• Journal of Chest Surgery
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• v.46 no.2
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• pp.130-134
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• 2013

Background: Rib fractures are the most common type of thoracic trauma and cause other complications. We explored the risk factors for pneumonia in patients with multiple rib fractures. Materials and Methods: Four hundred and eighteen patients who visited our hospital with multiple rib fractures between January 2002 and December 2008 were retrospectively reviewed. Chest X-rays and chest computed tomography were used to identify injury severity. Patients with only a single rib fracture or who were transferred to another hospital within 2 days were excluded. Results: There were 327 male patients (78%), and the median age was 53 years. The etiologies of the patients' trauma included traffic accidents in 164 cases (39%), falls in 78 cases (19%), slipping and falling in 90 (22%), pedestrian accidents in 30 (7%), industrial accidents in 41 (10%), and assault in 15 (4%). The median number of rib fractures was 4.8. Pulmonary complications including flail chest (2.3%), lung contusion (22%), hemothorax (62%), pneumothorax (31%), and hemopneumothorax (20%) occurred. Chest tubes were inserted into the thoracic cavity in 216 cases (52%), and the median duration of chest tube insertion was 10.26 days. The Injury Severity Score (ISS) and rib score had a median of 15.27 and 6.9, respectively. Pneumonia occurred in 18 cases (4.3%). Of the total cases, 33% of the cases were managed in the intensive care unit (ICU), and the median duration of stay in the ICU was 7.74 days. Antibiotics were administered in 399 patients (95%) for a median of 10.53 days. Antibiotics were used for more than 6 days in 284 patients (68%). The factors affecting pneumonia in patients with multiple rib fractures in multivariate analysis included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). The use of antibiotics was not associated with the occurrence of pneumonia (p=0.28). In-hospital mortality was 5.3% (n=22). Conclusion: The factors affecting risk of pneumonia in patients with multiple rib fractures included age (p=0.004), ISS (p<0.001), and rib score (p=0.038). Elderly patients with multiple traumas have a high risk of pneumonia and should be treated accordingly.

• Journal of Korean Foot and Ankle Society
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• v.22 no.3
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• pp.95-99
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• 2018

Purpose: The purpose of this study was to evaluate the radiologic outcomes of distal fibular fractures and to analyze the risk factors associated with nonunion. Materials and Methods: Between January 2009 and March 2016, 13 patients who had final nonunion with ankle fracture were included. In the control group, 370 patients who had undergone bony union and removed metal implants were included. All patients underwent the same surgical procedure and had the same treatment method, ultimately achieving satisfactory open reduction results with less than 2 mm fracture gap. Surgical treatment of fracture was considered to have the same effect on nonunion, and factors that might be associated with nonunion were evaluated. SPSS ver. 13.0 (SPSS Inc., USA) was used for all statistical analyses. Pearson's chi-square test and multi-variate regression analysis were performed to determine the factors affecting nonunion of distal fibular fracture. A p-value less than 0.05 was considered statistically significant, and relative risk was assessed. Results: The mean age of 13 patients was 46.9 years (range, 16~57 years); there were 8 men and 5 women. Among the 13 patients with nonunion, atrophic was the most common (12 cases). The association between the injury mechanism and the Lauge-Hansen classification and diabetes mellitus was not statistically significant. Distal fibular fractures with tibia shaft fracture (p=0.015) and Danis-Weber type C fracture (p=0.023), open fracture (p=0.011), and smoking (p=0.023) were significantly associated with nonunion. Conclusion: In this study, the combined injury of the ipsilateral tibia shaft fracture, open fracture, and Danis-Weber type C fracture may increase the possibility of nonunion. Therefore, caution is advised to prevent nonunion.

• Journal of Trauma and Injury
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• v.26 no.3
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• pp.157-162
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• 2013

Purpose: Abdominal trauma rarely causes injuries involving duodenum. But, it is associated with higher rate of the complication and mortality than other abdominal injuries. There are many options for the management of duodenal injuries. Herein we are to review our experiences and find out the risk factors related to the morbidity and the mortality in traumatic duodenal injuries. Methods: The medical records of total 25 patients who managed by surgical managements and survive more than 48 hours were conducted from January 2006 to December 2012. The clinical characteristics, treatments, and outcomes are reviewed. Results: Among 25 patients, most of them (n=17, 68.0%) were managed by the pyloric exclusion and the gastrojejunostomy. The $3^{rd}$ portion is the most injured site (n=15, 60.0%), and the majority exhibited grade 2 severity (n=14, 56.0%). Most of patients had blunt abdominal traumas (n=23, 92.0%) so that many of them (n=14, 56.0%) had other combined abdominal injuries. The mean ISS is $11.5{\pm}6.2$. The surgery related mortality rate was 28.0%. There was no statistical significance between each factors and the mortality except leakage (p=0.012). But, we could find some trends about traumatic duodenal injuries in this study. The mortality rates of them who older than 55 years were higher than others. And, all 3 patients who delayed the operation more than 24 hours after the trauma had some complications or died. Also, the patients who had the $2^{nd}$ portion injury, grade 3 injury, or combined abdominal injury were less survived. Conclusion: Duodenal injury is related to high rate of morbidity(47.8%) and mortality(28.0%). Age, portion of injury, OIS grade, ISS>15, combined intra-abdominal operation, and trauma to operation time over 24 hrs have some trend with attribution to mortality. Especially leakage of duodenal injury is related to mortality.

• Journal of Environmental Health Sciences
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• v.42 no.5
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• pp.333-344
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• 2016

Objectives: This study aimed to examine risk-accepting personality traits and associated factors among farmers. Methods: Data were collected from farmers aged over 40 living in Goryeong, North Gyeongsang-do Province, Korea. Study participants were enrolled in the Korean Rural Cohort study from 2011 to 2014. Surveys for the risk perception of farming were made through face-to-face interviews. Chi-square tests and logistic regression analysis were conducted adjusting for gender, age, marital status, and education. Results: Several factors such as gender, age, marital status, age first worked as a farmer, duration of farming, and history of pesticide poisoning were associated with risk-accepting personality traits among farmers. Farmers with risk-accepting personalities tend to be older, less educated, and have self-employed health insurance. Farmers who started farming after the age of 50 are likely to be risk averse compared to farmers who started farming before the age of 20 (OR=0.41, 95% CI; 0.21, 0.82). Frequent spraying of pesticides was marginally associated with higher risk acceptance among female farmers (OR=1.61, 95% CI: 0.99, 2.64). Male farmers who had experienced pesticide poisoning in their lifetime showed higher odds of risk-accepting personality traits (OR=2.20, 95% CI: 1.03, 4.72) Conclusion: Risk-acceptors were more likely to spray pesticides frequently and to experience more pesticide poisoning compared to risk-averse individuals. This result suggests that farming hazards are to some degree driven by risk-accepting personality traits. Further investigation of how risk-accepting behaviors influence farming practices and pesticide poisoning is needed.

• 대한예방의학회:학술대회논문집
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• 1995.10a
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• pp.137-138
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• 1995

• Journal of the Korean Society of Safety
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• v.35 no.2
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• pp.61-66
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• 2020

As asbestos-containing buildings are getting older, asbestos deconstruction works are increasing. As a result, accident risks such as falls, cuts, electric shocks, and suffocation are increasing. Existing studies are mostly about health management and institutional policy research and there is little research on work risk. So workplace risk assessments that are easily applicable in the field are required to be applied. Sealing is the first process of asbestos deconstruction and is the first step to ensure worker's safety. Job Safety Analysis(JSA) and Checklist were used to identify the risk factors and to calculate the level of the risk. By comparing the two risk assessment tools, it was figured out that the JSA is appropriate for the initial process and change of work procedure while Checklist is appropriate for repetitive work. Because the sealing process is sort and simple, it is unlikely to cause serious injury. But since the risk of falling and cuts are exist, safety education and supervision are necessary to maintain a safe working environment.

• Journal of Preventive Medicine and Public Health
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• v.50 no.2
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• pp.83-90
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• 2017

Objectives: The aim of this study was to model the avoidable burden of the risk factors of road traffic crashes in Iran and to prioritize interventions to reduce that burden. Methods: The prevalence and the effect size of the risk factors were obtained from data documented by the traffic police of Iran in 2013. The effect size was estimated using an ordinal regression model. The potential impact fraction index was applied to calculate the avoidable burden in order to prioritize interventions. This index was calculated for theoretical, plausible, and feasible minimum risk level scenarios. The joint effects of the risk factors were then estimated for all the scenarios. Results: The highest avoidable burdens in the theoretical, plausible, and feasible minimum risk level scenarios for the non-use of child restraints on urban roads were 52.25, 28.63, and 46.67, respectively. In contrast, the value of this index for speeding was 76.24, 37.00, and 62.23, respectively, for rural roads. Conclusions: On the basis of the different scenarios considered in this research, we suggest focusing on future interventions to decrease the prevalence of speeding, the non-use of child restraints, the use of cell phones while driving, and helmet disuse, and the laws related to these items should be considered seriously.

• Research in Community and Public Health Nursing
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• v.19 no.1
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• pp.36-45
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• 2008

Purpose: This study was to estimate the prevalence of dementia in order to estimate the associations of dementia with its risk factors in the community elderly. Methods: The multistage random cluster sampling method was used to select the subjects. The response rate was 94.3%. For the 1st stage screening survey, the Korean-version Mini-Mental State Examination (K-MMSE) and the Bathel Index of activities of daily living (ADL) and instrumental activities of daily living (IADL) were used as primary screening tools. At the 2nd stage. diagnoses were confirmed according to the Clinical Dementia Rating Scale (CBR) and Computer Tomogram (CT). Results: Age-sex adjusted prevalence (%) [95% CI] of dementia was 6.25% [4.47-7.83] (male 4.21% [2.40-6.02]; female 8.28% [5.71-10.85]). Four statistically significant risk factors of the dementia were identified: age 70-74 (OR=1.367), age 75-79 (OR=1.712), age 80-84 (OR=2.465), age 85 over (OR=7.363) illiteracy (OR=3.827); unconsciousness after head injury (OR=3.383), and no exercise (OR=2.188). Hosmer and Lemeshow goodness-of-fit index of dementia risk model was E (legit of dementia)= -4.337+$0.312^*Age(70{\sim}74)+0.538^*Age(75{\sim}79)+0.902^*Age(80{\sim}84)+1.996^*Age$(85over)+$1.342^*$Illiteracy+$1.219^*$Unconsciousness after head trauma+$0.783^*$No exercise. We confirmed that the overall prevalence of dementia in adults aged 65 and older was 94.3%. The risk factors of dementia were explained by age, illiteracy unconsciousness after head trauma and no exercise. Conclusion: These data have been used to estimate the incidence of dementia in elderly community population and to manage the possible role of risk factors as predictors of dementia.

• Clinics in Shoulder and Elbow
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• v.25 no.1
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• pp.36-41
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• 2022

Background: Distal biceps rupture is a relatively uncommon injury that can significantly affect quality of life. Early complications following biceps tendon repair are not well described in the literature. This study utilizes a national surgical database to determine the incidence of and predictors for short-term complications following distal biceps tendon repair. Methods: The American College of Surgeons' National Surgical Quality Improvement Program database was used to identify patients undergoing distal biceps repair between January 1, 2011, and December 31, 2017. Patient demographic variables of sex, age, body mass index, American Society of Anesthesiologists class, functional status, and several comorbidities were collected for each patient, along with 30-day postoperative complications. Binary logistic regression was used to calculate risk ratios for these complications using patient predictor variables. Results: Early postoperative surgical complications (0.5%)-which were mostly infections (0.4%)-and medical complications (0.3%) were rare. A readmission risk factor was diabetes (risk ratio [RR], 4.238; 95% confidence interval [CI], 1.180-15.218). Non-home discharge risk factors were smoking (RR, 3.006; 95% CI, 1.123-8.044) and ≥60 years of age (RR, 4.150; 95% CI, 1.611-10.686). Maleness was protective for medical complications (RR, 0.024; 95% CI, 0.005-0.126). Surgical complication risk factors were obese class II (RR, 4.120; 95% CI, 1.123-15.120), chronic obstructive pulmonary disease (COPD; RR, 21.981; 95% CI, 3.719-129.924), and inpatient surgery (RR, 8.606; 95% CI, 2.266-32.689). Conclusions: Complication rates after distal biceps repair are low. Various patient demographics, medical comorbidities, and surgical factors were all predictive of short-term complications.

• Physical Therapy Korea
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• v.8 no.3
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• pp.107-117
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• 2001

Falls are the most serious health problems in elderly population. They are a major cause of premature death, physical injury, immobility, psychosocial dysfunction, and nursing home placement. To reduce the alarming rate of falls and related excessive mortality and morbidity, efforts must be made to detect persons at risk of falling and to prevent or reduce the frequency of falls. To facilitate such approaches, it is essential to find the cause of falling (and under what conditions) of the elderly and the factors that are associated with risk of falling. This study was aimed at designing interventions that minimize risk of falling by ameliorating contributing factors while maintaining or improving patient's mobility.