This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.
Brachial plexus injury developing after axillary thoracotomy is an uncommon complication. But if it occurs, it may cause annoying events. We recently experienced 2 patients who developed brachial plexus injury after wedge resection by axillary thoracotomy . The first patient was a 22 year-old man with right spontaneous pneumothorax . After wedge resection of the right upper lung by axillary thoracotomy, he complained total paralysis of the right arm. An electromyogram was obtained at 7 days after operation, with the confirmation of brachial plexus injury. He was discharged at 22days after operation and brachial plexus injury was completely recovered 4 months after discharge. The second patient was a 17 year-old man with recurrent right pneumothorax. He underwent wedge resection of the right upper lung by axillary thoracotomy. Electromyogram confirmed the diagnosis of brachial plexus injury in the immediate postoperative period. He was discharged at 15 days after operation and brachial plexus injury was recovered 2months after discharge.Brachial plexus injury after axillary thoracotomy is caused by stretching around the clavicle and tendon of pectoralis minor by fixation of the abducted arm to the frame. Thus, when we perform wedge resection by axillary thoracotomy, we must avoid over-stretching of the brachial plexus in positioning. If brachial plexus injury develops, immediate attention and management with close rapport are important to avoid possible medicolegal problems.
Head Injuries due to traffic accidents are now the leading cause of death and long term disability in males between 30-50 years. Many patients with head injuries experience mild dysfunction of cognition without major neurosurgical problems, and this may interfere with successful rehabilitation. However, not many studies have been done to investigate the cognitive functioning following mild head injuries. The purpose of this study was to obtain injured patient's dermographic data including medical, neuropsychological and social data, and to investigate the cause of injury and alcohol use at the time of injury. This study focused on the recovery of cognitive function in patients with head injuries and used the Mini Mental State Examination(MMSE) score and its correlation with dermographic and social data. Data on 77 patients with minor head injuries who were admitted to the department of Neurosurgery in 3 and I hospital in Dae Jun from September 1991 to February 1992 were analyzed. The findings of this study are as follows ; 1) Out of the 77 cases reviewed in this study, 62 were male, 15 were female. 2) A higher incidence of injury was observed between 7:00 PM and 12:00 PM. 3) The most common cause of head injury in traffic accidents was pedestrian accidents, and the next most frequent cause was motorcycle accidents. 4) Thirteen of the 77 cases in this study were under the influence of alcohol at the time of injury, and they were all male. 5) The MMSE scores one month after injury and at discharge were significantly lower in patients with head injuries that included skull fractures than in patients without skull fractures, suggesting lower cognitive function in patients with skull fractures. 6) The level of consciousness at admission and three days after admission measured by the GCS for drivers under the influence of alcohol was lower than for sober drivers. The MMSE score was also lower for drunken drivers. 7) The MMSE score one month after the injury had a reciprocal relationship with the age of the patient. 8) The MMSE score one month after the injury and at discharge were highly correlated with the duration of unconsciousness. 9) The MMSE score one month after injury and at discharge were highly correlated with the GCS scores at admission, three days after admission, and one week after admission.
Jeon, Se-Il;Im, Soo Bin;Jeong, Je Hoon;Cha, Jang Gyu
Journal of Trauma and Injury
/
v.30
no.2
/
pp.51-54
/
2017
We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.
Lee Hyoung-Soo;Jeong Chan-Ju;Yang Hoi-song;Shin Young-Il
The Journal of Korean Physical Therapy
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v.16
no.3
/
pp.142-151
/
2004
The purpose of this study was to determine the validity and the reliability of the WISCI II to ascertain its value in the walking function evaluation of spinal cord injury patient. The WISCI II consists of 20 variables with a total valus ranging from 6 to 20 score. A group of 23 spinal cord injury patient were included in this study. To determine the validity, kappa statistics between the WISCI II and SCIM II were measured. The result of this study are as follows: 1) In the validity study, the kappa statistics between the WISCI II and SCIM II were 0.79 and 0.84 for an initial total score and a discharge total score respectively, indicating a reasonable agreement between the two test. 2) In the reliability study, the Cronbach's alpha coefficient was 0.83 and 0.95 for total score indicating a good internal consistency. The finding suggest that the WISCI II demonstrated an acceptable validity and reliabilit for the evaluation of walking function capacity of spinal cord injury patient in clinical practice.
Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Hixon, Brenda
International Journal of Advanced Culture Technology
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v.7
no.2
/
pp.28-33
/
2019
Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.
This study selected in-depth discharge damage survey data and analyzed 92,364 patients whose main diagnosis was S00-T98 (damage, addiction, and specific other results due to external factors) based on the Korean Standard Classification of Diseases and Deaths (KCD-7th) among patients discharged from the hospital after inpatient treatment from January 2016 to December 2018. As a result of analyzing the general characteristics of injured and traumatic patients, the incidence rate of men was higher in gender, and the incidence rate of women increased as the year increased. As a result of analyzing the characteristics of injury and trauma patients other than injury, the injury intention had a high rate of unintentional damage, the damage place was the highest on the road/road, and it showed a decreasing trend as the year increased, and it showed an increasing trend in the residential area. It can be used as basic data for the establishment of a related system to prevent damage as a result of subsang.
Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.
Journal of Korean Academy of Nursing Administration
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v.2
no.2
/
pp.43-57
/
1996
The purpose of this research conducted has been an the development of a computer program to be used for nursing of spinal cord injury patients. The research is also intended to contribute by supplying the basic data, to the development of other programs in relevant areas where similar nursing information system is required. This research used System Development Life Cycle method. Results from the study were as follows : The scope of Information System in nursing practice were based on a wide range of mateials as charts at four hospitals in Pusan that cover the nursing period of spinal cord injury patients from admission to discharge and other sources of reference, the research is done for nursing diagnosis, nursing history, admission and discharge education, and the performing of doctor's order, which were divided into a subsystem that consisted of help, Patient Management, Performing of Docter's Order, and Basic Data Management and then these was analysed systematically using Hierachy Plus Input Process Output, necessary information, data flow diagram, and conceptual designs were developed for chosem system. Furthemore, the system has been programed by a conceptual design that includes the objects of the program and the origins of the sources. The oder to make sure of the proper function, the computer program was actually applied to a nursing practice that had been developed for a hypothetical situation through the two nurses who were in charge of spinal cord injury patients after they were trained to understand the structure and the contents of computer program about the nursing practice from using the computer program developed. Also, the compensatory strategy has been worked out against any problems to arise. It is expected that this kind of nursing practice information system to be used for the spinal cord injury patients that has been developed through the processes shown above will increase the satisfaction for both patients and nurses by enabling them to give more professional advice and service to the development of more information systems for many hospitals.
In this study, we analyzed situation and length of stay(LOS) variations of inpatients with pressure ulcer using patient safety indicators developed by the United States Agency for Healthcare Research and Quality(AHRQ) and proposed management of medical quality and development of policy. The dataset was taken from 1,373 database of the hospital discharge injury survey from 2005 to 2008. Analysis method was used frequency and chi-square test, ANOVA, multiple linear regression analysis. In result, distribution of inpatients with pressure ulcer by sex were 52.5%(male), 47.5%(female), respectively and aged $65{\geqq}years$ was the highest in age group. LOS of inpatients with nervous system principal disease was the longest. Independent variables which were statistically associated with LOS of inpatients with pressure ulcer were year, sex, insurance type, bed size, operation, principal diagnosis. Therefore, hospital should develop the standardized strategy and guidelines to manage pressure ulcer inpatients efficiently and apply it into the medical information system.
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