• 제목/요약/키워드: Elderly Hospital

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고령의 급성 심근경색증 환자에서 성별에 따른 영향 (Impact of Gender Differences in Elderly Patients with Acute Myocardial Infarction)

  • 설수영;정명호;이승헌;손석준;조재영;김민철;심두선;홍영준;박형욱;김주한;안영근;조정관;박종춘
    • The Korean Journal of Medicine
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    • 제94권1호
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    • pp.96-106
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    • 2019
  • 목적: 급성 심근경색증 환자에서 성별의 차이가 임상 경과에 미치는 영향은 잘 알려져 있다. 이전의 연구들은 여성 심근경색증 환자의 임상 경과가 남성에 비하여 비슷하거나 더 좋지 않았다고 보고되었으나, 급성 심근경색증을 가진 고령 환자에서 성별에 따른 예후의 차이에 대한 보고는 많지 않다. 방법: 2011년 11월부터 2015년 6월까지 한국인 급성 심근경색증 등록 연구 사업에 등록된 75세 이상의 고령인 환자 2,953예(80.2 ± 4.2세, 남자: 48.2%)를 대상으로 하였다. 결과: 여성 환자는 1,529 (51.8%)였으며, 평균 나이는 남성보다 유의하게 많았다(80.7 ± 4.4 years vs. 79.6 ± 4.0 years, p < 0.001). 심혈관질환의 위험인자인 고혈압은 고령 여성에서 남성에 비하여 유의하게 많았다(74.8 vs. 60.3%, p < 0.001). 흡연과 협심증, 심근경색증, 뇌졸중 등 과거력은 고령의 남성에서 여성과 비교하여 유의하게 많았다. 고령의 여성 환자는 남성에 비하여 응급 의료 서비스 이용 빈도가 유의하게 낮았다(11.5 vs. 15.4%, p < 0.001). 고령 여성의 PRU 값이 남성보다 유의하게 높았으나, 항 혈소판 제제 사용에는 유의한 차이가 없었다. 관상동맥중재술의 성공률은 고령 여성이 남성에 비하여 낮았다(p = 0.049). 병원내 사망률은 성별 간에 유사하였으며(7.1 vs. 8.4%), 단변량 콕스 회귀분석 결과 1년 추적 관찰 기간 동안 주요 심장 사건은 고령의 여성에서 고령의 남성보다 유의하게 낮았다(HR 1.19, 95% CI 1.00-1.41, p = 0.045). 주요 심장 사건에 영향을 주는 독립적인 인자는 나이, 흉통, 호흡곤란, Killip class, 심부전증 등이었다. 다변량 분석 결과 1년 추적 관찰 기간 중 주요 심장 사건 발생의 독립적인 인자는 고령의 남성(HR 1.37, 95% CI 1.14-1.65, p < 0.001), 연령, Killip class, 당뇨병 및 심부전증이었다. 결론: 심근경색증을 가진 고령의 환자에서 성별 간에 병원내 사망률과 시술 주위 합병에서는 유의한 차이가 없었다. 그러나 1년 추적 관찰 기간 동안 고령의 여성에서 남성보다 더 양호한 예후를 보였다.

Transitional care for high-risk elderly patients pre/post discharge by collaboration between general hospital and community pharmacy: a pilot study

  • Park, Mi Seon;Lee, Ji Hee;Lee, Heung Bum;Kim, Ju Sin;Choi, Eun Joo
    • 한국임상약학회지
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    • 제32권1호
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    • pp.27-36
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    • 2022
  • Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

Effects of Therapeutic Ball Exercise and Hippotherapy for Balance Ability in Elderly

  • Kang, Kwon Young;Kim, Ji Sung;Choi, Yoo Rim;Lee, Joon Hee;Wang, Joong San;Park, Si Eun;Kim, Hong Rae;Shin, Hee Joon
    • 국제물리치료학회지
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    • 제3권2호
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    • pp.435-439
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    • 2012
  • This study was conducted to evaluate the effect of the exercise on elderly balance ability by using hippotherapy and therapeutic ball exercise. 10 patients were assigned to the hippotherapy group and they got with 30 minutes of hippotherapy. Another 10 elderly were assigned to the therapeutic ball group and they got with 30 minutes of therapeutic ball exercise. All procedures were repeated 5 times a week for the total of four weeks. To investigate the participants balancing abilities, the Time" Up & Go"(TUG) and One Leg Stand Test(OLST) were evaluated. The results of study were significant differences between pre-test and post-test of TUG and OLST(p<.05), and there were no significant differences between hippotherapy and therapeutic ball exercise(p>.05). The conclusion showed that both the hippotherapy and the therapeutic ball exercises were effective on elderly balancing ability. Consequently, it would be better to practice therapeutic ball than hippotherapy for elderly exercise because the more economical and there is less restriction of space than the hippotherapy.

급성기 노인 입원 환자의 자기효능감과 가족지지가 우울에 미치는 영향 (Self-efficacy and Family Support as Predictors of Depression in Elderly Patients admitted to Hospital)

  • 박병남;박진희
    • 가정∙방문간호학회지
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    • 제21권1호
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    • pp.52-59
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    • 2014
  • Purpose: The purpose of this study was to identify the prevalence and the predictors of depression in elderly patients admitted to hospital. Methods: A sample of 157 subjects aged 65 and over was selected from a university hospital in Korea. Data were collected through self-reported questionnaires during the period from April to August 2012. The data were analyzed using t-tests, ANOVAs, Pearson's correlation coefficients, and multiple regressions with the SPSS/Win program. Results: The prevalence of depression was 54.8%; the mean score for depression was 17.30. Depression in elderly patients had a significant correlation with age, educational level, marital status, and perceived economy level from the demographic characteristics, self-efficacy, and family support. A hierarchical multiple regression analysis revealed that a combination of self-efficacy and family support accounted for 27% of the depression in elderly patients. Conclusion: The findings of this study suggest that programs designed to effectively prevent and manage depression among elderly patients should consider variables such as self-efficacy and family support.

Arthroscopic Decompression of an Inferior Paralabral Cyst of the Shoulder in an Elderly Patient: A Case Report

  • Kim, Ju-Oh;An, Ki-Yong;Bong, Hwang-Se;Lee, Kyu-Jung;Min, Woong-Bae
    • Clinics in Shoulder and Elbow
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    • 제18권4호
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    • pp.266-268
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    • 2015
  • The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.

요양병원 입원 노인의 우울 관련요인 (The Factors Related to Depression of the Elderly Patients in Geriatric hospital)

  • 김명희;김윤경
    • 대한예방한의학회지
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    • 제16권3호
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    • pp.27-35
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    • 2012
  • Objective : The study was designed to identify the factors related to depression of the elderly patients in geriatric hospital. Method : The subjects consisted of 198 old people who admitted in three geriatric hospital located in Daegu City. The Data was collected through interview with questionnaire from July 16 to August 16, 2012. Results : The general characteristics which significantly affected depression was perceived health status(F=18.158, p=.000). There was a slightly negative correlation between activity daily living & depression(r=-.378,p=.000) and strongly negative correlation between life satisfaction & depression(r=-.573, p=.000). Among the factors related to depression of the subjects, life satisfaction had highest expanatory power of 32.8%. Conclusion : The finding of this study provide useful information for constructing an intervention program and care for the elderly patients in geriatric hospital with depression.

The effects of psychological factors on elderly of depression scale and Electroephalography

  • Kang, Byeong-Woo;Jung, Mi-Hyun;Cho, Byung-Jun
    • 한국컴퓨터정보학회논문지
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    • 제21권12호
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    • pp.157-163
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    • 2016
  • Purpose : This study purposed on the understanding of psychology in the elderly women using depression scale and electroephalography. The subjects were thirty elderly women in geriatric care hospital. All participants were elderly women over 65 years old. The subjects signed up with informed consent and they were divided into a normal elderly group, an exercise elderly group and a hospital elderly group. They were randomly assigned with 10 persons. Methods : The study instruments were Geriatric Depression Scale(GDS) and Poly-G-I. Brain wave activity was measured by 'power spectrum analysis' of TeleScan program. Statistic analysis consisted of average, standard deviation, One-way ANOVA and post-hoc Tukey using SPSS 21.0 version. The significance was set at .05. Results : Depression scale results showed that the exercise elderly group were $10.60{\pm}5.36$ points which was the lowest among the three groups. The Normal elderly group was $16.20{\pm}5.59$, and the hospitalized elderly group was $16.70{\pm}6.76$ points. There was no significant difference between the normal elderly group, exercise elderly group and hospitalized elderly group. The hospitalized group showed statistical difference in relative theta power in the area of Fp1, F3, F4, T3, P3 as compared to the normal elderly group and the exercise elderly groups. There was no significant difference between relative beta power and relative gamma power in three groups. Conclusion : Geriatric depressed scale showed no significant difference in each group. This is indicated in the mental problems associated with depression. This indicates a higher level of depression in the hospitalized elderly women, more than in the normal elderly women and exercise elderly women groups.

요양병원과 종합병원 노인 입원환자의 섬망 유병율과 유발요인 (Prevalence and Precipitating Factors for Delirium in Elderly Patients Admitted to Long-Term Care Hospitals or to General Hospital)

  • 양영희
    • 기본간호학회지
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    • 제17권1호
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    • pp.26-34
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    • 2010
  • Purpose: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. Method: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. Results: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. Conclusion: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

기허(氣虛)로 변증된 고령산모의 유산 후 유발된 질환 1례에 대한 임상 증례 보고 (A Case Report of Postpartum Disease Induced by Abortion in an Elderly Gravida)

  • 이연주;박현재
    • 대한한방부인과학회지
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    • 제20권4호
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    • pp.217-224
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    • 2007
  • Purpose: The purpose of this study is to report the effect of oriental treatments for the postpartum disease caused by abortion in an elderly gravida. Methods: The patient in this case, 40 years-old female was admitted at You-Min oriental medicine hospital for 26days($3rd/Jan/2007{\sim}29th/Jan/2007$) due to postpartum disease caused by abortion. Her chief complains were chilling, vertigo, nausea, whole body pain, and sweating. This patient was treated with oriental treatment such as herb medication, acupuncture and moxibustion therapy. Results: After the oriental medical treatment, the patient was improved in the clinical symptom of postpartum disease caused by abortion and the aging process. Conclusion: This case study shows that the postpartum disease caused by abortion in an elderly gravida would be treated more carefully in oriental medicine considering women#s aging.

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노인보건의료센터의 다인병실 건축계획에 관한 연구 (A study on the architectural guideline of the patient room in the geriatric medical center)

  • 윤우용;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제17권3호
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    • pp.17-26
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    • 2011
  • Nowadays, Korean society is quickly transforming into an aging society. There are lots of problems resulting from old aged society. First of all, in the case of medical service, it is an urgent task to find out what is the most proper care for the elderly in order to reduce medical expenses. It can be said that the geriatric hospital has to be designed to give adequate medical service to the elderly. However, it is hard to find out what the differences is between the general hospital and the geriatric hospital. Especially, the plan of the patient room has to reflect thoughtful consideration relating to characteristics of the elderly due to the fact that there is a close connection between the patient room and residence. Therefore this study aims to suggest the guideline and the plan of the patient room for the elderly.