• Journal of the Korean Burn Society
• /
• v.23 no.1
• /
• pp.1-6
• /
• 2020

Purpose: PL, creatinine and urine output are biomarkers of the suitability and prognosis of fluid therapy in severe burn patients. The purpose of this study is to evaluate the usefulness of predicting mortality by biomarkers and its change during initial fluid therapy for severe burn patients. Methods: A retrograde review was performed on 733 patients from January 2014 to December 2018 who were admitted as severe burn patients to our burn intensive care unit (BICU). Plasma lactate, serum creatinine and urine output were measured at the time of admission to the BICU and after 48 hours. ABSI score, Hangang score, APACHEII, revised Baux index and TBSA were collected after admission. Results: 733 patients were enrolled. PL was the most useful indicators for predicting mortality in burn patients at the time of admission (AUC: 0.813) and after 48 hours (AUC: 0.698). On the other hand, mortality prediction from initial fluid therapy for 48 hours showed different results. Only creatinine showed statistical differences (P<0.05) in mortality prediction. But there were no statistical differences in mortality prediction with PL and UO (P>0.05). Conclusion: In this study, PL was most useful predictor among biomarkers for predicting mortality. Improvement in creatinine levels during the first 48 hours is associated with improved mortality. Therefore, efforts are needed to improve creatinine levels.

• Maxillofacial Plastic and Reconstructive Surgery
• /
• v.41
• /
• pp.49.1-49.8
• /
• 2019

Background: The purpose of this study was to review the clinical features of oromaxillofacial infections in patients presenting to a hospital emergency ward, to identify the key factors affecting the requirement for hospitalization, and the potential risk factors predisposing to a prolonged length of hospital stay. Methods: A retrospective medical record review of the 598 patients treated for oromaxillofacial infection from 2013 to 2017 at the oral and maxillofacial surgery department, Yangsan Pusan National University Hospital, was conducted. The following information was collected from each patient: sex, age, past medical history, site of infection, etiology, admission or outpatient care, level of C-reactive protein (mg/dL), fascial spaces involved, treatment method, and duration of hospitalization. Chi-squared tests were used to identify risk factors, which were further analyzed using multivariable logistic regression. Results: A total of 606 patients were eligible for inclusion in the study, of which eight were excluded due to having incomplete charts; thus, 598 patients were included: 55% were male, mean patient age was 47.1 ± 19.9 years, and 12.9% of patients were diabetic. Furthermore, 71.2% of patients had infection originating in the mandible; the most common tooth of origin was lower posterior, and 29.8% of patients were hospitalized. Risk factors for hospital admission were elderly patients with concurrent disease, elevated C-reactive protein level, and multiple-space infection in the oromaxillofacial area. The duration of hospitalization was correlated with both diabetes and age. Conclusions: The requirement for hospital admission is determined by the severity of the infection; even severe infections, once treated with appropriate surgery, have no relation to the length of hospital stay. The important risk factors for increased duration of hospitalization are diabetes mellitus and older age. The understanding of risk factors associated with a prolonged hospital stay during the treatment of oromaxillofacial infection will aid in treatment planning as well as highlight the importance of adequate diabetes control in patients at risk of such infection.

• Journal of Convergence for Information Technology
• /
• v.9 no.6
• /
• pp.194-201
• /
• 2019

This cohort study aimed to identify the effects of daily PM10 exposure on the hospital admission of patients with respiratory diseases, during the nine-year period (2002-2010), in Seoul, Korea. The research subjects were 13,974 patients who had been hospitalized with respiratory diseases, including chronic obstructive pulmonary disease (COPD), asthma, and pneumonia. During the follow-up period, an increase of 10 ug/m3 in PM10 under the threshold of 50 ug/m3 of PM10 led to hospital admission in 1.38% of the age group younger than 15 years, 1.62% in those 65 years or older, 2.87% in patients 75 years or older and in 1.50% of pneumonia patients, 1.51% of COPD patients, and 1.55% of pneumonia and asthma patients. Under the threshold of 80 ug/m3 of PM10, there was a 3.71% increase in new patients admitted in the age group 65 years or older and 4.25% in those at least 75 years old. Our study found that high PM10 was associated with increased risk of admission of respiratory patients, especially in the elderly. People who already have a respiratory disease should refrain from exposure to particulate matter when there is a high concentration of PM10, especially older patients.

• Korean Journal of Hospice Care
• /
• v.3 no.2
• /
• pp.55-60
• /
• 2003

Purpose: The appropriate duration for effective hospice care is estimated about 3 months. However, the length of hospice care of many hospice patients is mostly less than 1 months. This is too short for effective hospice care. Therefore we investigated the reason by clinical considuations include the length of hospie care, duration from diagnosed as terminatlly ill to refer to hospice, the recogntion of hospice of doctors, patients and familis. Methods: This study was designed to retrospective cohot study. The data was obtaind from 50 hospice patients those who died in hospital from July to September in 2003. Results: Out of 50 patient, 30 were male(60%). The median age wes 60years in males and was 61 years in femailes. The most prevalant cancer was colorectal cancer(9 patients, 18%), followed by hepatoma(8 patients, 16%), and stomach cancer(7 patients, 14%). The most prevalent symptom was pain(37 patients 74%) and most prevalant reason of admission was also pain(30 patients, 60%). The most prevalent physician specialty was general internal medicine(21 doctors, 42%), followed by oncology(19 doctors, 38%). The median days form diagnosed terminally ill to refere to hospice was 47 days. The median lengths of hospice care was 23 days and the median admission days was 17. Conclusion: We found that lack of recognition of hospice of doctors, patients and families made the lengths of hospice care too short. If the patient and family go to hospice just after diagnosed as terminally ill, they could get more effective hospice care. To resolve these problems, it is needed education for them constantly.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.1
• /
• pp.149-152
• /
• 2013

Objective: To compare the influence of breast-conserving surgery (BCS) and modified radical mastectomy (MRM) on the psychological state of breast cancer patients. Methods: Patients receiving MRM or BCS, and fulfilling the study criteria, were recruited. Patients were required to complete a self-reporting inventory (SCL-90) on admission and 6 months after surgery and a self-rating depression scale (SDS) when discharged from hospital and 6 months after surgery. Results: A total of 70 patients received MRM and 50 BCS. Compared with the national standard, patients suffered to some extent psychological problems on admission, at discharge from hospital and at 6 months after surgery. Patients received BCS had a higher score of SDS compared with those with MRM when discharged from hospital. However, 6 months after surgery, SDS score increased in MRM and decreased in the BCS group, so the difference was significant. Conclusion: The short-term psychological state of patients receiving BCS is worse than that with MRM but superior to MRM 6 months postoperatively. BCS imposed less influence on long term psychological state of breast cancer patients compared with MRM.

• Journal of Korean Academy of Nursing Administration
• /
• v.5 no.3
• /
• pp.415-424
• /
• 1999

The purpose of this study was to estimate the population requiring nursing home services for frail elders who received home care nursing services. This study identified the need of nursing home services and the proportion of elders over 60 years of age requiring nursing home services according to the admission eligibility including items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. In this study, survey research design was conducted. A total of 49 home care nurses were collected. They were asked to assess the need of nursing home services based on items with intensity of home care nursing services and the criteria for screening of patients requiring home care nursing services. Using secondary data analysis from the survey on 'The Evaluation of Home Care Nursing Service Program in 1994 in Korea', the proportion of elders requiring nursing home services was estimated. The estimated numbers and proportion of frail elders requiring nursing home services were 169 (86.2%) aged persons among community dwelling elders based on admission eligibility. However, the proportion of aged persons was 68% using the only criteria for screening of patients requiring for screening home care nursing services.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.13 no.2
• /
• pp.55-61
• /
• 2015

Purpose: Many studies have examined the mechanisms of impaired glucose homeostasis after organophosphate (OP) exposure, however no study has evaluated the clinical utility of blood glucose measurements in patients with OP poisoning. The current study was conducted to evaluate the initial glucose level at presentation and the glycemic variables during the first 3 days after admission as a predictor of mortality. Methods: This retrospective observational case series included 228 patients with a history of OP poisoning. Among other clinical data, information on the initial glucose level at presentation and mean glucose level, delta glucose level, and the presence of a hypoglycemic event during the first 3 days of admission, was collected. Results: Survivors had lower initial glucose levels at presentation and glucose variability during the first 3 days of admission compared to non-survivors. The frequency of hypoglycemic events was higher in non-survivors. In multivariate analysis, the initial glucose level (> 233 mg/dl) was an independent predictor of mortality, along with age. Conclusion: The initial glucose level at presentation can be helpful in prediction of mortality in cases of OP intoxication at bedside. The physician should pay attention to patients with a glucose level >233 mg/dl at presentation after ingestion of OP.

• Korean Journal of Adult Nursing
• /
• v.20 no.1
• /
• pp.149-162
• /
• 2008

Purpose: The purpose of this study was to understand the meanings and nature of ICU admission experienced among patients with critical illness. The present study adopted a hermeneutic phenomenological method which was developed by van Manen. Methods: The participants for this study were 6 men and 3 women, who were over the age of 20 with ICU admission period more than 3 days. Data were collected by using in-depth interviews and observations from March, 2007 to September, 2007. The contents of the interviews were tape-recorded with the consent of the subject. Results: The essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were as follows: a body that cannot react the way it wants, a wave of fear and insecurity everywhere, a struggle to survive, coming out from death's door, loss of time path, a long and continued waiting until escaping, more of machinery room than a patient's room, existence of life and death, an abyss of suffering seen thru another patient, taken care of by a doctor, trust and distrust, family, the ultimate safe zone. Conclusion: Critically ill patients in ICU experienced feelings of discomfort, unsafety, and insecurity. The result of this study can give nurses some insight into these experiences and help promote empathetic care.

• Korean Journal of Adult Nursing
• /
• v.21 no.4
• /
• pp.435-445
• /
• 2009

Purpose: This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU. Methods: All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively. Results: VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture. Conclusion: These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

• Journal of Korean Public Health Nursing
• /
• v.14 no.2
• /
• pp.191-202
• /
• 2000

This study was conducted for 39 patients who are recipients of allogeneic hemopoietic stem cell transplantation at BMT ward of St. Mary's hospital affiliated to Catholic University of Korea from April to September 1999. The subjects were devided into two groups; those who received both TEl and chemo therapy as conditioning regimen (TEl group). and those who used chemo agents as singular conditioning regimen (chemo group). The oral intake status of the two groups were compared through physical assessment and blood chemistry exam of the subjects, and factors influencing their nutritional change and oral intake were explored in each stage of the transplantation (six stages: admission, conditional stage, date of transplantation, one week after transplantation, two weeks after transplantation, and three weeks after transplantation). The prior aim of the study was to provide baseline data to minimize delayed treatment from nutritional deficiency of the subjects. The results were as follows: 1. TBI group was significantly decreased of oral calorie intake in two weeks after transplantation compared to admission and conditioning stage while that of chemo group was significantly decreased on the date of transplantation. 2. TBI group was significantly decreased of protein intake in two weeks after transplantation compared to admission and conditioning stage. In chemo group, protein intake was significantly decreased on the date of transplantation compared to admission. It was remarkable that TBI group showed lesser protein intake than chemo group. 3. Both group were significantly decreased of BMI in one week and three weeks after transplantation compared to admission. TBI group showed significantly higher BMI than chemo group. 4. Both group were significantly decreased of Triceps Skinfold Thickness (TST)on the date of transplantation compared to admission stage. 5. TBI group was significantly decreased of mid-arm muscle circumference (MAMC) in two weeks after transplantation compared to admission, conditioning, date of transplantation. 6. TBI group was significantly decreased of albumin level in two weeks after transplantation compared admission stage. In chemo group, it was significantly decreased on the date of transplantation compared to admission, three weeks after the transplantation. 7. TBI group was significantly decreased of transferrin level in two weeks after transplantation compared admission, conditioning, date of transplantation and one week after transplantation. In chemo group, it was decreased of transferrin level in 3 weeks after transplantation. 8. Oral intake of TEl group was impacted by vomiting before transplantation and gingivitis after transplantation. In chemo group, it was impacted by vomiting before transplantation and by two factors, gingivitis and nausea, after transplantation. The results showed oral calorie intake was not different between the two groups while protein intake was significantly lower in TBI group than chemo group. Oral intake was significantly impacted by vomiting before transplantation in both groups, but affected by oral gingivitis in TBI group and gingivitis and nausea in chemo group after transplantation. This findings present that standardized strategies to manage nutrition and gingivitis more effectively are desperately needed to enhance oral intake and protein intake of patients who receive TBI as conditioning regimen.