• 제목/요약/키워드: hospital logistic

검색결과 1,590건 처리시간 0.03초

노인 환자의 골관절염 수술 후 발생한 섬망과 섬망 위험요인 (Postoperative Delirium in Elderly Patients with Osteoarthritis Surgery: Incidence and Risk Factors)

  • 박은아;김민영
    • 근관절건강학회지
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    • 제22권2호
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    • pp.57-66
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    • 2015
  • Purpose: The purpose of this study was to evaluate the incidence of postoperative delirium in elderly patients with osteoarthritis surgery and identify risk factors for its development. Methods: This study enrolled 288 patients who underwent osteoarthritis surgery in a hospital between May and November 2014. Data were collected prospectively. The Nursing Delirium Screening Scale was used to detect delirium. Multivariable logistic regression analysis was used to identify independent risk factors for postoperative delirium. Patients were also followed for outcome. Results: Postoperative delirium developed in 42 patients (14.6%). Logistic regression analysis identified old age, low physical activity, antipsychotic agents, number of catheters, and intensive care unit admission as risk factors. Worse outcomes, including increased hospital mortality, reoperation, and discharge at care facilities, occurred in subjects who developed delirium. Conclusion: Osteoarthritis surgery in elderly patients was associated with a high incidence of postoperative delirium. The results of the this study regarding patient populations vulnerable to delirium should be taken into account so that such patients could be identified preoperatively or in the immediate postoperative period.

중소 병원 간호사들의 업무상 손상경험에 영향을 미치는 요인파악 (Factors Associated with Work-Related Injuries of Nurses in Small and Medium Sized Hospitals)

  • 황지인;황은정
    • 간호행정학회지
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    • 제16권3호
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    • pp.306-313
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    • 2010
  • Purpose: This study was conducted to examine the factors associated with work related injuries of nurses in small and medium sized hospitals. Method: A cross-sectional survey was conducted with nurses in eight hospitals from October 2007 to January 2008. A questionnaire was designed to collect information on nurses' work related injuries, and individual and job related characteristics. The response rate was 65.1%. Data from 294 nurses were analyzed. Multiple logistic regression analysis was performed to determine factors associated with work related injuries. Result: Of the 294 nurses, 19.1% (n=56) responded as having at least one injury during their job performance. The logistic regression analysis revealed that the significant factors influencing work related injuries were job satisfaction, stress recognition, and hospital's location. Nurses with a higher job satisfaction were less likely to experience work related injuries (OR=0.58). Nurses with a higher stress recognition (OR=2.57) and those working at hospitals in metropolitan cities (OR=3.28) were more likely to experience work related injuries. Conclusions: The result of this study indicated that a substantial proportion of nurses in small and medium sized hospitals had experienced injuries related to nursing job. Interventions to prevent work related injuries among nurses should take into account the job satisfaction, stress recognition, and hospital characteristics.

환자교차 설계 방법을 적용한 소아천식 입원에 대한 도시 대기오염의 급성영향평가 (Associations between Air Pollution and Asthma-related Hospital Admissions in Children in Seoul, Korea: A Case-crossover Study)

  • 이종태
    • Journal of Preventive Medicine and Public Health
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    • 제36권1호
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    • pp.47-53
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    • 2003
  • Objectives : I used a case-crossover design to investigate the association between air pollution, and hospital admissions for asthmatic children under the age of 15 years in Seoul, Korea Methods : I estimated the changes in the levels of hospitalization risk from theinterquartile (IQR) increase in each pollutant concentrations, using conditional logistic regression analyses, with controls for weather information. Results : Using bidirectional control sampling, the results from a conditional logistic regression model, with controls for weather conditions, showed the estimated relative risk of hospitalization for asthma among children to be 1.04 (95% confidence interval (CI), 1.01-1.08) for particulate matter with an aerodynamic diameter less than or equal to 10m (IQR=40.4ug/m3); 1.05 (95% CI, 1.00- 1.09) for nitrogen dioxide (IQR=14.6ppb): 1.02 (95% CI,0.97-1.06) for sulfur dioxide (IQR=4.4ppb): 1.03 (95% CI, 0.99-1.08) for ozone (IQR=21.7ppb): and 1.03 (95% CI, 0.99-1.08) for carbon monoxide f10R=1.0ppm). Conclusions : This empirical analysis indicates the bidirectional control sampling methods, by design, would successfully control the confounding factors due to the long-term time trends of air pollution. These findings also support the hypothesis that air pollution at levels below the current ambient air quality standards of Korea is harmful to sensitive subjects, such as asthmatic children.

일 대학병원 종합건강증진센터를 내원한 수진자의 대사증후군과 관련요인 (Metabolic Syndrome and Associated Risk Factors Among the Clients of a Comprehensive Medical Examination Center)

  • 서정아
    • 동서간호학연구지
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    • 제14권2호
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    • pp.47-53
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    • 2008
  • Purpose: Metabolic syndrome (also known as insulin resistance syndrome) represents a constellation of hypertriglyceridemia, hypertension, impaired glucose tolerance, and obesity. Presently, the influence of various factors on metabolic syndrome was assessed in patients of a university hospital comprehensive medical examination center. Methods: Age, sex, blood pressure, height, weight, triglyceride level, high-density lipoprotein cholesterol, and glucose levels were measured in 67 people (37 males and 30 females). These factors were correlated with tobacco use, alcohol consumption, and exercise habits. Metabolic syndrome and abdominal obesity were assessed according to NCEP-ATP III criteria and the Asia-Pacific guidelines (male obesity defined as a waist circumference exceeding 90 cm), respectively. Data was analyzed using t-test, 2-test, and logistic regression. Results: Respective percentages were: tobacco use (14.9% of the 67 people), no tobacco use (85.1%), alcohol consumption (62.7%), no alcohol consumption (37.3%), regular exercise (25.4%), no regular exercise (74.6%). Logistic regression analysis revealed a gender-related odds ratio of 2.3 for metabolic syndrome and no exercise. Conclusions: Weight reduction and physical exercise may decrease the prevalence of metabolic syndrome. Early identification of metabolic syndrome and risk factor modification is prudent in cases of obesity, diabetes, hyperlipidemia, and hypertension.

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Risk Factors for Thyroid Cancer in Females Using a Logit Model in Lahore, Pakistan

  • Asif, Faiza;Ahmad, Muhammad Riaz;Majid, Arshia
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권15호
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    • pp.6243-6247
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    • 2015
  • Background: Thyroid cancer (TC) is a more common endocrine malignancy in females and is a major cause of death in developing countries. Therefore the aim of this study was to explore possible risk factors of thyroid cancer in females of Pakistan. Materials and Methods: This study covered 232 females, including 127 (54.7%) cases and 105 (45.2%) controls, from the INMOL Hospital and Sheikh Zayed Hospital, Lahore. Different risk factors were explored by the descriptive and inferentially statistics. Odds ratios and 95% confidence intervals for different risk factors were computed using logistic regression. Results: The results showed six risk factors, marital status, family history of thyroid cancer, iodine in the diet, oxidative stress, fast food and fried food, to demonstrate positive significant links to thyroid cancer (odds ratios and 95% confidence intervals of :2.152, 1.104-4.198; 2.630, 1.416-4.887; 2.391, 1.282-4.458; 4.115, 2.185-7.750; 3.656, 1.851-7.223; 2.357, 1.268-4.382; and 2.360, 1.199-4.643, respectively). Conclusions: The Oxidative stress, marital status, family history of cancer, fast food, use of iodine diet and fried food are the risk factors of thyroid cancer in females.

Usefulness of Shock Index to Predict Outcomes of Trauma Patient: A Retrospective Cohort Study

  • Kim, Myoung Jun;Park, Jung Yun;Kim, Mi Kyoung;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • 제32권1호
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    • pp.17-25
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    • 2019
  • Purpose: We investigated how prehospital, emergency room (ER), and delta shock indices (SI) correlate with outcomes including mortality in patients with polytrauma. Methods: We retrospectively reviewed the medical records of 1,275 patients who visited the emergency department from January 2015 to April 2018. A total of 628 patients were enrolled in the study. Patients were divided into survivor and non-survivor groups, and logistic regression analysis was used to investigate independent risk factors for death. Pearson coefficient analysis and chi-square test were used to examine the significant relationship between SI and clinical progression markers. Results: Of 628 enrolled patients, 608 survived and 27 died. Multivariate logistic regression analysis reveals "age" (p<0.001; OR, 1.068), "pre-hospital SI >0.9" (p<0.001; OR, 11.629), and "delta SI ${\geq}0.3$" (p<0.001; OR, 12.869) as independent risk factors for mortality. Prehospital and ER SIs showed a significant correlation with hospital and intensive care unit length of stay and transfusion amount. Higher prehospital and ER SIs (>0.9) were associated with poor clinical progression. Conclusions: SI and delta SI are significant predictors of mortality in patients with polytrauma. Moreover, both prehospital and ER SIs can be used as predictive markers of clinical progression in these patients.

Employment Status Change and New-Onset Depressive Symptoms in Permanent Waged Workers

  • Kim, Hyung Doo;Park, Shin-Goo
    • Safety and Health at Work
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    • 제12권1호
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    • pp.108-113
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    • 2021
  • Background: This study aimed to investigate the relationship between changes in employment status and new-onset depressive symptoms through a one-year follow-up of permanent waged workers. Methods: We analyzed the open-source data from the Korea Welfare Panel Study. Using the 2017 data, we selected 2,314 permanent waged workers aged 19 to 59 years without depressive symptoms as a base group. The final analysis targeted 2,073 workers who were followed up in 2018. In 2018, there were five categories of employment status for workers who were followed up: permanent, precarious, unemployed, self-employed, and economically inactive. Multiple logistic regression was used to determine the association between employment status change and new-onset depressive symptoms. Results: Adjusted multiple logistic regression analysis showed that among male workers, workers who went from permanent status to being unemployed (odds ratio: 4.50, 95% confidence interval: 1.19 to 17.06) and from permanent status to being precarious workers (odds ratio: 3.15, 95% confidence interval: 1.30 to 7.65) had significantly high levels of new-onset depressive symptoms compared with those who retained their permanent employment status. There were no significant increases in new-onset depressive symptoms of male workers who went from permanent status to being self-employed or economically inactive. On the other hand, no significant differences were found among female workers. Conclusion: Our study suggests that the change of employment status to precarious workers or unemployment can cause new-onset depressive symptoms in male permanent waged workers.

25-Hydroxyvitamin D level is associated with mortality in patients with critical COVID-19: a prospective observational study in Mexico City

  • Parra-Ortega, Israel;Alcara-Ramirez, Diana Guadalupe;Ronzon-Ronzon, Alma Angelica;Elias-Garcia, Fermin;Mata-Chapol, Jose Agustin;Cervantes-Cote, Alejandro Daniel;Lopez-Martinez, Briceida;Villasis-Keever, Miguel Angel;Zurita-Cruz, Jessie Nallely
    • Nutrition Research and Practice
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    • 제15권sup1호
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    • pp.32-40
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    • 2021
  • BACKGROUND/OBJECTIVES: Considering the high number of deaths from coronavirus disease 2019 (COVID-19) in Latin American countries, together with multiple factors that increase the prevalence of vitamin D deficiency, we aimed to determine 25-hydroxyvitamin D (25[OH]D) levels and its association with mortality in patients with critical COVID-19. SUBJECTS/METHODS: This was a prospective observational study including adult patients with critical COVID-19. Data, including clinical characteristics and 25(OH)D levels measured at the time of intensive care unit admission, were collected. All patients were followed until hospital discharge or in-hospital death. The patients were divided into those surviving and deceased patient groups, and univariate and multivariate logistic regression analyses were performed to determine independent predictors of in hospital mortality. RESULTS: The entire cohort comprised 94 patients with critical COVID-19 (males, 59.6%; median age, 61.5 years). The median 25(OH)D level was 12.7 ng/mL, and 15 (16%) and 79 (84%) patients had vitamin D insufficiency and vitamin D deficiency, respectively. The median serum 25(OH)D level was significantly lower in deceased patients compared with surviving (12.1 vs. 18.7 ng/mL, P < 0.001). Vitamin D deficiency was present in 100% of the deceased patients. Multivariate logistic regression analysis revealed that age, body mass index, other risk factors, and 25(OH)D level were independent predictors of mortality. CONCLUSIONS: Vitamin D deficiency was present in 84% of critical COVID-19 patients. Serum 25(OH)D was independently associated with mortality in critical patients with COVID-19.

Between-Hospital Variation in All-Cause Mortality for Potentially Avoidable Hospitalizations in Older People

  • Kim, Jae-Hyun;Lee, Yunhwan
    • 보건행정학회지
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    • 제29권2호
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    • pp.220-227
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    • 2019
  • Background: Potentially avoidable hospitalizations (PAH) contribute to an increased post-discharge mortality. Methods: To investigate the between-hospital variation and the relationship between all predictors and mortality after discharge among older adults with PAH, we studied 15,186 older patients with PAH in 2,200 hospitals included in the National Health Insurance Service-Senior claims database from 2002 to 2013. Multivariable multilevel logistic regression analyses were performed to analyze the variance at between-hospital for mortality after accounting for differences in patient characteristics. Results: The between-hospital variation in mortality that could be attributed to hospital practice variations were 37.6% at 1-week to 13.9% at 12-month post-discharge, after adjustment for individual patient characteristics and hospital-level factors. Hospital-level factors significantly explained mortality at 3 weeks after discharge. Clinics, compared with general hospitals, demonstrated a 2.75 times higher likelihood of deaths at 3-week post-discharge (p<0.001). Compared with private hospitals, public hospitals exhibited 1.61 times higher odds of 3-week mortality (p=0.01). Conclusion: This study demonstrates considerable between-hospital variations in PAH-related mortality that could be attributed to hospital practices. Monitoring of hospitals to identify practice variations would be warranted to improve the survival of older patients with PAH.

최근 배출된 전문의의 개원지역 선택에 영향을 미치는 개인요인 분석 (Individual factors influencing the location decisions of practicing physicians)

  • 김창엽;윤석준;이진석;김용익
    • 보건행정학회지
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    • 제9권3호
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    • pp.21-32
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    • 1999
  • The purpose of this study is to assess individual decisive factors for distribution of medical specialists in Korea. A data set was constructed using several published data sources. including the Korean Medical Association's physician master file as a principal source for physician information. Linear logistic regression analysis was performed to assess the relationship between the location of private specialist clinic for practice with six variables related with individual characteristics: age. sex. location of postgraduate training hospital. location of medical school graduated, size of hospital for training, and specialty. Analysis showed that location of practice. classified into urban and rural areas, was significantly associated with the variables of sex. location of postgraduate training hospital. location of medical school. In addition, significant association was found between the location of practice which was categorized into "near-Seoul area" and others, and sex, location of postgraduate training hospital. and location of medical school. We could conclude that to improve area maldistribution of physicians locations of hospitals for training and medical schools have to have the highest priority in the policymaking.icymaking.

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