• Tuberculosis and Respiratory Diseases
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• v.69 no.4
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• pp.243-249
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• 2010

Background: Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and mortality worldwide. The aim of this study was to evaluate the risk factors associated with recurrent hospital admissions for exacerbation of COPD in Korea. Methods: A retrospective study of 77 consecutive patients hospitalized for exacerbation of COPD at Pusan National University Hospital during the time period January 2005 to May 2008 was performed. The information was collected from the hospitalization period: clinical information, spirometric measures, and laboratory variables. In addition, socioeconomic characteristics, co-morbidity, anxiety, and depression were reviewed. Frequent readmission was defined as 2 or more hospitalizations in the year following discharge. Results: During the 1-year period after discharge, 42 patients (54.6%) reported one hospital admission and 35 patients (45.4%) reported 2 or more hospital readmissions. Among the 35 frequent readmission patients, 4 had more than 10 readmissions. Univariate analysis showed that a body mass index (BMI) <$18.5kg/m^2$, duration >36 months, forced expiratory volume in 1 second ($FEV_1$) <50% predicted, arterial $CO_2$ partial pressure ($PaCO_2$) >40 mm Hg, and arterial oxygen saturation ($SaO_2$) <95% at discharge were associated significantly with frequent readmissions. The multivariate analysis revealed that BMI <$18.5kg/m^2$, $PaCO_2$ >40 mm Hg at discharge were independently associated with frequent readmissions for exacerbation of COPD. Conclusion: Frequent readmissions for exacerbation of COPD were associated with low BMI and hypercapnia at discharge.

• Health Policy and Management
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• v.19 no.4
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• pp.18-32
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• 2009

The goal of this study was to predict the health outcomes of lung cancer surgery based on the Charlson comorbidity index (CCI). An attempt was likewise made to assess the prognostic value of such data for predicting mortality, survival rate, and length of hospital stay. A medical-record review of 389 patients with non-small-cell lung cancer was performed. To evaluate the agreement, the kappa coefficient was tested. Logistic-regression analysis was also conducted within two years after the surgery to determine the association of CCI with death. Survival and multiple-regression analyses were used to evaluate the relationship between CCI and the hospital care outcomes within two-year survival after lung cancer surgery and the length of hospital stay. The results of the study showed that CCI is a valid prognostic indicator of two-year mortality and length of hospital stay, and that it shows the health outcomes, such as death, survival rate, and length of hospital stay, after the surgery, thus enabling the development and application of the methodology using a systematic and objective scale for the results.

• Tuberculosis and Respiratory Diseases
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• v.69 no.5
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• pp.361-367
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• 2010

Background: Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea. Methods: Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression. Results: We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups. Conclusion: Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.

• Journal of Preventive Medicine and Public Health
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• v.39 no.3
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• pp.229-234
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• 2006

Objectives: Cardiovascular disease is one of the main causes of death and morbidity in Korea. In this study, the prevalence and incidence of developing hypertension in a male-workers' cohort were investigated during 3-years follow-up with a view to find the risk factors that affected the development of hypertension. Methods: Among the 5,374 people who participated in a routine health check up, 3,852 people with normal blood pressure and who had no history of hypertension were prospectively followed up for 3 years. The classification of hypertension was based on the JNC7 report (the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure). Life style factors and underlying diseases that were related to the risk factors of hypertension were collected by using a self-report questionnaires via the internet. Results: The prevalence of hypertension was 28.3% (1,520/5,374) at the first screening (2001). It was found that the incidence in 2004 of hypertension for the follow-up subjects (3,711) who had normal blood pressure in 2001 was 7.6 per 100 person-year. Multiple logistic regression analysis of the variables related to the risk factors of hypertension was carried out. The relative risks were 1.037 (95% CI=1.022-1.053) as the age increased 1 year and 1.039 (95% CI=1.023-1.055) as the body mass index increased $1kg/m^2$. The relative risk for the prehypertensive group was 2.501 (95% CI=1.986-3.149) compared to the normotensive group. These results showed that age, body mass index and the baseline blood pressure were significantly related to the incidence of hypertension. Conclusions: The incidence of hypertension was 7.6 per 100 person-year during follow-up. It was concluded that the risk factors for developing hypertension in the short-term were age, BMI, and prehypertension; Especially, this showed that it is necessary for prehypertensives to manage their body weight and blood pressure to prevent hypertension in middle-age by modifying their life style.

• Journal of the Korean Dietetic Association
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• v.26 no.1
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• pp.42-53
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• 2020

The relationship of abdominal obesity ("AO") with co-morbidity and mortality is well established. This study assessed the factors associated with AO, which was defined as a waist circumference ≥90 cm for men and ≥85 cm for women, in the group aged over 65 years. A total of 1,435 subjects were analyzed among the participants of the 2014 Korean National Health and Nutrition Examination Survey. Statistical methods for a complex sample were applied by using a SPSS program (ver. 25.0). AO was more frequently found in females. The results of the logistic regression analysis showed that heavy drinking (OR: 1.53), no weight training (OR: 0.68), stressful mental status (OR: 0.61), bad health-related quality of life (by EQ_5D, OR: 1.45), hypertension (OR: 2.18), prediabetes (OR: 1.94), diabetes (OR: 1.63), low HDL-cholesterol (OR: 1.86), anemia (OR: 0.55), and heavy energy intake (OR: 1.41) were significantly related with the prevalence of AO after adjustment for gender. Heavy drinking (OR: 1.89), bad self-rating of health status (OR: 1.72), low HDL-cholesterol (OR: 1.85), heavy energy intake (OR: 1.79), low intake of riboflavin (OR: 1.60) were still significantly related with the prevalence of AO after adjustment for gender and body mass index (BMI), this study suggests that certain characteristics of health habits, mental health status, and chronic diseases may be associated with AO. This study did not establish the existence of relationship between nutrient intakes, except for riboflavin, and risk of AO, but this study suggests that prospective research is needed to establish causal connections among those factors.

• Nutrition Research and Practice
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• v.12 no.2
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• pp.101-109
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• 2018

BACKGROUD/OBJECTIVES: The objective of this study was to investigate the effects of vitamin C on inflammation, tumor development, and dysbiosis of intestinal microbiota in an azoxymethane (AOM)/dextran sulfate sodium (DSS)-induced inflammation-associated early colon cancer mouse model. MATERIALS/METHODS: Male BALB/c mice were injected intraperitoneally with AOM [10 mg/kg body weight (b.w)] and given two 7-d cycles of 2% DSS drinking water with a 14 d inter-cycle interval. Vitamin C (60 mg/kg b.w. and 120 mg/kg b.w.) was supplemented by gavage for 5 weeks starting 2 d after the AOM injection. RESULTS: The vitamin C treatment suppressed inflammatory morbidity, as reflected by disease activity index (DAI) in recovery phase and inhibited shortening of the colon, and reduced histological damage. In addition, vitamin C supplementation suppressed mRNA levels of pro-inflammatory mediators and cytokines, including cyclooxygenase-2, microsomal prostaglandin E synthase-2, tumor necrosis $factor-{\alpha}$, Interleukin $(IL)-1{\beta}$, and IL-6, and reduced expression of the proliferation marker, proliferating cell nuclear antigen, compared to observations of AOM/DSS animals. Although the microbial composition did not differ significantly between the groups, administration of vitamin C improved the level of inflammation-related Lactococcus and JQ084893 to control levels. CONCLUSION: Vitamin C treatment provided moderate suppression of inflammation, proliferation, and certain inflammation-related dysbiosis in a murine model of colitis associated-early colon cancer. These findings support that vitamin C supplementation can benefit colonic health. Long-term clinical studies with various doses of vitamin C are warranted.

• The Korean Journal of Health Service Management
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• v.12 no.2
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• pp.125-134
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• 2018

Objectives : The purpose of this study was to analyze factors related to the functional state of stroke patients after discharge from hospital. Methods : The data was provided from a hospital in Wonju, Gangwon-do. The subjects of the analysis were those who were admitted to the emergency room due to stroke from July to December 2016. The dependent variable was the patient's functional status as measured by the modified Rankin Scale(mRS). Independent variables were demographic factors (age, sex, and marriage status), transportation and distance factors (transportation, travel distance), inpatient factors (lengths of stay, Charlson Comorbidity Index (CCI), Tissue plasminogen activator, National Institute of Health Stroke Scale (NIHSS). Hierarchial regression analysis was applied for the analysis. Results : In the hierarchical regression analysis, Model 3, including socio-demographic factors, transportation, distance factors, and inpatient factors, was the best fitted model. It showed that functional status of stroke patients was positively associated with age, length of stay, CCI, NIHSS, and negatively associated with unmarried status. Conclusions : Results indicated that management of stroke requires care from the pre-disease stage, and a customized education program policy is needed for high-risk stroke patients who are older and have comorbid illness.

• Journal of Korean Critical Care Nursing
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• v.16 no.3
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• pp.99-108
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• 2023

Purpose : This retrospective study aims to provide basic data for intervention to improve clinical outcomes and identify the characteristics of the rebound hyperthermia (RHG) and non-rebound hyperthermia (NRHG) groups by checking body temperature in patients with post-cardiac arrest syndrome. Method : The study involved 118 patients who completed target temperature management (TTM) in an acute-care unit. Data were analyzed for frequency, percentages, mean, standard deviation, median, and quartiles, and compared using the chi-squared test and Mann-Whitney U-test. Results : Rebound hyperthermia (RH) was observed in 74 (62.7%) patients, predominantly male (69.5%), with an average age of 64.54 ± 15.98, and a body mass index of 23.22 ± 4.75kg/m² (overweight). Hypertension (50%) was the most common co-morbidity, followed by diabetes and heart disease (33.1%). Neuron-specific enolase levels were higher in the NRHG 24, 48, and 72 hours after recovery of spontaneous circulation (p = .037, p < .001, p = .008). The APHCHE IV was also higher in the NRHG (p < .001). RH occurred 25.49 (7.28-52.96) hours after TTM completion, lasting for 2 (1-3) hours. Temperature reduction strategies included notifying doctors, administering antipyretics, and nursing intervention, with the latter being the most common at 94.6%. Half of the subjects in the RHG and 77.3% in the NRHG fell into cerebral performance categories 3, 4, and 5 (p = .003). Conclusion : RH is more likely a body mechanism related to CPR and TTM than a result of pathogenic infection. Therefore, we require an active intervention for hyperthermia, and a patient-specific nursing intervention protocol.

• Sleep Medicine and Psychophysiology
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• v.5 no.1
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• pp.103-110
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• 1998

Objectives : High co-morbidity of periodic limb movements during sleep(PLMS) and obstructive sleep apnea syndrome(OSAS) is well known and their incidences tend to increase in the elderly. Previous studies have inconsistently rep0l1ed increase or no change of periodic limb movement index(PLMI) by nasal continuous positive airway pressure(CPAP) in OSAS without analyzing possible variables affecting PLMI. We attempted to examine PLMI change evoked during CPAP titration and also factors affecting it in OSAS. Methods : Twenty-nine OSAS patients(M:F=26:3, mean age: $51.6{\pm}10.6\;yrs$) without other sleep disorders except for PLMS were selected, based on the nocturnal (baseline) polysomnograhy. Another night of noctumal polysomnography was performed for CPAP pressure titration. We compared between those two nights PLMI, mean and lowest $SaO_2$, and sleep variables. We also calculated PLMI differences between baseline and CPAP nights, named as delta PLMI (value of CPAP night PLMI minus value of baseline night PLMI). Correlations were calculated between delta PLMI and factors such as age, body mass index, applied CPAP pressure, baseline night values of respiratory disturbance index, mean and lowest $SaO_2$, and sleep parameter differences between baseline and CPAP nights. Results : Decrease of RDI(p<.01) and increase in mean and lowest $SaO_2$ (p<.05, p<.01) were observed during CPAP night. No sleep parameters showed significant change except for the decrease of total stage 1 sleep%(p<.01) during CPAP night. Ten out of 29 patients showed PLMI increase, while the other 19 patients showed either no change(n=14) or even PLMI decrease(n=5) during CPAP night. The 10 patients showing PLMI increase during CPAP night showed a significant positive correlation between delta PLMI and baseline night RDI(p<.05), which meant that PLMI increase was found to be more prominent in higher RDI patients than in lower RDI ones. There were no significant correlations between delta PLMI and other factors in the other 19 patients. Conclusions : We suggest that during the baseline night PLMS would have been underscored and/or masked due to the overlapping of PLMS and apneas/hypopneas or the arousals induced by apneas/hypopneas. Despite its still unknown mechanism, the CPAP application may unmask PLMS and increase PLMI in a subgroup of OSAS patients. It needs to be evaluated further whether the chronic CPAP use sustains the above finding.

• Sleep Medicine and Psychophysiology
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• v.12 no.1
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• pp.58-63
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• 2005

Objectives: REM sleep behavior disorder (RBD), characterized by excessive motor activity during REM sleep, is associated with loss of muscle atonia. In recent years, it has been reported that RBD has high co-morbidity with CNS disorders (especially, Parkinson's disease, dementia, multiple system atrophy, etc.). We aimed to assess differences in clinical and polysomnographic findings among RBD patients, depending on the presence or absence of central nervous system (CNS) disorders. Methods: The medical records and polysomnographic data of 81 patients who had been diagnosed as having RBD were reviewed. The patients were classified into two groups: associated RBD (aRBD, i.e., with a clinical history and/or brain MRI evidence of CNS disorder) and idiopathic RBD (iRBD, i.e., without a clinical history and/or brain MRI evidence of CNS disorder) groups. Twenty-one patients (25.9%) belonged to the aRBD group and 60 patients (74.1%) belonged to the iRBD group. The clinical characteristics and polysomnographic findings of the two groups were compared. Results: Periodic limb movement disorder (PLMD), i.e., PLMI (periodic limb movement index)>5, was observed more frequently in the aRBD group than in the iRBD group (p<0.001, Fisher's exact test). Also, obstructive sleep apnea syndrome (OSAS), i.e., RDI (respiratory disturbance index)>5, was found more frequently in the aRBD group (p=0.0042, Fisher's exact test). The percentages for slow wave sleep and sleep efficiency were significantly lower in the aRBD group than in the iRBD group. Conclusion: We found that 1 out of 4 RBD patients had associated CNS disorders, warranting more careful neurological evaluation and follow-up in this category of RBD. In this category of RBD patients, we also found more frequent PLMD and OSAS. These patients were also found to have lower slow wave sleep and sleep efficiency. In summary, RBD patients with associated CNS disorders suffer from more disturbed sleep than those without them.