• 제목/요약/키워드: prognostic scores

검색결과 93건 처리시간 0.032초

한국어판 Skindex-29를 통해 본 피부과 환자의 삶의 질 (Quality of Life in Patients with Skin Disease)

  • 김민희;김자혜;윤화정;고우신
    • 대한한의학회지
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    • 제26권3호
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    • pp.43-54
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    • 2005
  • Backgrounds : Many people think that ski disease has littel influence on the quality of life in patient, but various studios show that skin disease may produce a range of impacts on QOL. Nevertheless, there is much to be learned about the association between the duality of life and skin disease in the area of Oriental dermatology. Objectives : This study was conducted fe investigate the impact of the various skin diseases on QOL and explore prognostic factors that influence outcomes. Methods : 103 patients were recruited who filled out more than $90\%$ of the skindex-29 questionnaire. The function of sum scores and three domain scores with each skin disease were investigated, as well as the correlation of each domain scores. Results : The disease with the lowest qualify of life was atopic dermatitis. followed by eczematous dermatitis, seborrheic dermatitis and acne vulgaris in order. The sum scales showed significant correlation with three domain scores in atopic dermatitis, urticaria, allergodermia, acne vulgaris, psoriasis and seborrheic dermatitis, The correlation of all three domain scores was significant in atopic dermatitis, urticaria, allergodermia, and psoriasis. Conclusions : Tn this study, skin disease affects the quality of life in physical, social, and psychological factors- Thus, we must consider the quality of life as well as clinical severity inpatients with skin disease.

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Comparative validity of microalbuminuria versus clinical mortality scores to predict pediatric intensive care unit outcomes

  • Nismath, Shifa;Rao, Suchetha S.;Baliga, B.S.;Kulkarni, Vaman;Rao, Gayatri M.
    • Clinical and Experimental Pediatrics
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    • 제63권1호
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    • pp.20-24
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    • 2020
  • Background: Predicting the prognosis of patients admitted to the pediatric intensive care unit (PICU) is very important in determining further management and resource allocation. The prognostication of critically ill children can be challenging; hence, accurate methods for predicting outcomes are needed. Purpose: To evaluate the role of microalbuminuria at admission as a prognostic marker in comparison to standard Pediatric Risk of Mortality (PRISM) and Pediatric Logistic Organ Dysfunction (PELOD) mortality scores in children admitted to the PICU. Methods: This cross-sectional study was conducted from January 2015 to October 2016. Eighty-four patients aged 1 month to 18 years admitted to the PICU of teaching hospitals for more than 24 hours were enrolled by convenience sampling method. Microalbuminuria was estimated by spot urinary albumin-creatinine ratio. PRISM and PELOD scores were calculated using an online calculator. Outcome measures were PICU length of stay, inotrope usage, multiorgan dysfunction, and survival. ACR was compared with mortality scores for predicting survival. Results: Microalbuminuria was present in 79.8% with a median value of 85 mg/g (interquartile range, 41.5-254 mg/g). A positive correlation was found between albumin-creatinine ratio and PICU length of stay (P=0.013, r=0.271). Albumin-creatinine ratio was significantly associated with organ dysfunction (P=0.004) and need for inotropes (P=0.006). Eight deaths were observed in the PICU. The area under the curve for mortality for albumin-creatinine ratio (0.822) was comparable to that for PRISM (0.928) and PELOD (0.877). Albumin-creatinine ratio >109 mg/g predicted mortality with a sensitivity of 87.5% and specificity of 63.2%. Conclusion: Microalbuminuria is a good predictor of PICU outcomes comparable with mortality scores.

체외충격파를 이용한 테니스 엘보우의 치료에서 석회화 병변의 영향 (Effects of Calcific lesion on Shockwave Therapy of the Tennis Elbow)

  • 이석범;;송영준;이기병
    • Clinics in Shoulder and Elbow
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    • 제7권1호
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    • pp.35-40
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    • 2004
  • Purpose: The aim of this study was to investigate effects of calcific lesion on shockwave therapy of the tennis elbow. Materials and Methods: twenty-four patients with refractory tennis elbow were treated with shock waves. The patients were evaluated by assessment of pain using visual analog scale (VAS) and simple elbow test (SET). Comparision of clinical outcomes for the patients with and without calcification in the extensor tendon and/or cortical irregularity of lateral condyle was tried to determine if this could be a possible prognostic factor in clinical settings. Overall clinical outcomes were evaluated by Roles and Maudsley score at 12 months after ESWT. Results: Significant improvement of symptoms were observed in 20 (83 %) patients at 12 months follow up according to Roles and Maudesley scores. The patients with calcification and/or cortical irregularity improved significantly better, when compared to the patients without calcification and/or cortical irregularity at follow up. Conclusion: This study suggests that shock waves therapy could be considered as effective and noninvasive treatment modality for refractory tennis elbow. Also calcific deposit in extensor tendon and/or cortical irregularity of the lateral epicondyle was seem to be good prognostic factor for shock wave therapy for tennis elbow

패혈증환자에서 APACHE III Scoring System의 예후적 가치 (The Prognostic Value of the First Day and Daily Updated Scores of the APACHE III System in Sepsis)

  • 임채만;이재균;이성순;고윤석;김우성;김동순;김원동;박평환;최종무
    • Tuberculosis and Respiratory Diseases
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    • 제42권6호
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    • pp.871-877
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    • 1995
  • 연구배경: 중환자의 예후를 정량화하는 체점체계 중 APACHE III system은 중환자실 제 1병일 점수는 물론 일갱신 점수도 환자의 위험도를 갱신하는 것이 알려진 바 있어 패혈증 환자들에서 APACHE III score의 예후 지표로서의 가치를 알아 보고자 하였다. 방법: 48명의 패혈증 환자들에서 후향적으로 중환자실 제 1병일, 2병일 및 3병일의 APACHE III score를 조사하여 패혈증 생존자와 비생존자 간의 차이를 분석하였다. 결과: 패혈증 생존자는 비생존자에 비해 APACHE III system에 따른 중환자실 제 1병일 정수가 유의하게 낮았으며, 제 2일 및 제 3일의 점수도 각각의 전날 점수에 비해 유의하게 감소하였다. 폐혈증 비생존자의 경우 제 1병일 점수가 생존자에 비해 높았고, 제 2병일 및 제 3병일 점수 역시 각각의 전날 점수에 비해 증가하는 경향을 보였다. 결론: APACHE III system에 따른 제 1병일 점수 및 제 3병일까지의 점수의 일변동은 패혈증 환자의 예후를 반영하는 것으로 사려된다.

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Comparisons of the Prognostic Predictors of Traumatic Brain Injury According to Admission Glasgow Coma Scale Scores Based on 1- and 6-month Assessments

  • Oh Hyun-Soo;Seo Wha-Sook;Lee Seul;Song Ho-Sook
    • 대한간호학회지
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    • 제36권4호
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    • pp.621-629
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    • 2006
  • Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

Factors Prognostic for Survival in Japanese Patients Treated with Sunitinib as First-line Therapy for Metastatic Clear Cell Renal Cell Cancer

  • Kawai, Y;Osawa, T;Kobayashi, K;Inoue, R;Yamamoto, Y;Matsumoto, H;Nagao, K;Hara, T;Sakano, S;Nagamori, S;Matsuyama, H
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5687-5690
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    • 2015
  • Background: Factors predictive of survival have been identified in Western patients with metastatic clear cell renal cell carcinoma (mCCRCC) treated with sunitinib. Less is known, however, about factors predictive of survival in Japanese patients. This study evaluated factors prognostic of survival in Japanese patients with mCCRCC treated with first-line sunitinib. Materials and Methods: This retrospective study evaluated 46 consecutive Japanese mCCRCC patients treated with sunitinib as first line therapy. Clinical and biochemical markers associated with progression-free survival (PFS) were analyzed, with prognostic factors selected by uniand multivariate Cox regression analyses. Results: Univariate analysis showed that factors significantly associated with poor PFS included Memorial Sloan-Kettering Cancer Center poor risk scores, International Metastatic RCC Database Consortium poor risk and high (>0.5 mg/dl) serum C-reactive protein (CRP) concentrations (p<0.001 each). Multivariate analysis showed that high serum CRP was independently associated with poorer PFS (p=0.040). Six month disease control rate (complete response, partial response and stable disease) in response to sunitinib was significantly higher in patients with normal (${\leq}0.5mg/dl$) than elevated baseline CRP (p<0.001). Conclusions: CRP is a significant independent predictor of PFS for Japanese patients with mCCRCC treated with first-line sunitinib. Pretreatment CRP concentration may be a useful biomarker predicting response to sunitinib treatment.

미만성 축삭 손상에서 전산화단층촬영과 경사에코 자기공명영상을 이용한 예후의 평가 (Prognostic Value of Computed Tomography and Gradient-echo Magnetic Resonance Imaging in Diffuse Axonal Injury)

  • 정남기;진상찬;최우익
    • Journal of Trauma and Injury
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    • 제25권4호
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    • pp.122-131
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    • 2012
  • Purpose: Diffuse axonal injury (DAI) is clinically defined as a coma of over six hours in a head trauma victim without a focal mass lesion. The emergency physician usually resuscitates and stabilizes a comatose head trauma victim in the emergency Department. After assessment and treatment, the prognosis is very important to both the victim and the physician. The prognosis for DAI is based on Glasgow Coma Scale (GCS) and other imaging data. We investigated the prognostic value of computed tomography (CT) and gradient-echo magnetic resonance imaging (GRI) for head trauma victims with DAI. Methods: Fifty-three(53) head trauma victims of DAI were enrolled in this study from 2007 to 2012. During the study period of six years, data on trauma victims were collected retrospectively. We analyzed the differences in the Glasgow Outcome Scale (GOS) result between the CT and the GRI modalities. Results: We classified the study group by using GOS. Between the good outcome subgroup (GOS scores of 4 and 5) and the poor outcome subgroup (GOS score of 1-3), there were no statistical difference in sex, age, initial vital signs and initial GCS score. The good outcome subgroup had non-hemorrhage on CT(52%), which was correlated with good outcome and a shorter awakening time, while a larger number and a deeper location of hemorrhagic lesions on in GRI were correlated with poor outcome in DAI. Conclusion: We conclude that the existence of hemorrhagic lesions on CT, and the number and location of those lesions on GRI had good prognostic value for head trauma victims with DAI.

갑상선 질환에서 표피성장인자 수용체 발현 (The Expression of Epidermal Growth Factor Receptor in Thyroid Diseases)

  • 민병철;이용진;차성재;박용검;지경천;임현묵;박성일;박성준
    • 대한두경부종양학회지
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    • 제15권2호
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    • pp.156-161
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    • 1999
  • Objectives: The epidermal growth factor receptor(EGFR) family has been increasingly recognized as an important component in the control of normal cell proliferation and the pathogenesis of cancer. To confirm the usefulness of epidermal growth factor receptor as a tumor marker, we initiated this study. Materials and Methods: EGFR was measured by immunohistochemical staining using EGFR antibody. It was performed on section from paraffin blocks of 65 thyroid tissue including 33 paillary carcinoma, 11 follicular carcinoma, 11 nodular hyperplasia, 5 follicular adenoma and 5 normal thyroid tissue. We evaluated morphologic characteristic of various thyroid neoplasms, and the relationship between EGFR and other prognostic factors in papillary thyroid carcinomas. Results: The expression of EGFR was commonly found in neoplasms of thyroid, with trend for stronger staining in the more malignant tumor(p=0.000). Also the expression of EGFR in papillary thyroid cancer related to tumor characters including tumor size(p=0.042), extent(p=0.024) and prognostic features including AMES scores(p=0.019). The strong EGFR staining in papillary carcinoma was significantly associated with tumor recurrence(p=0.003). Conclusions: EGFR may have a role in the regulation of normal and neoplastic thyroid cell growth. EGFR status may help predict the clinical course of patients with malignant thyroid neoplasms. However, the study of more cases will be needed for significance of the information about the EGFR as an independent prognostic factor.

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Clinical Analysis of Novalis Stereotactic Radiosurgery for Brain Metastases

  • Gu, Hae-Won;Sohn, Moon-Jun;Lee, Dong-Joon;Lee, Hye-Ran;Lee, Chae-Heuck;Whang, C.-Jin
    • Journal of Korean Neurosurgical Society
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    • 제46권3호
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    • pp.245-251
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    • 2009
  • Objective : The authors analyzed the effectiveness and therapeutic response of Novalis shaped beam radiosurgery for metastatic brain tumors, and the prognostic factors which influenced the outcome. Methods : We performed a retrospective analysis of 106 patients who underwent 159 treatments for 640 metastatic brain lesions between January 2000 and April 2008. The pathologies of the primary tumor were mainly lung (45.3%), breast (18.2%) and GI tract (13.2%). We classified the patients using Radiation Therapy Oncology Group Recursive Partitioning Analysis (RPA) and then analyzed the survival and prognostic factors according to the Kaplan Meier method and univariate analysis. Results : The overall median actuarial survival rate was 7.3 months from the time of first radiosurgery treatment while 1 and 2 year actuarial survival estimates were 31% and 14.4%, respectively. Median actuarial survival rates for RPA classes I, II, and III were 31.3 months, 7.5 months and 1.7 months, respectively. Patients' life spans, higher Karnofsky performance scores and age correlated closely with RPA classes. However, sex and the number of lesions were not found to be significantly associated with length of survival. Conclusion : This result suggests that Novalis radiosurgery can be a good treatment option for treatment of the patients with brain metastases.

Impact of Tumor Length on Survival for Patients with Resected Esophageal Cancer

  • Mirinezhad, Seyed Kazem;Jangjoo, Amir Ghasemi;Seyednejad, Farshad;Naseri, Ali Reza;Mohammadzadeh, Mohammad;Nasiri, Behnam;Eftekharsadat, Amir Taher;Farhang, Sara;Somi, Mohammad Hossein
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권2호
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    • pp.691-694
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    • 2014
  • Background: Tumor length in patients with esophageal cancer (EC) has recently received great attention. However, its prognostic role for EC is controversial. The purpose of our study was to characterize the prognostic value of tumor length in EC patients and offer the optimum cut-off point of tumor length by reliable statistical methods. Materials and Methods: A retrospective analysis was conducted on 71 consecutive patients with EC who underwent surgery. ROC curve analysis was used to determine the optimal cut-off point for tumor length, measured with a handheld ruler after formalin fixation. Correlations between tumor length and other factors were surveyed, and overall survival (OS) rates were compared between the two groups. Potential prognostic factors were evaluated by univariate Kaplan-Meier survival analysis. A P value less than 0.05 was considered significant. Results: There were a total of 71 patients, with a male/female divide of 43/28 and a median age of 59. Characteristics were as follows: squamous/adenocarcinoma, 65/6; median tumor length, 4 (0.9-10); cut-off point for tumor length, 4cm. Univariate analysis prognostic factors were tumor length and modality of therapy. One, three and five year OS rates were 84, 43 and 43% for tumors with ${\leq}4cm$ length, whereas the rates were 75, 9 and 0% for tumors >4 cm. There was a significant association between tumor length and age, sex, weight loss, tumor site, histology, T and N scores, differentiation, stage, modality of therapy and longitudinal margin involvement. Conclusions: Future studies for modification of the EC staging system might consider tumor length too as it is an important prognostic factor. Further assessment with larger prospective datasets and practical methods (such as endoscopy) is needed to establish an optimal cut-off point for tumor length.