• Tuberculosis and Respiratory Diseases
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• 제69권4호
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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.

• 보건행정학회지
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• 제19권4호
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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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• 제69권5호
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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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• 제39권3호
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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.

• 대한영양사협회학술지
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• 제26권1호
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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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• 제12권2호
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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.

• 보건의료산업학회지
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• 제12권2호
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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.

• 중환자간호학회지
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• 제16권3호
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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.

• 수면정신생리
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• 제5권1호
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• pp.103-110
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• 1998

연구배경 : 사지운동증과 수면무호흡증은 공히 연령 증가에 따라 그 유병률이 증가한다. 흥미롭게도, 수면 무호흡증 환자에게 양압술을 시행하면 사지운동증이 증가 또는 유발된다는 보고들이 있다. 그러나 아직 일 관성 있는 결과가 나와있지는 않다. 저자들은 수면무호흡증환자에서 양압술 적용전후의 사지운동지수변화를 살펴보고 이러한 변화에 영향을 끼칠 수 있는 요인들을 밝혀내고자 하였다. 방법 : 야간 수면다원검사 결과 무호흡증으로 진단받았고 사지운동증외의 다른 수면장애가 병발되지 않았던 총 29명(남자 26명, 여자 3명)을 연구대상으로 하였다. 대상군의 평균연령은 $51.6{\pm}10.6$ 세이었다. 결과 : 기본측정일과 양압술 시행일의 사지운동지수는 각각 $5.7{\pm}9.5$회 (범위 0-35.4회), $12.0{\pm}9.2$ 회(범위 0-74.3회)로 양압술 시행일에서 유의하게 증가하였다(p<.05). 전체 대상군을 사지 운동 변화 여부에 따라 분류한 바 사지운동지수 증가군, 무변화군 및 감소군의 수는 각각 10명, 14명, 5명이었다. 사지운동지수 델타값과 연령, 비만 정도, 호흡 관련 변인, 수면구조 관련 변인 델타값 및 양압술 처방압력 과의 상관관계 분석 결과전체 대상군에서는 유의한 상관관계가 나타나지 않았다. 그러나 사지운동지수 증가군에서는 호흡장애지수와 사지운동지수 텔타값 간에 유의한 정상관관계를 보였다(p<.05). 동일군의 다른 변인들이나 다른 군의 제반 변인들에서는 유의한 소견이 나타나지 않았다. 결론 : 본 연구의 결과는 양압술 적용이 직접적으로 사지운동증을 유발하거나 증가시키기보다는 숨어 있거나 적게 판독되었던 사지 운동증을 무호흡의 해소와 함께 표출시킬 가능성을 제시한다.

• 수면정신생리
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• 제12권1호
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• pp.58-63
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• 2005

목 적：중추신경계 질환의 병발 여부에 따라 렘수면 행동 장애 환자들을 두 군으로 나눈 후, 인구학적 특성, 임상양상, 수면 변인들을 비교하여 차이점과 특성을 관찰하고자 하였다. 방법：서울대학교병원에서 야간수면다원검사를 통해 렘수면 행동장애로 확진받은 81명을 대상으로 하였다. 의무기록과 수면다원검사 소견을 후향적으로 조사하였고 필요한 경우 전화문진을 통해 자료를 보완하였다. 중추신경계 질환력과 뇌 자기공명검사 소견을 근거로 전체 대상을 중추신경계 질환을 동반한 병발성 렘수면 행동장애군과 그렇지 않은 특발성 렘수면 행동장애군으로 이분하였다. 그 후 두 군 사이의 인구학적 특성, 임상양상, 수면 변인을 비교분석하였다. 결 과：전체 대상군 81명 중 남자는 64명, 여자는 17명이었다. 그리고 전체 대상중에 21명(25.9%)에서 중추신경계 질환이 동반되어 병발성 렘수면 행동장애군으로, 나머지 60명(74.1%)에서 그렇지 않아 특발성 렘수면 행동장애군으로 분류하였다. 동반된 중추신경계 질환은 파킨슨병(11명), 올리브뇌교소뇌위축(olivopontocerebellar atrophy)(3명), 다발신경계위축증(multiple system atrophy)(2명), 파킨슨병을 동반하지 않은 치매(2명), 뇌경색(1명), 뇌교부종(1명), 뇌종양(1명)이었다. 전체 대상에서 수면장애가 병발된 경우는 74.1%로서 주기성 사지운동증과 폐쇄성무호흡증이었다. 주기성 사지운동증(사지운동 지수>5)과 폐쇄성 수면무호흡증(호흡장애지수>5)의 유병율이 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.0042, Fisher 검증). 심한 정도를 나타내는 주기성 사지운동지수와 호흡장애지수도 병발성 렘수면 행동장애군에서 유의하게 높았다(각각 p<0.001, p=0.017, 독립 t-test). 수면변인 중 서파수면분율과 수면효율은 병발성 렘수면 행동장애군에서 유의하게 낮았다(각각 p<0.001, p=0.017, 독립 t-test). 고 찰：렘수면 행동장애 환자의 25%에서 중추신경계 질환이 동반되어 있음을 확인하였다. 중추신경계 질환이 동반된 렘수면 행동장애에서는 주기성 사지운동증과 폐쇄성 수면 무호흡증 같은 다른 수면장애가 더 흔하게 병발하였고 그 정도 역시 더 심하게 나타났다. 수면구조에서도 특발성 렘수면 행동장애에 비해 서파수면과 수면효율이 모두 더 감소하는 소견을 보였다.