• Journal of Trauma and Injury
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• 제25권2호
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• pp.49-56
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• 2012

Purpose: For determining the prognosis of critically injured patients, transporting patients to medical facilities capable of providing proper assessment and management, running rapid assessment and making rapid decisions, and providing aggressive resuscitation is vital. Considering the high mortality and morbidity rates in critically injured patients, various studies have been conducted in efforts to reduce those rates. However, studies related to diagnostic factors for predicting severity in critically injured patients are still lacking. Furthermore, patients showing stable vital signs and alert mental status, who are injured via a severe trauma mechanism, may be at a risk of not receiving rapid assessment and management. Thus, this study investigates diagnostic factors, including physical examination and laboratory results, that may help predict severity in trauma patients injured via a severe trauma mechanism, but showing stable vital signs. Methods: From March 2010 to December 2011, all trauma patients who fit into a diagnostic category that activated a major trauma team in CHA Bundang Medical Center were analyzed retrospectively. The retrospective analysis was based on prospective medical records completed at the time of arrival in the emergency department and on sequential laboratory test results. PASW statistics 18(SPSS Inc., Chicago, IL, USA) was used for the statistical analysis. Patients with relatively stable vital signs and alert mental status were selected based on a revised trauma score of more than 7 points. The final diagnosis of major trauma was made based on an injury severity score of greater than 16 points. Diagnostic variables include systolic blood pressure and respiratory rate, glasgow coma scale, initial result from focused abdominal sonography for trauma, and laboratory results from blood tests and urine analyses. To confirm the true significance of the measured values, we applied the Kolmogorov-Smirnov one sample test and the Shapiro-Wilk test. When significance was confirmed, the Student's t-test was used for comparison; when significance was not confirmed, the Mann-Whitney u-test was used. The results of focused abdominal sonography for trauma (FAST) and factors of urine analysis were analyzed using the Chi-square test or Fisher's exact test. Variables with statistical significance were selected as prognostics factors, and they were analyzed using a multivariate logistics regression model. Results: A total of 269 patients activated the major trauma team. Excluding 91 patients who scored a revised trauma score of less than 7 points, 178 patients were subdivided by injury severity score to determine the final major trauma patients. Twenty-one(21) patients from 106 major trauma patients and 9 patients from 72 minor trauma patients were also excluded due to missing medical records or untested blood and urine analysis. The investigated variables with p-values less than 0.05 include the glasgow coma scale, respiratory rate, white blood cell count (WBC), serum AST and ALT, serum creatinine, blood in spot urine, and protein in spot urine. These variables could, thus, be prognostic factors in major trauma patients. A multivariate logistics regression analysis on those 8 variables showed the respiratory rate (p=0.034), WBC (p=0.005) and blood in spot urine (p=0.041) to be independent prognostic factors for predicting the clinical course of major trauma patients. Conclusion: In trauma patients injured via a severe trauma mechanism, but showing stable vital signs and alert mental status, the respiratory rate, WBC count and blood in the urine can be used as predictable factors for severity. Using those laboratory results, rapid assessment of major trauma patients may shorten the time to diagnosis and the time for management.

• 보건행정학회지
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• 제26권4호
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• pp.359-372
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• 2016

Background: The purpose of this study was to develop risk-adjustment models for acute stroke mortality that were based on data from Health Insurance Review and Assessment Service (HIRA) dataset and to evaluate the validity of these models for comparing hospital performance. Methods: We identified prognostic factors of acute stroke mortality through literature review. On the basis of the avaliable data, the following factors was included in risk adjustment models: age, sex, stroke subtype, stroke severity, and comorbid conditions. Survey data in 2014 was used for development and 2012 dataset was analysed for validation. Prediction models of acute stroke mortality by stroke type were developed using logistic regression. Model performance was evaluated using C-statistics, $R^2$ values, and Hosmer-Lemeshow goodness-of-fit statistics. Results: We excluded some of the clinical factors such as mental status, vital sign, and lab finding from risk adjustment model because there is no avaliable data. The ischemic stroke model with age, sex, and stroke severity (categorical) showed good performance (C-statistic=0.881, Hosmer-Lemeshow test p=0.371). The hemorrhagic stroke model with age, sex, stroke subtype, and stroke severity (categorical) also showed good performance (C-statistic=0.867, Hosmer-Lemeshow test p=0.850). Conclusion: Among risk adjustment models we recommend the model including age, sex, stroke severity, and stroke subtype for HIRA assessment. However, this model may be inappropriate for comparing hospital performance due to several methodological weaknesses such as lack of clinical information, variations across hospitals in the coding of comorbidities, inability to discriminate between comorbidity and complication, missing of stroke severity, and small case number of hospitals. Therefore, further studies are needed to enhance the validity of the risk adjustment model of acute stroke mortality.

• Journal of Korean Biological Nursing Science
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• 제19권1호
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• pp.48-54
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• 2017

Purpose: This study was done to identify the influence of severity of drinking problem, circadian rhythm and sleep quality in patients with alcohol use. Methods: A descriptive study design was utilized. Data were collected using self-report questionnaires from 139 patients with alcohol use disorder who were admitted to a psychiatric hospital in D city, Korea. The questionnaires included Alcohol Use Disorders Identification Test (AUDIT), Composite Scale of Morningness (CMS), Pittsburgh Sleep Quality Index (PSQI), and Korea sleep scale A. Data were analyzed using descriptive statistics, Pearson's correlation coefficients, and multiple regressions using the SPSS 20.0 program. Results: There was significant correlations among severity of problem drinking, circadian rhythm, sleep quality and sleep disorder. The significant factors influencing sleep disorder were severity of problem drinking(${\beta}=.12$, p= .042), circadian rhythm(${\beta}=-.14$, p= .039) and sleep quality(${\beta}=.63$, p= < .001). This model explained 56% of variance in sleep disorder(F = 57.34, p= < .001). Conclusion: The results of this study suggest that the development of sleep intervention programs for alcohol use disorder patients needs to consider severity of alcohol use, circadian rhythm and sleep quality, and sleep assessment and intervention are needed the early stage of the treatment and recovery process.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• 제32권4호
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• pp.144-153
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• 2021

Objectives: Anxiety disorders are the most common psychiatric disorders in adolescents and seem to occur the earliest among all forms of psychopathology. The aim of this study was to investigate the association of anxiety severity with health risk behaviors and mental health in adolescents. Methods: Data from the 2020 Korean Youth Risk Behavior Web-Based Survey were analyzed. A total of 54948 adolescents responded to the 7-item Generalized Anxiety Disorder Scale (GAD-7) for the assessment of their anxiety severity as well as to the mental health and health risk behavior survey. Logistic regression analysis, t tests, and variance analysis of a complex sample general linear model were used to examine the association of anxiety severity with health behaviors and mental health. Results: After statistical adjustment for sociodemographic characteristics, the subjects in the severe anxiety group were significantly more likely to be current smokers (odds ratio [OR]: 2.08, 95% confidence interval [CI]: 1.72-2.50), current drinkers (OR: 1.91, 95% CI: 1.67-2.19), experience habitual substance use (OR: 10.89, 95% CI: 8.22-14.42), have sexual intercourse (OR: 2.10, 95% CI: 1.76-2.51), and have unprotected intercourse (OR: 2.21, 95% CI: 1.67-2.92) than those in the normal group. Anxiety severity negatively correlated with sleep satisfaction and happiness, but positively correlated with stress perception, loneliness, depressive symptoms, and suicidality. Conclusion: Adolescent anxiety is associated with health risk behaviors and poor mental health. Thus, early screening and intervention for anxiety in adolescents could contribute to the management and coping of youth health risk behaviors in the community.

• 자동차안전학회지
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• 제10권1호
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• pp.20-26
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• 2018

The fatality of rollover accidents in motor vehicle crashes is high despite their low incidence. Through the investigation of a 12-passenger van rollover accident in which 10 passengers were involved, we intend to analyze the correlation between the severity of the injury and the position of the occupants. We collected accident information from medical records, interviews, photo-images of the damaged van, field surveys, and the results of the Korean New Car Assessment Program (KNCAP). Based on the occupants' position, we classified injury sites and estimated injury severity. Passenger injury severity was evaluated by trauma score calculation. The initiation type of the rollover accident was passenger side 'fall-over' and the Collision Deformation Classification (CDC) code for the damaged van was 00TDZO3. The crash of the van involved 10 passengers, with an average age of $16.3{\pm}4.2years$. Few of the occupants had fastened seat belts at the time of the incident, and there was no airbag installed. One patient sustained severe liver injury and another was diagnosed with a fracture of the right humerus. The most common injuries were at the upper extremities and the neck. The average of Injury Severity Score (ISS) was $4.8{\pm}5.9$, and the average ISS of right-seated, mid-seated and left-seated occupants was $7.5{\pm}9.3$, $1.5{\pm}0.7$, and $3.3{\pm}2.1$ respectively (p>0.05). In the rollover (to-passenger side) accident of occupant unfastened, the average ISS of right-seated occupants (near side) was higher, but there was no statistically significant difference.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제27권3호
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• pp.176-185
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• 2024

Purpose: Acute pancreatitis (AP) is common among children in Bangladesh. Its management depends mainly on risk stratification. This study aimed to assess the severity of pediatric AP using computed tomography (CT). Methods: This cross-sectional, descriptive study was conducted in pediatric patients with AP at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh. Results: Altogether, 25 patients with AP were included, of whom 18 (mean age, 10.27±4.0 years) were diagnosed with mild AP, and 7 (mean age, 10.54±4.0 years) with severe AP. Abdominal pain was present in all the patients, and vomiting was present in 88% of the patients. Etiology was not determined. No significant differences in serum lipase, serum amylase, BUN, and CRP levels were observed between the mild and severe AP groups. Total and platelet counts as well as hemoglobin, hematocrit, serum creatinine, random blood sugar, and serum alanine aminotransferase levels (p>0.05) were significantly higher in the mild AP group than in the severe AP group (p=0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of CT severity index (CTSI) were 71.4%, 72.2%, 50%, and 86.7%, respectively. In addition, significant differences in pancreatic appearance and necrosis were observed between the two groups on CT. Conclusion: CT can be used to assess the severity of AP. In the present study, the CTSI effectively assessed the severity of AP in pediatric patients.

• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.407-414
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• 2018

Objective: Anxiety has been shown to influence functional impairment in patients with attention deficit hyperactivity disorder (ADHD). This study aimed to compare functional impairment in subjects with and without adult ADHD and to investigate the associations among trait anxiety, functional impairment, and ADHD symptom severity. Moreover, the effects of ADHD symptom subtypes on trait anxiety and functional impairment were also examined. Methods: The sample included 209 adults between the ages of 20 and 31 years. Fifty-one adults received a diagnosis of ADHD, and an additional age, sex-matched group of 51 adults comprised the adult control. Participants were assessed with Conners' Adult ADHD Rating Scales (CAARS), the Beck Depression Inventory (BDI), the Spielberg Trait Anxiety Inventory (STAI-T), and the Sheehan Disability Scale (SDS). The relationships among ADHD severity, anxiety, and functional impairment were investigated using Pearson's correlation analysis. Subtypes of ADHD symptoms that predicted anxiety and functional impairment were investigated using regression analyses. Results: Adult ADHD patients significantly differed from normal control subjects according to BDI, STAI-T, and SDS assessment. Significant positive correlations were noted between ADHD severity, anxiety, and functional impairment. Multiple linear regression analysis confirmed anxiety as a mediator between functional impairment and ADHD CAARS symptom subscales. Conclusion: Patients with adult ADHD showed higher levels of anxiety, depression, and functional impairment. Additionally, ADHD symptoms and anxiety impacted subject functional impairment. Our results suggest that anxiety may be a strong mediator between ADHD severity and functional impairment.

• 식물병연구
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• 제27권2호
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• pp.49-60
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• 2021

Cashew (Anacardium occidentale L.) is an important cash crop in Tanzania as a source of income to cashew growers and provides foreign exchange for the country. Despite its significance, the crop is threatened by fast spreading disease known as cashew Fusarium wilt caused by Fusarium oxysporum. Field assessment and laboratory tests were conducted to determine incidences of the disease, severity, ecological factors that influence them and explored the pathogen host specificity in six cashew growing districts. The results revealed significant (P<0.001) variation of disease incidences and severity among the studied districts. The results further revealed that there is both positive and negative correlation between the incidence and severity of the disease versus the evaluated ecological factors. The soil pH, soil temperature, air temperature, and relative humidity depicted positive correlation of disease incidence and severity versus ecological factors at ρ=0.50 and ρ=0.60, ρ=0.20 and ρ=0.94, ρ=0.11 and ρ=0.812, ρ=0.05 and ρ=0.771 respectively while nitrogen, phosphorus, and carbon depicted negative correlations at ρ=-0.22 and ρ=-0.58, ρ=-0.15 and ρ=-0.94, ρ=-0.19 and ρ=-0.12 respectively. In terms of host range, none of the weed species was found to be a carrier of Fusarium pathogen implying that it is host specific or semi selective. The results revealed that the tested ecological parameters favor the growth and development of Fusarium pathogen. Thus, management of the disease requires nutrients replenishment and soil shading as essential components in developing appropriate strategies for the control and prevention of further spread of the disease.

• 한국기후변화학회지
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• 제6권3호
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• pp.223-231
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• 2015

Although a considerable part of climate change can be explained by temperature change, hydrological change such as precipitation, evapotranspiration, and runoff impact more on society. For the ascertain a hydrological change in agriculture sector, this study estimate evapotranspiration of cropland in the Korean peninsula, and then to assess the drought severity in the past 30 years through the estimated potential evapotranspiration and observed precipitation. The potential evapotranspiration is estimated by EPIC model and Penman-Monteith method and the drought severity in cropland of the Korean peninsula is assessed using Normalized Precipitation Evapotranspiration Index (NPEI) based on the difference in precipitation and potential evapotranspiration. In North Korea, the estimated evapotranspiration tends to increase even though a significant change is not found due to the change of climate. Although a time series change in drought severity in the past 30 years is not pronounced, a deviation by year and difference between South and North Korea is certain. One reason of this is difference in precipitation and evapotranspiration change according to the latitude. The result including expansion of facilities for water management in North Korea can be used for agricultural decision making, as well as base data of climate change adaptation.

• 한국수자원학회논문집
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• 제50권1호
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• pp.65-73
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• 2017

본 연구는 청미천 유역을 대상으로 1985년부터 2015년까지의 가뭄지수를 이용하여 첨두 가뭄심도와 가뭄기간을 분석하였다. 이을 위해 기상학적 가뭄지수로는 강수량만을 변수로 하는 SPI (Standardized Precipitation Index)와 강수량과 증발산량을 함께 고려하는 SPEI (Standardized Precipitation Evapotranspiration Index)를 적용하였으며, 수문학적 가뭄지수는 유역의 유출량을 변수로 하는 SDI (Streamflow drought index)를 적용하였다. SDI의 경우 청미천 유역을 구축한 SWAT 모형을 이용하여 도출한 유출량을 사용하였다. 그 결과 첨두 가뭄심도의 발생시기는 SPI, SPEI의 발생 후에 SDI가 발생하는 양상을 보였으며 평균적으로 SDI와 SPI는 0.59개월, SPEI는 0.72개월의 차이를 보인다. 최대 발생지체 시간은 SPI, SPEI 모두 2개월을 보인다. 또한 기상학적 가뭄이 해결될 수 있는 강우량임에도 수문학적 가뭄을 해결하지 못하는 경우가 발생함을 확인하였다.