • 제11권5호
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    • pp.347-354
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    • 2013
  • 양질의 의료 서비스를 요구하는 환자들은 증가하는 반면 의사나 간호사와 같은 전문 의료 인력은 한정되어 있어 그들에게 가해지는 업무 부담이 과중하게 부여되고 있는 실정이다. 이러한 문제를 해결하기 위한 대안으로 USN(Ubiquitous Sensor Network)을 이용한 환자 모니터링 시스템이 대두되고 있다. 본 논문에서는 USN을 산부인과에 적용하여 간호사의 업무 부담을 줄이기 위해 산모 모니터링 시스템 모델을 설계하였다. 효율성 평가는 서울소재 대학병원(S, K 병원) 두 곳을 모델로 설정하여 의사의 처방에 따른 측정 주기를 산출하여 실시하였으며, 그 결과는 간호사 1인이 12명의 환자(자연분만 6명, 자연분만 외 출산 6명)를 케어하는 경우 입원기간(5일 기준) 동안에 1,260분이 경감되는 것으로 나타났다. 또한 간호사의 기존 업무량과 모니터링 시스템 적용 후 업무량을 비교해 보았을 때 자연분만 산모의 경우 산모 수가 1명씩 증가함에 따라 하루에 50분씩, 자연분만 외 수술 산모의 경우 산모 수가 1명씩 증가함에 따라 하루에 130분씩 업무량 감소 효과가 있는 것으로 나타났다.

병원감염에 관한 판례의 동향 (Trends of the Precedent Case concerning Hospitalized Acquired Infection)

  • 이동필
    • 의료법학
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    • 제8권1호
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    • pp.61-105
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    • 2007
  • The Hospitalized Acquired Infection is defined as the case where the hidden infection or not found at the time of hospitalization occurs during the hospitalized period or, within 30 days to those who performed the surgery operation and then left the hospital. About 2/3 of the Hospitalized Acquired Infection are found as having the internal infection cases that are occurred by the patients' own virus due to the lowered immune system, while about 1/3 are found as having the external infection. The latter 1/3 of the external infection cases can be prevented through the infection management. And in case the new Hospitalized Acquired Infection case occur to the patient who was treated in the hospital, its responsibility issue will matter. As well in the disputes over the Hospitalized Acquired Infection cases, the cause-result relation between the damages and the medical staff's fault and as to whether there is failure of the medical staff or not. personnel should be proved in the medical-malpractice cases. In addition, the difficulties in proving such as expertise, secrecy propensity, discrete propensity and incompleteness will be considered to ease the burden of patient side's proving. Probability theory, Fact based assumption theory, Most adequate plaintiff preassumption or Expressed evidence theories are being discussed as the theories of eased burden of proof. In the result of gathering and reviewing Korea's precedent cases concerning the Hospitalized Acquired Infection, there are only a few accumulated prece dent cases and the attitude of the court also are also not consistent. Therefore, there are the precedents where the cause-result relation and the failure are immediately assumed when (1) timely proximity between the medical behavior and malpractice results, (2) proximity between the medical behavior-applied parts and the malpractice results-found parts, and (3) lack of other causes are separately evidenced; while the are the precedents only when 'the existence of the medical faults based on the common sense' is separately evidenced. It was found that the former and latter cases coexisted. The former is considered as based on the theory that separates the fault and cause-result relation not to consider them together, or regarded as based on the doubts that assumes the medical staff's neglect even though the Hospitalized Acquired Infection might be completely prevented by their efforts. However, the modern medical technology has the limitation as far as the prevention of the Hospitalized Acquired Infection. In conclusion, the assumption of the cause-result relation and that of the fault should be separately reviewed. Therefore, the latter precedents are considered as more reasonable, in the point the faulty behavior may be proved based on the common sense.

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