• Title/Summary/Keyword: the length of stay

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Analysis on the situation of inpatients with pressure ulcer by patient safety indicators (환자안전 지표에 의한 욕창발생 현황 분석)

  • Nam, Mun-Hee;Lim, Ji-Hye
    • Journal of Digital Convergence
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    • v.10 no.3
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    • pp.197-205
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    • 2012
  • In this study, we analyzed situation and length of stay(LOS) variations of inpatients with pressure ulcer using patient safety indicators developed by the United States Agency for Healthcare Research and Quality(AHRQ) and proposed management of medical quality and development of policy. The dataset was taken from 1,373 database of the hospital discharge injury survey from 2005 to 2008. Analysis method was used frequency and chi-square test, ANOVA, multiple linear regression analysis. In result, distribution of inpatients with pressure ulcer by sex were 52.5%(male), 47.5%(female), respectively and aged $65{\geqq}years$ was the highest in age group. LOS of inpatients with nervous system principal disease was the longest. Independent variables which were statistically associated with LOS of inpatients with pressure ulcer were year, sex, insurance type, bed size, operation, principal diagnosis. Therefore, hospital should develop the standardized strategy and guidelines to manage pressure ulcer inpatients efficiently and apply it into the medical information system.

Determinants of Satisfaction, Revisit Intention, and Recommendation Intention Using Decision Tree Analysis - Foreign Tourists Visiting Korea during the COVID-19 Pandemic - (의사결정나무분석을 활용한 방문 만족도, 재방문 의사, 타인 권유 의사 결정요인 분석 - 코로나19 상황에서의 한국 방문 외래관광객을 대상으로 -)

  • Won-Sik Kim
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.3
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    • pp.129-136
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    • 2023
  • The study aims to examine the determinants that affect satisfaction, revisit intention, and recommendation intention with foreign tourists who visited Korea despite the threat of COVID-19. This study employs the survey data collected by the Korea Tourism Organization from 8,135 foreign tourists who visited Korea in 2020. As the survey data contains a mixture of continuous and categorical variables, decision tree analysis can ensure analytical validity for the research. According to the analytical results, the determinants affecting satisfaction are the purpose of the visit and acceptance of self-quarantine during their stay. The factors influencing revisit intention are the purpose of the visit, frequency of the visit, and acceptance of self-quarantine during their stay. The determinants affecting recommendation intention are the purpose of the visit, length of stay, and gender. Based on the results of this analysis, this study not only explains the relationship between these determinants and tourism satisfaction, revisit intention, and recommendation intention, but also suggests implications for revitalizing tourism activities.

Married Immigrant Women's Child-Rearing Experiences Including Parenting Stress and Parenting Efficacy (국제결혼 이주여성의 양육경험 - 양육스트레스와 양육효능감을 중심으로 -)

  • Kim, Ji-Hyun;Oh, Jin-A;Yoon, Chae-Min;Lee, Ja-Hyung
    • Korean Parent-Child Health Journal
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    • v.12 no.1
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    • pp.46-60
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    • 2009
  • Purpose: The purpose of this study was to explore married immigrant women's child-rearing experiences including parenting stress and parenting efficacy using parallel/simultaneous mixed method design. Method: Participants of this quantitative study were 53 immigrant women in G City. Data was collected from May 1 to July 31 and analyzed using the SPSS 14 program. Qualitative data was collected from 8 immigrant women through focus group discussions from April, 22 to August 5, 2008 in G City and G Province. The data was analyzed using a content analysis method. Results: The mean score of parenting stress scale and parenting efficacy were 63.49 and 43.11 respectively. Significant differences were found in parenting stress according to nationality, length of stay, religion, economic status, education level, Korean language skill, number of children, and program participation. Significant differences were found in the Parenting efficacy according to the nation, length of stay, economic status, education level, Korean language skill, children's health status, and program participation. Three themes emerged through this analysis: 1) Isolation from the maternal parent, 2) Insufficient support system, 3) Conflicts and Compromise of child-rearing practices. Conclusion: Married immigrant women experience double burdens of mothering. There is a need to develop educational and support programs for them.

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Clostridioides difficile Infection Is Associated with Adverse Outcomes among Hospitalized Pediatric Patients with Acute Pancreatitis

  • Thavamani, Aravind;Umapathi, Krishna Kishore;Khatana, Jasmine;Sankararaman, Senthilkumar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.1
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    • pp.61-69
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    • 2022
  • Purpose: Studies in adults have shown an increasing incidence of Clostridioides difficile infection (CDI) in patients hospitalized with acute pancreatitis (AP). There is lack of epidemiological data on CDI and its impact on hospitalized pediatric patients with AP. Methods: We analyzed the National Inpatient Sample and Kids' Inpatient Database between the years 2003 and 2016 and included all patients (age <21 years) with a primary diagnosis of AP using specific International Classification of Diseases codes. We compared clinical outcomes between children with CDI and those without CDI. Our primary outcome was severe AP and secondary outcomes included length of stay and hospital charges. Results: A total of 123,240 hospitalizations related to AP were analyzed and CDI was noted in 0.6% of the hospital. The prevalence rate of CDI doubled from 0.4% (2003) to 0.8% (2016), p=0.03. AP patients with CDI had increased comorbidities, and also underwent more invasive surgical procedures, p<0.05. AP patients with CDI had a higher in-hospital mortality rate and increased prevalence of severe AP, p<0.001. Multivariate regression models showed that CDI was associated with 2.4 times (confidence interval [CI]: 1.91 to 3.01, p<0.001) increased odds of severe AP. CDI patients had 7.24 (CI: 6.81 to 7.67, p<0.001) additional hospital days while incurring $59,032 (CI: 54,050 to 64,014, p<0.001) additional hospitalization charges. Conclusion: CDI in pediatric patients with AP is associated with adverse clinical outcomes and increased healthcare resource utilization. Further studies are needed to elucidate this association to prevent the development of CDI and to improve outcomes.

Safety of middle meningeal artery embolization for treatment of subdural hematoma: A nationwide propensity score matched analysis

  • Carson P. McCann;Michael G. Brandel;Arvin R. Wali;Jeffrey A. Steinberg;J. Scott Pannell;David R. Santiago-Dieppa;Alexander A. Khalessi
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.25 no.4
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    • pp.380-389
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    • 2023
  • Objective: Middle meningeal artery embolization (MMAe) has burgeoned as a treatment for chronic subdural hematoma (cSDH). This study evaluates the safety and short-term outcomes of MMAe patients relative to traditional treatment approaches. Methods: In this retrospective large database study, adult patients in the National Inpatient Sample from 2012-2019 with a diagnosis of cSDH were identified. Cost of admission, length of stay (LOS), discharge disposition, and complications were analyzed. Propensity score matching (PSM) was utilized. Results: A total of 123,350 patients with cSDH were identified: 63,450 without intervention, 59,435 surgery only, 295 MMAe only, and 170 surgery plus MMAe. On PSM analysis, MMAe did not increase the risk of inpatient complications or prolong the length of stay compared to conservative management (p>0.05); MMAe had higher cost ($31,170 vs. $10,768, p<0.001) than conservative management, and a lower rate of nonroutine discharge (53.8% vs. 64.3%, p=0.024). Compared to surgery, MMAe had shorter LOS (5 vs. 7 days, p<0.001), and lower rates of neurological complications (2.7% vs. 7.1%, p=0.029) and nonroutine discharge (53.8% vs. 71.7%, p<0.001). There was no significant difference in cost (p>0.05). Conclusions: MMAe had similar LOS and decreased odds of adverse discharge with a modest cost increase compared to conservative management. There was no difference in inpatient complications. Compared to surgery, MMAe treatment was associated with decreased LOS and rates of neurological complications and nonroutine discharge. This nationwide analysis supports the safety of MMAe to treat cSDH.

Laparoscopic Cholecystectomy in Children (소아에 시행한 복강경 담낭 절제술)

  • Kim, Hee-Seong;Nam, So-Hyun;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo
    • Advances in pediatric surgery
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    • v.12 no.2
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    • pp.213-220
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    • 2006
  • Laparoscopic cholecystectomy has been increasingly used because of several advantages, less pain, better expectation for cosmesis (requires small incisions), and more rapid recovery compared with open cholecystectomy. Oral intake is tolerated on the day of operation or on the next. In this study, we evaluated the effectiveness and safety of laparoscopic cholecystectomy in children. Nine cases of laparoscopic cholecystectomy for acute and chronic cholecystitis in children were performed at Asan Medical Center between April 2002 and April 2004. Laparoscopic cholecystectomy was performed on a total of 10 patients, but one of them was excluded because of the simultaneous splenectomy for sickle cell anemia. Clinical presentation, operative findings, operation time, length of hospital stay, and postoperative complications were analyzed. Mean age was 10.4 (4.15) years, and only 3 of patients were less than 10 years. One patient was female. In 8 the diagnosis was calculous cholecystitis. Mild adhesions were found in 3 cases and intraoperative bile leakage in 2. There was no conversion to open surgery and there were no vascular, bowel, or bile duct injuries. Mean operation time was 82.2 (20.160) minutes; mean length of hospital stay was 2.1 (1.3) day. There was no postoperative complication. Laparoscopic cholecystectomy in children was remarkably free of side effects and complications and had a short recovery time. Laparoscopic cholecystectomy for cholecystitis is considered to be a standard procedure in children.

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Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition (경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향)

  • Rha Mi yong;Kim Eun mi;Cho Young Y.;Seo Jeong Meen;Choi Hay mie
    • Korean Journal of Community Nutrition
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    • v.11 no.1
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

The Mediating Role of Traditional News Media and the News Web in the Political Socialization of Korean Immigrants to the Host Society: Predicting Political Knowledge, Interest, and Participation (전통 뉴스 매체와 뉴스 웹 이용이 이민자들의 주류 정치사회화에 미치는 매개적 역할)

  • Lee, Hyo-Seong
    • Korean journal of communication and information
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    • v.22
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    • pp.211-247
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    • 2003
  • This study explored how Korean immigrants education, length of stay and English fluency affect their political socialization, mediated through traditional news media and the news Web use. Political socialization included political knowledge, interest, and participation. The media usage patterns included U.S. news media, U.S. news Web, Korean news Web, and Korean news Media use by Korean immigrants in the United State. This study found as follows. First, education, length of stay, and English fluency indirectly increased political socialization(political knowledge, interest, and participation) through their relationship with U.S. news media use. Second, U.S. news Web played a potentially important role in Korean immigrants' political socialization by increasing their political interest. Third, Korean news media partly contributed to Korean immigrants' political socialization by increasing their political interest. Fourth, Korean news Web use did not contribute to Korean immigrants' political socialization in terms of political knowledge, interest, and participation at all. In conclusion, this study found that traditional news media's role was more important than news Web's one in the process of immigrants' political socialization to the host society.

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Oral Nutrition During Continuous Albuterol for Pediatric Critical Asthma: A Matched Cohort Study

  • Maya Antionette Root;Carolyn Maria Ibrahim Pavlich;Anthony Alexander Sochet;Alexa Rae Roberts;Brett Walter Russi
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.6
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    • pp.364-371
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    • 2024
  • Purpose: The practice of withholding oral nutrition for children hospitalized for critical asthma receiving continuous albuterol is not evidence based. We sought to characterize oral nutrition practices in this population and estimate the frequency of aspiration-related respiratory failure. Methods: We performed a single-center retrospective, matched cohort study of children 3-17 years of age admitted to a pediatric intensive care unit from Oct 2020 to May 2023 for critical asthma receiving continuous albuterol. Cases provided oral nutrition were matched 1:2 to controls withheld nutrition by age and National Heart Lung and Blood Institute asthma severity classification. The primary outcome was aspiration-related respiratory failure defined as any respiratory support escalation following observed aspiration. Descriptive data included demographics, anthropometrics, pediatric asthma severity scores, adjunct asthma interventions, continuous albuterol duration, mortality, and length of stay. Results: Of 36 cases and 72 matched controls, the mean age was 9.1±3.9 years and 66.7% had moderate-severe persistent asthma. Cases and controls had comparable anthropometrics and admission pediatric asthma severity scores. No aspiration-related respiratory failure events were observed even among those receiving nutrition concurrent to noninvasive ventilation. Compared to controls, cases experienced a longer continuous albuterol duration (median: 1.1 [interquartile range: 0.7-1.8] versus 0.7 [interquartile range: 0.3-1.3] days, p<0.001). No differences in length of stay, adjunct interventions, endotracheal intubation rates, and mortality were observed between cases and controls. Conclusion: For children hospitalized for critical asthma, oral nutrition during continuous nebulized albuterol appeared well tolerated. While prospective validation is required, the practice of withholding oral nutrition for continuous albuterol administration may be unwarranted.

Minimally Invasive Procedure versus Conventional Redo Sternotomy for Mitral Valve Surgery in Patients with Previous Cardiac Surgery: A Systematic Review and Meta-Analysis

  • Muhammad Ali Tariq;Minhail Khalid Malik;Qazi Shurjeel Uddin;Zahabia Altaf;Mariam Zafar
    • Journal of Chest Surgery
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    • v.56 no.6
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    • pp.374-386
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    • 2023
  • Background: The heightened morbidity and mortality associated with repeat cardiac surgery are well documented. Redo median sternotomy (MS) and minimally invasive valve surgery are options for patients with prior cardiac surgery who require mitral valve surgery (MVS). We conducted a systematic review and meta-analysis comparing the outcomes of redo MS and minimally invasive MVS (MIMVS) in this population. Methods: We searched PubMed, EMBASE, and Scopus for studies comparing outcomes of redo MS and MIMVS for MVS. To calculate risk ratios (RRs) for binary outcomes and weighted mean differences (MDs) for continuous data, we employed a random-effects model. Results: We included 12 retrospective observational studies, comprising 4157 participants (675 for MIMVS; 3482 for redo MS). Reductions in mortality (RR, 0.54; 95% confidence interval [CI], 0.37-0.80), length of hospital stay (MD, -4.23; 95% CI, -5.77 to -2.68), length of intensive care unit (ICU) stay (MD, -2.02; 95% CI, -3.17 to -0.88), and new-onset acute kidney injury (AKI) risk (odds ratio, 0.34; 95% CI, 0.19 to 0.61) were statistically significant and favored MIMVS (p<0.05). No significant differences were observed in aortic cross-clamp time, cardiopulmonary bypass time, or risk of perioperative stroke, new-onset atrial fibrillation, surgical site infection, or reoperation for bleeding (p>0.05). Conclusion: The current literature, which primarily consists of retrospective comparisons, underscores certain benefits of MIMVS over redo MS. These include decreased mortality, shorter hospital and ICU stays, and reduced AKI risk. Given the lack of high-quality evidence, prospective randomized control trials with adequate power are necessary to investigate long-term outcomes.