• Title/Summary/Keyword: Admission Patients

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Use of Blood Transfusion at the End of Life: Does it Have Any Effects on Survival of Cancer Patients?

  • Goksu, Sema Sezgin;Gunduz, Seyda;Unal, Dilek;Uysal, Mukremin;Arslan, Deniz;Tatli, Ali Murat;Bozcuk, Hakan;Ozdogan, Mustafa;Coskun, Hasan Senol
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4251-4254
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    • 2014
  • Background: Treatment of anemia is an important issue in the palliative care setting. Blood transfusion is generally used for this purpose in supportive care. However the place of blood transfusion in terminally ill cancer cases is less far established. Objective: We aimed to outline the use of transfusions and to find the impact of blood transfusion on survival in patients with advanced cancer and very near to death. Design: Patients dying in 2010-2011 with advanced cancer were included in the study. We retrospectively collected the data including age, type of cancer, the duration of last hospitalisation, ECOG performance status, Hb levels, transfusion history of erythrocytes and platelets, cause and the amount of transfusion. The anaemic patients who had transfusion at admission were compared with the group who were not transfused. Survival was defined as the time between the admission of last hospitalisation period and death. Results: Three hundred and ninety eight people with solid tumours died in 2010-2011 in our clinic. Ninety percent of the patients had anemia at the time of last hospitalisation. One hundred fifty three patients had erythrocyte transfusion at admission during the last hospitalisation period (38.4%). In the anaemic population the duration of last hospitalisation was longer in patients who had erythrocyte transfusion (15 days vs 8 days, p<0.001). Conclusions: Patients who had blood transfusion at the end of life lived significantly longer than the anaemic patients who were not transfused. This study remarks that blood transfusions should not be withheld from terminal cancer patients in palliative care.

Concentration of Air Pollutants and Asthma in Taejon City (대전지역 대기오염물질농도와 천식 환자수의 관련성)

  • 서원호;장성실;권호자
    • Journal of Environmental Health Sciences
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    • v.26 no.2
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    • pp.80-90
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    • 2000
  • To determine the effect of air pollutants in Taejon City, we used medical insurance claim data for asthma and the data monitored from telemetry system of Ministry of Environment for air pollutants and meteorological factors. From November 1st, 1997 to October 31th, 1998, 95,629 asthma patients were covered by medical insurance at Taejon City. Subjects were composed of 49,563 males (51.8%) and 46.336 females(48.2%), and among the subjects, the proportion under 15 years old was 62.8% of the total. During the study period, daily mean concentrations of each air pollutants-So2, No2, CO, O3 and TSP-were 9.8 ppb, 17.6 ppm, 1.414 pp, 17.3 ppb and 60.6 $\mu\textrm{g}$/㎥, respectively, which were lower than each of the environmental recommended exposure levels, Through the simple correlation analysis between each air pollutants and meteorological factors, O3 was positively correlated with temperature, but negatively with relative humidity. TSP, SO2, NO2, CO were negatively correlated with meteorological factors, and these air pollutants except O3 were positively correlated with each other, O3 was correlated with TSP positively but the others negatively. Estimating relative risks of each air pollutant with the baseline general additive model, daily mean concentrations of TSP(Lag 0, 1, 4, 5day) were significantly associated with the increase of the asthma admission. Two age subgroups, under 15 and 15~54 have shown various association of all air pollutants concentration with the asthma admission. However, in case of over 54 age subgroup, only TSP(Lag 0 day) among all air pollutants was associated with the asthma admission. Each of ambient outdoor pollutant concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations in Taejon City are significantly associated with the admission of asthma patients even though all concentrations were much lower than the environmental recommended exposure levels. Therefore, continuous effort lowering air pollutant concentration and introducing an active environmental conservation policy should be implanted for preventing hazardous health effects. Considering major proportion of asthma admissions, high susceptibility and less confounding factors among the age subgroup under 15 will be a useful target population for assessing such health effect monitoring.

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A Study on the Maternal Characteristics and Clinical Changes After Korean Medicine Postpartum Care - A Comparative Study with Pre-Study in 2010 - (한방 산후조리 이용 산모의 특성과 치료결과 보고 - 2010년 선행 연구와의 비교 고찰 -)

  • Noh, Eun-Ji;Choi, Su-Ji;Lee, Dong-Nyung;Kim, Dong-Il
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.3
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    • pp.57-72
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    • 2019
  • Objectives: This study aims to assess the maternal characteristics and changes of body among patients who received Korean medicine postpartum care compared to pre-study. Methods: From January 1, 2018 to February 28, 2019, we included 31 postpartum patients who had body composition analysis at admission and discharge among 34 patients who received postpartum care in ${\square}{\square}$ University Hospital. We used SPSS 21.0 for window to test for statistical significance. Results: The average age, weight, and caesarean section rate increased compared to previous study. The average period of postpartum care has decreased. After postpartum care, abdominal circumference, body weight and Body Mass Index (BMI) was significantly decreased, but not as much as pre-study. The coefficient of determination was derived to predict the effects of postpartum care and calculated as "$Abdominal\;circumference\;change=2.745+0.593{\times}admission\;period$", "$weight\;change=0.214+0.345{\times}admission\;period$" and "$BMI\;change=0.198+0.120{\times}admission\;period$". Conclusions: Compared to previous study, as the maternal age increased and admission period decreased, the weight loss after childbirth decreased. It is necessary to provide individual treatment through coefficient of determination.

Retrospective Observation of Liver Function Parameters for 101 Patients Using Herbal Drugs for One Month (1개월 이상 한약을 복용한 101명의 간기능 검사에 대한 후향적 관찰)

  • Kim, Dong-Min;Kim, Hyee-Kwon;Cho, Seong-Yeun;Kim, Yong-Suk;Nam, Sang-Soo
    • The Journal of Korean Medicine
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    • v.31 no.2
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    • pp.149-157
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    • 2010
  • Objective: The purpose of this study was to investigate the level of safety on liver functions when Korean herbal medicine was taken internally. Method: 101 inpatients who took Korean herbal medicine were enrolled and liver function test (aspartic aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, gamma glutamyltranspeptidase, albumin, lactate dehydrogenase) was performed on admission and 1 month later. Results: In 101 patients, alkaline phosphatase and gamma glutamyltranspeptidase decreased significantly compared with the value taken on admission (p<0.05) but aspartic aminotransferase, alanine aminotransferase, total bilirubin, albumin, and lactate dehydrogenase were not significantly changed (p>0.05). In the patients who took Scutellaria baicalensis (n=34), alkaline phosphatase decreased and albumin increased significantly (p<0.05). Among the patients who took Atractylodes macrocephala (n=29), alkaline phosphatase decreased significantly (p<0.05). In the patients who took Glycyrrhiza uralensis or Paeonia lactiflora, liver function parameters were not significantly changed (p>0.05). On admission 11 patients had abnormal liver function and 2 patients had liver injury while 7 patients had abnormal liver function and 2 patients showed liver injury 1 month later. Conclusions: This study suggests that prescribed Korean herbal medicine does not injure liver function.

A Relation between Functional Outcome and Changes of Tongue Inspection in Stroke Patients (중풍환자의 설상변화와 운동기능향상의 관련성 연구)

  • 최동준;김재관;문상관;조기호;김영석;배형섭;이경섭
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.113-118
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    • 2000
  • Objectives : Stroke patients have continuously increased and many studies have been performed to predict their prognosis. Tongue Inspection is a diagnostic method that has been widely used in oriental medicine. The aim of this study was to examine if stroke patients' motor recovery might be related to tongue inspection. Methods : MBI(Modified Barthel Index) and tongue inspection of stroke patients within 3 days of onset were assessed on admission and at 10 days following admission. Results : Functional recovery was significantly better in those who showed favorable changes of tongue, especially in tongue coat color(P=0.030) and thick and thin tongue coat(P=0.092). Conclusions : The results suggest that tongue inspection can be used to predict a prognosis of early stage stroke patients.

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Usefulness of the SAFARI score for predicting convulsive seizure in patients with aneurysmal subarachnoid hemorrhage (비외상성 동맥류성지주막하출혈 환자에서 SAFARI 점수를 이용한 경련 발생 예측의 유용성)

  • Baik, Seung Jun;Hong, Dae Young;Kim, Sin Young;Kim, Jong Won;Park, Sang O;Lee, Kyeong Ryong;Baek, Kwang Je
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.5
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    • pp.449-454
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    • 2018
  • Objective: The SAFARI score was introduced to assess the risk of convulsive seizure during admission for aneurysmal subarachnoid hemorrhage in 2017. This study was conducted to determine whether the SAFARI score derived from the afore-mentioned study could be applied to patients with aneurysmal subarachnoid hemorrhage in Korea. Methods: We conducted a retrospective study of patients who were diagnosed with aneurysmal subarachnoid hemorrhage from March 2013 to October 2017. Patients' age, sex, blood pressure, pulse rate, body temperature, Glasgow-Coma Scale, Hunt-Hess scale, modified Fisher grade, size of ruptured aneurysm, surgery type, transfusion, and SAFARI score were compared between the seizure and non-seizure groups. The area under the receiver operator characteristic curves was calculated to evaluate the predictive ability for seizure during admission. Logistic regression analysis was used to analyze predictive factors for seizure during admission. Results: A total of 220 patients were included. Ninety-seven (44.1%) were male and 123 (55.9%) were female. The mean age of the patients was 65.8 years old (range, 56-75). The area under the curve of the SAFARI score for predicting seizure was 0.813. The SAFARI score was the only significant predictor of seizure during admission, while other factors were not statistically significant upon logistic regression analysis. Conclusion: The SAFARI score could be used for predicting seizure during admission in patients with aneurysmal subarachnoid hemorrhage.

Correlations between Cognitive Function and Functional Ability in Strokes using MMSE and FIM

  • Kim, Eun-Joo
    • International Journal of Contents
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    • v.5 no.3
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    • pp.86-90
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    • 2009
  • The Purpose of this study was to investigate correlations between the Mini-Mental State Examination (MMSE) and the Functional Independence Measure (FIM) in strokes. The data collected retrospectively from fifty-five stroke rehabilitation patients. The MMSE and FIM at the time of admission and discharge were obtained from patients' medical records. Firstly, Pearson correlation coefficients of the MMSE score at the time of admission revealed $0.286{\sim}0.747$ with FIM at the time of discharge (p<0.05). Also, the change of MMSE score significantly correlated with the change of total FIM scores in strokes (r=0.409, p<0.05). Because the MMSE scores at the time of admission and FIM at the time of discharge are correlated, the MMSE scores can be used to predict the FIM at the time of discharge and establish a rehabilitation program.

Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

  • Chung, Pil-Wook;Won, Yu-Sam;Kwon, Young-Joon;Choi, Chun-Sik;Kim, Byung-Moon
    • Journal of Korean Neurosurgical Society
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    • v.45 no.6
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    • pp.355-359
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    • 2009
  • Objective : It has been suggested that elevated cardiac troponin T (cTnT) level is a marker of increased risk of mortality in acute ischemic stroke and subarachnoid hemorrhage (SAH). However, the association of serum cTnT level and prognosis of intracerebral hemorrhage (ICH) has been sparsely investigated. The aim of this study was to identify the relationship between cTnT level and the outcome in patients with spontaneous ICH. Methods : We retrospectively investigated 253 patients identified by a database search from records of patients admitted in our department for ICH between January 1, 2003 and December 31, 2007. The patients were divided into 2 groups; the patients in group 1 (n=225) with serum cTnT values of 0.01 ng/mL or less, and those in group 2 (n=28) with serum cTnT values greater than 0.01 ng/mL. Results : The serum cTnT level was elevated in 28 patients. There were significant differences in sex, hypertension, creatine kinase-myocardial band, midline shift, side of hematoma, and presence of intraventricular hemorrhage between the 2 groups. Logistic regression analysis identified the level of consciousness on admission, cTnT and midline shift as independent predictors of hospital mortality. Conclusion : Theses results suggest that increased serum cTnT level at admission is associated with in-hospital mortality and the addition of a serum cTnT assay to routine admission testing should be considered in patients with ICH.

Relevance of emergency level assessment by the Korean Triage and Acuity Scale for adult patients in a local emergency medical center

  • Lee, Gun Woo;Lee, Suk Hee;Lee, Kyung-Woo;Jang, Tae Chang;Kim, Gyun Moo;Seo, Young Woo;Ko, Seung Hyun
    • Journal of The Korean Society of Emergency Medicine
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    • v.29 no.6
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    • pp.595-602
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    • 2018
  • Objective: The Korean Triage and Acuity Scale (KTAS), which was implemented in 2016, needs to be assessed for its validity and reliability. Here we evaluate the relevance of emergency level assessment by analyzing the validity of KTAS as a Korean standardized triage system. Methods: We retrospectively analyzed the medical records of adults who presented to a local emergency room (ER) during an 18-month period. We compared medical resources used, life-saving interventions performed, length of stay (LOS) in ER, admission rate, and mortality at each KTAS level. Results: Among a total of 40,339 patients, most patients were at KTAS 4 (n=19,532, 48.4%) and the longest median LOS in ER was 450 minutes at KTAS 2. As the KTAS level increased, the percentage of medical resources used and lifesaving interventions performed increased significantly. The odds of total admission and intensive care unit admission were significantly higher at KTAS 1 through 4 compared to those at KTAS 5. The odds related to admission and mortality were also significantly higher at KTAS 3 than at KTAS 4. Conclusion: We concluded that the KTAS, as a Korean standardized triage system of emergency level assessment, is relevant. Further, KTAS 1-3 and KTAS 4-5 are appropriate criteria to distinguish emergency and non-emergency patients.

In-hospital malnutrition among adult patients in a national referral hospital in Indonesia

  • Dyah Purnamasari;Nur Chandra Bunawan;Dwi Suseno;Ikhwan Rinaldi;Drupadi HS Dillon
    • Nutrition Research and Practice
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    • v.17 no.2
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    • pp.218-227
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    • 2023
  • BACKGROUND/OBJECTIVES: Malnutrition during hospitalization is linked to increased morbidity and mortality, but there are insufficient studies observing clinical factors contributing to weight loss during hospitalization in Indonesia. This study was therefore undertaken to determine the rate of weight loss during hospitalization and the contributing factors. SUBJECTS/METHODS: This was a prospective study involving hospitalized adult patients aged 18-59 yrs, conducted between July and September 2019. Body weight measurement was taken at the time of admission and on the last day of hospitalization. The factors studied were malnutrition at admission (body mass index < 18.5 kg/m2), immobilization, depression (Beck Depression Inventory-II Indonesia), polypharmacy, inflammatory status (neutrophil-lymphocytes ratio; NLR), comorbidity status (Charlson Comorbidity Index; CCI), and length of stay. RESULTS: Totally, 55 patients were included in the final analysis, with a median age of 39 (18-59 yrs) yrs. Of these, 27% had malnutrition at admission, 31% had a CCI score > 2, and 26% had an NLR value of ≥ 9. In all, 62% presented with gastrointestinal symptoms, and depression was documented in one-third of the subjects at admission. Overall, we recorded a mean weight loss of 0.41 kg (P = 0.038) during hospitalization, with significant weight loss observed among patients hospitalized for 7 days or more (P = 0.009). The bivariate analysis revealed that inflammatory status (P = 0.016) was associated with in-hospital weight loss, while the multivariate analysis determined that the contributing factors were length of stay (P < 0.001) and depression (P = 0.019). CONCLUSIONS: We found that inflammatory status of the patient might influence the incidence of weight loss during hospitalization, while depression and length of stay were independent predictors of weight loss during hospitalization.