• 제목/요약/키워드: mortality pattern

검색결과 220건 처리시간 0.031초

신생아 외과 환자의 수술 후 사망률 변화에 대한 연구 (Mortality Analysis of Surgical Neonates: A 20-year Experience by A Single Surgeon)

  • 이은정;최금자
    • Advances in pediatric surgery
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    • 제12권2호
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    • pp.137-146
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    • 2006
  • Pediatric surgery could establish a definitive position in the medical field on the basis of a stable patient population. Neonatal surgery, the core of pediatric surgery, requires highly skilled surgeons. However, recent advancement of prenatal diagnosis followed by intervention and decreased birth rate has resulted in a significant decrease in the neonatal surgical population and the number of surgical operations. The purpose of this study is to examine the outcome of neonatal surgeries and to propose a guide for the future surgeries. A total of 359 neonatal surgical patients operated upon at the Department of Surgery, Ewha Medical Center, during past 21 years were studied. The study period hasbeen divided into two time periods: from 1983 to 1993 and from 1994 to 2004. Analysis was based on the Clinical Classification System and mortality pattern, frequency of disorders, occurrence and cause of death, and other changes. Neonatal surgery was 6.4 % of all pediatric surgery during the total 21 year period, 9.9 % in the first period and 4.8 % in the second. Male to female ratio increased from 2.7:1 to 2.1:1. The overall mortality was 6.7 %, and there was significant decrease from 7.4 % in the first period to 6.0 % in the second. The clinical classification system (CCS) for death cases included class II 2, III 4, and IV 7 during the first period and class III 3, and IV 8 during the second, respectively. According to the mortality pattern by Hazebroek, there were 6 preventable death cases during the first period, and only one in the second, and 2 non-preventable death cases during the first period and 8 in second, respectively. Although the patients in the second period had more serious diseases, surgical mortality has been decreased in the second period, which may be the result of improved surgery methods for newborns and advanced patient care.

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개발도상국의 인구변천 유형과 특징 (The Pattern and Characteristics of Demographic Transition in Developing Countries)

  • 정성호
    • 한국인구학
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    • 제29권2호
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    • pp.89-113
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    • 2006
  • 본 연구는 개발도상국의 지역별 인구변천 유형과 특징을 검토하는데 그 목적이 있다. 이를 위해 본 연구는 개발도상국의 인구변천 유형을 인구변천 단계와 관련시키고 있다. 그 다음으로 출산력과 사망력이 지난 40년간 어떻게 변화되어 왔는지를 다양한 지표를 활용하여 검토하고 있다. 분석결과 출산력의 경우 아프리카 지역은 최근까지도 비교적 높은 출산율을 보여 인구변천의 제2단계에 돌입한 것으로 보인다. 이 지역은 또한 알제리, 리비아, 모로코 등 아프리카 북부지역의 국가와 나머지 국가들이 인구변천 과정에서 뚜렷한 차이를 보인다. 서남아시아의 국가들 역시 인구변천의 제2단계에 있다고 볼 수 있다. 서남아시아 국가 증 아프카니스탄과 예맨은 지난 40년 간 출산력 수준의 변화는 거의 없고 사망력 수준만 약간 감소하는 전형적인 아프리카 형태를 보이고 있다. 이에 반해 동아시아 지역은 출산력의 감소 속도가 사망률의 감소 속도보다 훨씬 빠르게 나타나서 인구의 증가폭이 둔화되는 양상을 보이는 인구변천의 제3단계에 속한다고 볼 수 있다. 중남미 지역 국가들도 동남아시아 국가들의 경우와 비슷하게 출산력의 감소 속도가 사망력의 감소 속도보다 빠르게 나타나 인구의 증가 폭이 둔화되는 인구변천의 제3단계에 속한다. 특히 동남아시아의 한국과 싱가포르는 매우 빠른 속도로 출산력 감소를 보였으며 최근에는 오히려 저출산이 문제가 될 정도로 낮은 출산력 수준을 보이고 있다. 사망력의 경우 특히 평균수명은 지역별로 큰 차이를 보인다. 평균수명이 가장 높은 국가 중의 하나인 싱가포르가 78.0세인데 반해 르완다는 39.9세에 머무르고 있다. 아프리카의 평균수명이 낮은 것은 여러 가지 설명이 가능하나 최근에 크게 확산되고 있는 에이즈의 영향이 가장 클 것으로 판단된다.

병원의 급성심근경색증 진료 결과 공개의 효과 (Impact of public releasing of hospitals' performance on acute myocardial infarction outcomes)

  • 은상준;김윤;이은정;장원모
    • 한국의료질향상학회지
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    • 제17권1호
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    • pp.69-78
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    • 2011
  • Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

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사회$\cdot$경제적 요인별 차별 사망력의 변화: 1970 ~ 1986 (The Changes of Mortality Differentials by Socioeconomic Determinats(1970~86) : Based on Death Registration Data)

  • 윤덕중;김태헌
    • 한국인구학
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    • 제12권2호
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    • pp.1-21
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    • 1989
  • For the analysis of mortality differentials by socioeconomic factors based on death registration data, we have considered four variables : place of residence, educational attainment, marital status and occupation. The age range adopted were 5 to 64 years of age for place of residence, and 25 to 64 years of age for the other factors. The mortality differentials by socioeconomic variables were clear and in the expected direction: mortality levels among urban residents, better educated groups, and non- agricultural workers were lower than among the other sub- groups. The average mortality level in rural areas is much higher than in urban areas : the rural mortality levels were at least double the urban levels at ages below 40 years, but became smaller after age 40, and no clear differentials by urban I rural residence increased until 1974~76 for the both sexes, but since the then differentials have declined slowley for both sexes. This changing pattern of mortality differentials by place of residence can be explained by historical socioeconomic development : the development generally started in urban areas, and rural areas followed : in the course of socioeconomic development the differences between the death rates in the two areas became smaller and finally the mortality levels in the two areas became nearly the same, as is found in the developed countries nowadays. The inverse relationships between mortality and educational level became stronger between the periods 1970~72 and 1984~86, but showed the same atterns of mortality differentials in both period : larger differences among the younger age groups, and for males, than among the older age groups, and for females. The increasing mortality differentials in the fourteen-year period between 1970~72 and 1984~86 were caused by inadequate living standards of the non- educated, whose proportion in the total population, however, dropped sharply during that period. Also, the much lower proportions of low - educated groups or of persons with no formal education among males than females helped to establish the clearly pronounced differentials. The mortality differentials by marital status in Korea showed the usual pattern : the mortality rates of the married in each age and sex group were clearly lower than those of others during the fourteen-year period between 1970~72 and 1984~86. In Korean society which remotes universal marriage, the never married recorded especially high death rates, presumably mainly because of ill - health, but also possibly because of the stigma attached to celibacy. However, the mortality differentials by marital status changed with the changes in the proportionate distribution by marital status during the period : the differences between the death rates of the married and never married groups became smaller, the proportion of the never married group increased : in contrast, the differences between mortalities of the married and widowed / divorced / separated groups widened, with the decrease in the proportion of the later group ; this tendency was perticularly marked for females. Occupational groups also showed clear mortality differences : among four occupational groups mortality of males was highest among agricultural workers and lowest among 'professional, admi-nistrative and clerical workers, However, when the death rates were standardized by educational level, the death rates by occupation in age group 45~64 years were nearly the same (excet for the mixed group consisting of unemployed, students, military servicemen and unknown). Therefore, the clear mortality dfferentials by occupation in Korea resulted mainly from the differences in educational level between different occupation groups. Since socioeconomic characteristics are related to each other, the net effect of each variable was examined. Each of the three variables - ducational level, marital status and urban / rural residence affected significantly Korean adult mortality when the effects of the other variables were controlled. Among the three variables educational level was the most important factor for the determination of the adult mortality level. When male's occupation was added to the above three variables, the effects of occupation on adult mortality were notably smaller after control for the effects of the other three variables while the net effects of these three variables were nearly the same irrespectively whether occupation was included or not. Thus, the differences in educational level (mainly), place of residence and marital status bring out the clear differences in observed mortality levels by occupation.

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개발도상국에서의 출산력 변천 추이 (Regional Demographic Transition in Developing Countries)

  • 정성호
    • 한국인구학
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    • 제28권2호
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    • pp.183-203
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    • 2005
  • 본 연구는 개발도상국의 지역별 인구변천 추이를 검토하는데 그 목적이 있다. 이를 위해 본 연구는 개발도상국의 인구변천 추이를 지역별로 나누어 검토하고자 한다. 이는 개발도상국의 인구변천 추이가 지역별 국가별로 커다란 차이를 보이기 때문이다. 분석결과 출산력의 경우 아프리카 지역은 최근까지도 비교적 높은 출산율을 보이는데 반해 동아시아 지역은 매우 빠른 속도로 출산력 감소를 보였으며 최근에는 오히려 저출산이 문제가 될 정도로 낮은 출산력 수준을 보이고 있다. 사망력의 경우에도 지역별로 큰 차이를 보인다. 특히 영아사망률의 경우 아프리카 대륙은 매우 높은 수준을 보이는데 반해 동남아시아 국가들은 비교적 낮은 수준을 보이고 있다. 평균수명도 지역별로 큰 차이를 보인다. 평균수명이 가장 높은 국가 중의 하나인 싱가포르가 78.0세인데 반해 르완다는 39.9세에 머무르고 있다. 아프리카의 평균수명이 낮은 것은 여러 가지 설명이 가능하나 최근에 크게 확산되고 있는 에이즈의 영향이 가장 클 것으로 판단된다. 다양한 사회경제지표들과 출산력 및 사망력 지표들의 관계도 지역별 국가별로 뚜렷한 차이를 보인다.

Spatial Point-pattern Analysis of a Population of Lodgepole Pine

  • Chhin, Sophan;Huang, Shongming
    • Journal of Forest and Environmental Science
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    • 제34권6호
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    • pp.419-428
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    • 2018
  • Spatial point-patterns analyses were conducted to provide insight into the ecological process behind competition and mortality in two lodgepole pine (Pinus contorta Dougl. ex Loud. var. latifolia Engelm.) stands, one in the Lower Foothills, and the other in the Upper Foothills natural subregions in the boreal forest of Alberta, Canada. Spatial statistical tests were applied to live and dead trees and included Clark-Evans nearest neighbor statistic (R), nearest neighbor distribution function (G(r)), and a variant of Ripley's K function (L(r)). In both lodgepole pine plots, the results indicated that there was significant regularity in the spatial point-pattern of the surviving trees which indicates that competition has been a key driver of mortality and forest dynamics in these plots. Dead trees generally showed a clumping pattern in higher density patches. There were also significant bivariate relationships between live and dead trees, but the relationships differed by natural subregion. In the Lower Foothills plot there was significant attraction between live and dead tees which suggests mainly one-sided competition for light. In contrast, in the Upper Foothills plot, there was significant repulsion between live and dead trees which suggests two-sided competition for soil nutrients and soil moisture.

수온에 따른 명태(Theragra chalcogramma) 수정란의 부화 패턴과 부화 자어의 기형 발생에 미치는 영향 (Effects of Rearing Water Temperature on Hatching Pattern and Larval Malformation of Walleye Pollock Theragra chalcogramma Fertilized Eggs and Larvae)

  • 권오남;홍우석;박진철
    • 한국수산과학회지
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    • 제54권6호
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    • pp.948-953
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    • 2021
  • To find the optimal eggs to larvae transforming temperature of walleye pollock Theragra chalcogramma, we investigated their hatching pattern, mortality, and larval deformities. Results showed that the hatching quality decreased as the water temperature increased and dropped sharply above 13℃. The highest hatching rate was achieved at 7℃, whereas the lowest was at 15℃. Dead eggs were not observed at 7℃; however, dead egg ratios were significantly high at 4.5℃ and above 13℃ (P<0.05). Mortality of larvae after hatching was not observed at 4.5℃, but was significantly high above 13℃. The DNA content of the larvae did not show any significant difference at all water temperatures; however, RNA content was the highest at 7℃ and was significantly low above 11℃. In addition, RNA/DNA ratio was the highest at 7℃. Larval deformities after hatching were low at 7-11℃ and higher at higher or lower water temperature. Therefore, the hatching index and larval health index of Walleye pollock eggs in this study show that 7℃ to 11℃ seems to be the optimal transforming water temperature range.

소아 흉부 둔상 환자의 임상적 고찰 (Clinical Investigation of Pediatric Blunt Thoracic Trauma)

  • 정태교;현성열;김진주;류일;이근;조진성;황성연;이석기
    • Journal of Trauma and Injury
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    • 제18권2호
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    • pp.119-126
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    • 2005
  • Background: Blunt thoracic trauma in children has a high morbidity and mortality. In this study, we assessed the significance of the injury pattern, mechanism and initial status in emergency department on severity and prognosis in pediatric blunt thoracic trauma patients. Method: We retrospectively reviewed medical records and chest X-ray and CT images of 111 pediatric blunt thoracic trauma patients from October 2000 to June 2005. Data recorded age, gender, season, injury mechanism, injury pattern, associated injury, length of hospital stay and cause of death. Result: Of all 111 patients, 68 patients were injured by motor vehicle accidents, 30 were falls, 5 were motorcycle accidents, 3 were sports accidents and 5 were miscellaneous. In thoracic trauma, single injury of lung contusion were 35 patients and 32 patients had multiple thoracic injuries. Hospital stay in school age group were longer than preschool age group. The causes of death were brain injury in 9, respiratory distress in 4, and hypovolemic shock in 2 patients. Emergently transfused and mechanically ventilated patients had higher mortality rates than other patients. Patients required emergency operation and patients with multiple thoracic injuries had higher mortality rates. Conclusion: In this study, patients with combined injury, emergency transfusion, mechanical ventilation, emergency operation, multiple injuries in chest X-ray had higher mortality rates. Therefore in these pediatric blunt thoracic trauma patients, accurate initial diagnosis and proper management is required.