• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.44-51
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• 2007

Purpose: The purpose of this study was to compare suicide mortality by region in South Korea. Method: Suicide mortality differentials were calculated for several mortality indicators by geographical regions from raw data of the cause of death from KNSO. Results: The results are as follows; the Crude suicide death rate was 22.63 per 100,000. The highest was in Kangwon showing 37.84% whereas, Chungnam, and Jeonbuk followed after. Suicide was 4.4% of all causes of death, but Inchon and Ulsan showed a higher proportion. The male suicide death rate was 31.12 per 100,000 and females 14.09. The ratio of gender suicide mortality was 2.21, per 100,000 and was the highest in Jeju. For age-specific suicide death rates, the rate increased as age advanced, showing 2.33 per 100,000 in 0-19years, 18.68 in 20-39, 30.48 in 40-59, 63.33 in 60 years and over. In Ulsan, Kangwon, and Inchon, age-specific suicide death rates of the 60 and over age group were higher than other regions, Daegu, Busan, and Kangwon showed a higher age-specific suicide mortality of the 40-59 age group, and Kangwon, Jeonnam, and Chungnam had a higher age-specific suicide mortality of the 20-39 age group. Conclusions: Suicide mortality differed by region. These results can be used for a regional health care plan and planning for suicide prevention by regions.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.131-139
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• 2017

Purpose: Trauma systems have been shown to decrease injury-related mortality. The present study aimed to compare the mortality rates of patients with major trauma (injury severity score >15) treated before and after the establishment of a level I trauma center. Methods: During this 20-month study, participants were divided into pre-trauma center and trauma center groups, and trauma and injury severity score (TRISS) method was used to compare mortality rates during 10-month periods before and after the establishment of the trauma center (October 2013 to July 2014 vs. October 2014 to July 2015). Results: Of the 541 total participants, 278 (51.5%) visited after the establishment of the trauma center. The Z and W statistics indicated better outcomes in the trauma center group than in the pre-trauma center group (Z statistic, 2.635 vs. -0.700; W statistic, 4.640). The trauma center group also exhibited meaningful reductions in the time interval from the emergency department (ED) visit to emergency surgery (118.0 minutes vs. 142.5 minutes, p=0.020) and the interval from the ED visit to intensive care unit admission (202.0 minutes vs. 259.0 minutes, p=0.035) relative to the pre-trauma center group. Conclusions: The TRISS and multivariate analysis revealed significant improvements in survival rates in the trauma center group, compared to the pre-trauma center group.

• Journal of Chest Surgery
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• v.50 no.1
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• pp.14-21
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• 2017

Background: Off-pump coronary artery bypass (OPCAB) is performed worldwide, but significant risks are associated with conversion to on-pump surgery. Therefore, we evaluated the composite outcomes between an OPCAB group and a conversion group. Methods: From January 2008 to December 2012, 100 consecutive patients underwent OPCAB at Hallym University Sacred Heart Hospital, of whom 84 underwent OPCAB without adverse events (OPCAB group), and 16 were converted to on-pump surgery (conversion group). Early morbidity, early and long-term mortality, and major adverse cardiac and cerebrovascular events (MACCEs) were the primary and long-term composite endpoints. Results: The mean follow-up period was $55{\pm}26months$, with 93% of the patients completing follow-up. The composite outcomes in the OPCAB and conversion groups were as follows: early morbidity, 2.3% versus 12.5%; early mortality, 4.7% versus 0%; long-term mortality, 14.3% versus 25.0%; and MACCEs, 14.3% versus 18.8%, respectively. No composite endpoints showed statistically significant differences. Preoperative acute myocardial infarction (AMI) was identified as an independent risk factor for conversion (p=0.025). Conclusion: The conversion group showed no statistically significant differences in early mortality and morbidity, MACCEs, or long-term mortality compared with the OPCAB group. The preoperative diagnosis of AMI was associated with an increased number of conversions to on-pump surgery.

• Journal of the Korean Dietetic Association
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• v.5 no.1
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• pp.48-53
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• 1999

This study was prospectively conducted to investigate any relationship of nutritional status at the time of admission to length of hospital stay and mortality. All patients admitted to the Asan Medical Center between October 13 and November 12, 1997 who met the study criteria were included in the study. Patients were classified as Not-at-risk, At-risk Ⅰ or At-risk Ⅱ based on the levels of serum albumin and total lymphocyte count in a computerized nutrition screening program. Sixty three percent of the patients were classified as Not-at-risk Group, 29% as At-risk Group Ⅰ and 8% as At-risk Group Ⅱ. Significant correlation was observed between nutritional status and LOS (P＜0.01) as well as mortality rate (P＜0.05). The more the patient had the nutritional risk factors, the longer the LOS and the higher the mortality rate were. Further studies have to be done in order to demonstrate cost-effectiveness of medical therapy for the malnourished hospitalized patients.

• Journal of Chest Surgery
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• v.30 no.1
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• pp.17-26
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• 1997

Objeitives. The surgical mortality of congenital heart defects has been reduced (or the very young age group. Especially, young age at repair is an important risk factor for mortality after repair of tetralogy of Falloff. Some risk factors were analyzed Methods. Three hundred and sixty six patients underwent surgical Intervention. Ages ranged from 5 days to 64 years, and 80 patients were adults(over 15 years of age). The defects consisted of 313(84.2%) acyanotic and 53(15.8%) cyanotic anomalies. The surgical mortalities were evaluated by univariate and multivariate analysis. Results. The overall surgical mortality was 10.4%. Mos deaths occurred in the infant group younger than 6 months(20/38 deaths) and in cyanotic group(21/38 deaths). Surgical infant mortality younger than 12 months was 24.8%(25/101). Risk factors of mortality in open heart surgery were age(p< 0.0001), body weight(p< 0.0001), pump time(p< 0.0001), aortic cross clamp time(p< 0.0001), use of total circulatory arrest(p<0.0001) and cyanotic disease(p<0.0001) by univariate analysis. But by multivariate analysis, the risk factor of mortality in open heart surgery was disease entity(p=0.002) only. A disease group with the highest risk was a cyanotic group(odds ratio was 15.3 relative to ventricular septal defect) excluding tetralogy of Falloff(odds ratio=0.27). Conclusions. Even though the most important risk factor was disease entity, we should conentrate our efforts on the technically improvable factors affecting surgical mortality indicated by univarlate analysis.

• Journal of Preventive Medicine and Public Health
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• v.45 no.1
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• pp.21-28
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• 2012

Objectives: The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women. Methods: A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (${\geq}65$ years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels. Results: Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Conclusions: Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.

• Journal of Chest Surgery
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• v.24 no.3
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• pp.271-279
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• 1991

From May 1977 to April 1990, 1000 cases of open heart surgery were performed under the cardiopulmonary bypass. There were divided into group A[500 cases, from May 1977 to June 23rd 1986] and group B[500 cases, from June 23rd 1986 to April 1990] which were analyzed, summarized, and compared. Of 1000 cases of open heart surgery, 677 cases[67.7%] were congenital heart diseases, and 323 cases[32.3%] were acquired heart diseases. In 677 cases of congenital heart disease, there were 545 cases with acyanotic congenital heart anomaly[A: 279, B: 266] and 132 cases with cyanotic congenital heart anomaly[A: 87, B: 45]. In 323 cases of acquired heart disease, most cases were valvular heart disease[315 cases, A: 133, B: 182] in which 357 valves were implanted. The operative mortality of congenital R acquired heart disease was 7.8% & 8.0%, and then overall mortality was 7.9%. The operative mortality was markedly decreased. [about half] from 10.0% of A group to 5.6% of B group.

• Journal of Environmental Health Sciences
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• v.39 no.1
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• pp.90-98
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• 2013

Objectives: Many studies have shown that air pollution and temperature have adverse effects on mortality and morbidity. But the interactive effect between air pollution and temperature on mortality has been rarely investigated. This study aims to explore whether temperature modifies the associations between ambient particulate matter less than $10{\mu}m$ in diameter ($PM_{10}$) and mortality in Seoul, Korea. Methods: The time-series analysis examined the effect of the interaction between $PM_{10}$ and temperature on mortality from 1999 to 2010 in Seoul. In order to examine the interactive effect between $PM_{10}$ and temperature on mortality, we fitted a response surface model controlling the time-trends and meteorological variables. The effects of $PM_{10}$ were stratified by temperature stratum to quantitatively estimate the $PM_{10}$-health outcome associations. Results: When temperature was low (below the threshold temperature), the percentage increases per $10{\mu}g/m^3$ increase of $PM_{10}$ increased 0.38% (95% Confidence Interval[CI]: 0.09~0.68%) and 0.31% (95% CI: - 0.07~0.68%) of mortality in the all age group and ${\geq}65$ year age group, respectively. When temperature was high (above the threshold temperature), the percentage increases per $10{\mu}g/m^3$ increase of $PM_{10}$ increased 1.09% (95% CI: 0.47~1.72%) and 1.35% (95% CI: 0.65~2.06%) for mortality in the all age group and ${\geq}65$ year age group, respectively. Conclusion: The results of this study showed strong modification by temperature in the association between $PM_{10}$ and mortality. We recommend that public health strategies to minimize adverse health impact of heat and $PM_{10}$ should be considered in control and prevention measures for air pollution and weather-related health impacts.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.282-290
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• 2023

Objectives: This study aimed to evaluate the potential interaction between kidney function and the non-linear association between serum calcium levels and cardiovascular disease (CVD) mortality. Methods: This study included 8927 participants enrolled in the Dong-gu Study. Albumin-corrected calcium levels were used and categorized into 6 percentile categories: <2.5th, 2.5-25.0th, 25.0-50.0th, 50.0-75.0th, 75.0-97.5th, and >97.5th. Restricted cubic spline analysis was used to examine the non-linear association between calcium levels and CVD mortality. Cox proportional hazard regression was used to estimate hazard ratios (HRs) for CVD mortality according to serum calcium categories. All survival analyses were stratified by the estimated glomerular filtration rate. Results: Over a follow-up period of 11.9±2.8 years, 1757 participants died, of whom 219 died from CVD. A U-shaped association between serum calcium and CVD mortality was found, and the association was more evident in the low kidney function group. Compared to the 25.0-50.0th percentile group for serum calcium levels, both low and high serum calcium tended to be associated with CVD mortality (<2.5th: HR, 6.23; 95% confidence interval [CI], 1.16 to 33.56; >97.5th: HR, 2.56; 95% CI, 0.76 to 8.66) in the low kidney function group. In the normal kidney function group, a similar association was found between serum calcium levels and CVD mortality (<2.5th: HR, 1.37; 95% CI, 0.58 to 3.27; >97.5th: HR, 1.65; 95% CI, 0.70 to 3.93). Conclusions: We found a non-linear association between serum calcium levels and CVD mortality, suggesting that calcium dyshomeostasis may contribute to CVD mortality, and kidney function may modify the association.

• Journal of Chest Surgery
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• v.24 no.11
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• pp.1045-1057
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• 1991

Over the past four decades after World War II a great deal of data and clinical experiences have been accumulated relating to the diagnosis and surgical treatment of cardiovascular diseases in Korea. Clinical data after the first open heart surgery by Professor Yung Kyoon Lee on August 7, 1959 up to 1984 revealed the total number of cardiovascular surgery in Korea as 13,100 cases performed in 22 institutes with overall hospital mortality of 7.7%[Cardiovascular Surgery in Korea 1985], Publishing committee of the Korean Thoracic and Cardiovascular Surgical Society collected the data of cardiovascular surgical cases in Korea again in between 1985 and 1990 from 38 institutes out of total 42 institutes of open heart centers in Korea. The results are: 1. The survey reply ratio was 90.5%[38 out of 42 institutes]. 2. Of the total 30,061 cases of cardiovascular surgery reported from 38 institutes 1,402 cases were failed as hospital mortality of 4.7%[4.5% of the 21,761 operations for congenital, and 5.2% of the 8,300 operations for acquired heart diseases]. Out of the total congenital cases, 17,303 cases were acyanotic group with a operative mortality as 2.0%, and 4,458 cases were cyanotic group with a hospital mortality as 14.le The incidence of corrective operations for complex congenital cardiac anomalies were increasing recently with decreasing age group. 3. During the year in 1990, 38 institutes performed 5,427 cardiovascular surgery with a hospital mortality of 3.4%. 4. Of the total cumulative 6,458 cases for cardiac valve surgery more than 90% cases were put to prosthetic valve replacement with hospital mortality as 4.8%. And the incidence of re-Do valve surgery was increasing recently as 13.1% in 1990. 5. Coronary artery bypass graft was increasing recently with 7.9% of hospital mortality in total 440 cases. Intracardiac operation for intractable arrhythmia was started since 1987 as 49 cases in total. Experiences on VAD and ECMO were also reported sporadically in recent year. 6. Home made oxygenator[OXYREX] is now in clinical use, and under animal experiment for clinical trial in near future.