• Title/Summary/Keyword: Injury Risk Factors

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Cause and Prevention of Falling in the Elderly (노인낙상의 원인과 예방)

  • Chung, Nak-Su;Choi, Kyu-Hwan
    • 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.

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Characteristics of Fall Events and Fall Risk Factors among Inpatients in General Hospitals in Korea (입원 환자의 낙상실태 및 위험요인 조사연구: 국내 500병상 이상 종합병원을 중심으로)

  • Choi, Eun Hee;Ko, Mi Suk;Yoo, Cheong Suk;Kim, Mi Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.350-360
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    • 2017
  • Purpose: The purpose of this study was to investigate the present status of falls among inpatients in general hospitals and to identify the fall risk factors that reflect the characteristics of domestic hospitals. Methods: Data were collected between December 15, 2016 and January 15, 2017 from 32 Korean hospitals having 500 or more beds. First, 42 risk factors were extracted based on literature review and expert opinions. Then the importance of each factor was evaluated by 223 nurses from medical and surgical adult ward and intensive care units in 40 hospitals. Results: The incidence rate of falls in 18 hospitals was 3.87 per 1,000 total discharged patients and 0.55 per 1,000 patient-days, and the rate of injury-related falls was 40.5%. Major risk factors for falling were identified as the following: being over 65 years of age, history of falls during admission, physical mobility disorders requiring assistance, physical factors (dizziness or vertigo, unstable gait, general weakness, walking aids, visual problems), cognitive factors (delirium, lack of understanding on limitations), neurological disease, CNS medications Conclusion: The findings provide information that can be in the development of a fall risk assessment tool for inpatients in general hospitals in Korea.

The Characteristics and Risk Factors of Medical Device Related Pressure Injury in Intensive Care Unit Patients (중환자실 환자의 의료기기 관련 욕창 특성과 위험요인)

  • Jo, Mi Hyeon;Choi, Hye-Ran
    • Journal of Korean Critical Care Nursing
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    • v.16 no.2
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    • pp.28-41
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    • 2023
  • Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results : Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.

Biomechanical Analysis of Injury Factor According to the Change of Direction After Single-leg Landing

  • Kim, Jong-Bin;Park, Sang-Kyoon
    • Korean Journal of Applied Biomechanics
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    • v.26 no.4
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    • pp.433-441
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    • 2016
  • Objective: The purpose of this study was to understand the injury mechanism and to provide quantitative data to use in prevention or posture correction training by conducting kinematic and kinetic analyses of risk factors of lower extremity joint injury depending on the change of direction at different angles after a landing motion. Method: This study included 11 men in their twenties (age: $24.6{\pm}1.7years$, height: $176.6{\pm}4.4cm$, weight: $71.3{\pm}8.0kg$) who were right-leg dominant. By using seven infrared cameras (Oqus 300, Qualisys, Sweden), one force platform (AMTI, USA), and an accelerometer (Noraxon, USA), single-leg drop landing was performed at a height of 30 cm. The joint range of motion (ROM) of the lower extremity, peak joint moment, peak joint power, peak vertical ground reaction force (GRF), and peak vertical acceleration were measured. For statistical analysis, one-way repeated-measures analysis of variance was conducted at a significance level of ${\alpha}$ <.05. Results: Ankle and knee joint ROM in the sagittal plane significantly differed, respectively (F = 3.145, p = .024; F = 14.183, p = .000), depending on the change of direction. However, no significant differences were observed in the ROM of ankle and knee joint in the transverse plane. Significant differences in peak joint moment were also observed but no statistically significant differences were found in negative joint power between the conditions. Peak vertical GRF was high in landing (LAD) and after landing, left $45^{\circ}$ cutting (LLC), with a significant difference (F = 9.363, p = .000). The peak vertical acceleration was relatively high in LAD and LLC compared with other conditions, but the difference was not significant. Conclusion: We conclude that moving in the left direction may expose athletes to greater injury risk in terms of joint kinetics than moving in the right direction. However, further investigation of joint injury mechanisms in sports would be required to confirm these findings.

Is Routine Repeated Head CT Necessary for All Pediatric Traumatic Brain Injury?

  • Kim, Won-Hyung;Lim, Dong-Jun;Kim, Se-Hoon;Ha, Sung-Kon;Choi, Jong-Il;Kim, Sang-Dae
    • Journal of Korean Neurosurgical Society
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    • v.58 no.2
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    • pp.125-130
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    • 2015
  • Objective : Repeated computed tomography (CT) follow up for traumatic brain injury (TBI) patients is often performed. But there is debate the indication for repeated CT scans, especially in pediatric patients. Purpose of our study is to find risk factors of progression on repeated CT and delayed surgical intervention based on the repeated head CT. Methods : Between March, 2007 and December, 2013, 269 pediatric patients (age 0-18 years) had admitted to our hospital for head trauma. Patients were classified into 8 subgroups according to mechanisms of injury. Types, amount of hemorrhage and amount changes on repeated CT were analyzed as well as initial Glasgow Coma Scale (GCS) scores. Results : Within our cohort of 269 patients, 174 patients received repeat CT. There were progression in the amount of hemorrhage in 48 (27.6%) patients. Among various hemorrhage types, epidural hemorrhage (EDH) more than 10 cc measured in initial CT was found to be at risk of delayed surgical intervention significantly after routine repeated CT with or without neurological deterioration than other types of hemorrhage. Based on initial GCS, severe head trauma group (GCS 3-8) was at risk of delayed surgical intervention after routine repeated CT without change of clinical neurologic status. Conclusion : We suggest that the patients with EDH more than 10 cc or GCS below 9 should receive repeated head CT even though absence of significant clinical deterioration.

Comparison of the Predictive Validity of the Pressure Injury Risk Assessment in Pediatric Patients: Braden, Braden Q and Braden QD Scale (소아 환자에서 욕창 위험도 사정 도구의 예측타당도 비교: Braden, Braden Q 및 Braden QD 도구)

  • Kang, Ji Hyeon;Lim, Eun Young;Lee, Nam Ju;Yu, Hye Min
    • Journal of Korean Clinical Nursing Research
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    • v.30 no.1
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    • pp.35-44
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    • 2024
  • Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

Protective dental splint for oroendotracheal intubation: experience of 202 cases

  • Lee, Kang-Hee;You, Tae-Min;Park, Wonse;Lee, Sun Hwa;Jung, Bock-Young;Pang, Nan-Sim;Kim, Kee-Deog
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.15 no.1
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    • pp.17-23
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    • 2015
  • Background: Dental injury as a result of oroendotracheal intubation during general anesthesia is very common. We report our experiences of using mouthguard to prevent dental injury during intubation based on our protocol. Methods: This retrospective study enrolled patients referred for preanesthetic evaluation, those patients with a history of any of the dental treatments to their anterior teeth listed on our fabrication protocol from January 1, 2009 to June 30, 2010. Results: No cases of dental trauma during oroendotracheal intubation were reported among the 202 patients who used a protective device. 66% of the patients had risk factors for hard tissue damage aged 10-40 years. At the ages of 40-70 years, the incidence of risk group for periodontal damage was higher. Conclusions: Preanesthetic consultation was effective for preventing dental injury, so preanesthetic questionnaire and proper dental consultation would be helpful.

A Study on Injury Characteristics by Working Place in the Saw Milling Industry (일반제재업종에서의 작업공정별 재해특성 연구)

  • Rhee, Hong Suk;Yi, Kwan Hyung;Kim, Young Sun
    • Journal of the Korea Safety Management & Science
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    • v.16 no.3
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    • pp.45-54
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    • 2014
  • The average injury rate in sawmilling industry for the last 5 years is 4.99%, which means that more than 200 injuries have occurred in that industry every year. Because the first step in risk assessment is the hazard identification, it is very important to know how to define the hazard and nature of harm. We analyzed 643 accident records of three years(2010-2012) and carried out site survey for the same cases. As a result, the most common types of work at the time of injury in sawmilling industry were removing jammed wood 81(12.8%), wood carrying task 52(8.1%), wood cutting 49(7.6%), travelling table log band saw 41(6.4%), maintenance 37(5.8%) etc. In addition, there were statistically significant differences in some analysis factors such as injured body parts, employment size, and handling material among different working places. Therefore, it is concluded that differentiated prevention efforts are necessary in each workplace.

Postoperative infection after cranioplasty in traumatic brain injury: a single center experience

  • Mahnjeong, Ha;Jung Hwan, Lee;Hyuk Jin, Choi;Byung Chul, Kim;Seunghan, Yu
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.255-260
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    • 2022
  • Purpose: To determine the incidence and risk factors of postoperative infection after cranioplasty in patients with traumatic brain injury (TBI). Methods: Data of 289 adult patients who underwent cranioplasty after TBI at a single regional trauma center between year 2018 and 2021 were reviewed retrospectively. Patient characteristics and various procedural variables, such as interval between craniectomy and cranioplasty, estimated blood loss, laterality and materials of the bone flap, and duration and classification of perioperative antibiotics usage were analyzed. Results: Postoperative infection occurred in 17 patients (5.9%). Onset time of infectious symptom ranged from 9 days to 174 days (median, 24 days) after cranioplasty. The most common cultured organism was Staphylococcus aureus (47.1%), followed by Klebsiella pneumoniae (17.6%) and Enterococcus faecalis (17.6%). Patients with postoperative infection were more likely to have diabetes (odds ratio [OR], 6.96; 95% confidence interval [CI], 1.92-25.21; P=0.003), lower body mass index (OR, 0.81; 95% CI, 0.66-0.98; P=0.029), and shorter duration of perioperative antibiotics (OR, 0.83; 95% CI, 0.71-0.98; P=0.026). Conclusions: For TBI patients with diabetes, poor nutritional status should be managed cautiously for increased risk of infection after cranioplasty. Further studies and discussions are needed to determine an appropriate antibiotics protocol in cranioplasty.

Risk Factors for Falls Among Elderly People Living in the Rural Community

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.13 no.4
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    • pp.16-22
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    • 2006
  • Falling is a serious problem associated with aging. Unintentional injury, which most often results from falling, is one of the leading causes of death in elderly people. The purpose of this study is to investigate the risk factors of falls and to compare characteristics of people who fall with that of non-fallers among the rural community-dwelling elderly of Korea. A sample of 201 people, living in the community, aged 60 years and over was taken from the members of a center for seniors located in Jecheon city. The mean age of the participants was 70.5 years of age. The participants are comprised of 151 women and 50 men. Eighty four of the 201 participants (41.8%) fell during the previous year. Twenty two of the fallers (26.2%) fell down more than two times. It was found that fallers had poorer eyesight, multiple chronic diseases and a more difficult time walking than non-fallers. In the logistic regression analysis of falls, only the difficulty of walking one kilometer (OR=2.4) and chronic diseases (OR=2.5) have shown an increased risk of falls. The risk of recurrent falls is, in addition, influenced by the difficulty of walking one kilometer. The result of our study shows that the impairment of mobility was the strongest risk factor of recurrent falling.

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