• Title/Summary/Keyword: Outcome predictor

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Predictors of Quality of Life among Hemodialysis Patients (혈액투석환자의 삶의 질에 대한 영향요인)

  • Kim, Eun-Young;Kim, Jin-Sun
    • Korean Journal of Adult Nursing
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    • v.16 no.4
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    • pp.597-607
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    • 2004
  • Purposes: Quality of life is an important health outcome for hemodialysis patients. The purposes of this study were to identify the level of quality of life and to identify the predictors of quality of life among hemodialysis patients. Method: A descriptive correlational study was conducted. Data were collected from 103 hemodialysis patients at the hospitals in a community using structured questionnaire and medical record. Data were analyzed using descriptive statistics, t-test, ANOVA, correlation, and stepwise multiple regression. Results: Quality of life among hemodialysis patients was relatively lower than that of previous studies. In the final analysis, quality of life was predicted by presence of comorbidity, emotional health, gender, physical health, and knowledge of disease. These variables accounted for 45% of variance of the quality of life. The presence of comorbidity was the most significant predictor of quality of life among hemodialysis patients. Conclusion: Interventions to increase quality of life among hemodialysis patients such as health promotion program and educational program for dietary compliance are needed. These must be developed and applied.

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Parenting Attitudes Profiles as Perceived by Adolescents: The Influence of Parents' Life Satisfaction and Self-Esteem and Academic Engagement and Academic Helplessness of the Adolescents Associated with the Profiles (청소년이 지각한 부모의 양육태도 유형: 부모의 삶의 만족도와 자아존중감의 영향력과 유형에 따른 청소년의 학업열의와 학업 무기력)

  • Ki, Ppudah
    • Human Ecology Research
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    • v.59 no.2
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    • pp.215-231
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    • 2021
  • The study set out to identify the number of types of parental attitude profiles and their characteristics, as perceived by adolescents. The study also examined whether predictor variables (parent life satisfaction and self-esteem) influence parenting attitude profiles and whether these profiles, in turn, influence adolescent academic engagement and academic helplessness. The sample consisted of data on 2,590 adolescents and their parents from the 2018 Korean Children and Youths Panel Survey (KCYPS). The adolescents were in the first grade of middle school. Using Mplus, the author applied latent profile analysis to identify the parenting attitude profiles and predictor and outcome variables associated with these profiles. Three profiles were identified based on major features: (1) coercion-inconsistency (8.3%), (2) general (47.3%), and (3) warmth-autonomy support (44.4%). Parent life satisfaction and self-esteem predicted the classification of the profiles. Also, the parental profiles identified the level of adolescent academic engagement and academic helplessness. The findings have important implications for family policies and practices given the significance of parent psychological status, particularly life satisfaction and self-esteem, on their adolescent children's academic engagement and academic helplessness.

One Year Naturalistic Outcome Study of Panic Disorder Patients (공황장애 환자의 1년 자연 경과 추적 연구)

  • Kim, Min-Hoo;Lee, Dong-Eoun;Chung, Seock-Hoon;Song, Hae-Cheol;Hahn, Oh-Su;Lee, Seon-Hyung;Kwon, Soo-Hee;Hong, Jin-Pyo
    • Anxiety and mood
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    • v.2 no.2
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    • pp.108-114
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    • 2006
  • Objectives : Only a few prospective studies of panic disorder are available. This study investigated naturalistic outcome of panic disorder patients at twelve months after the initial diagnosis. Methods : A total of 84 subjects were diagnosed with panic disorder by diagnostic interview, Structured Clinical Interview for DSM-IV (SCID-IV) and Anxiety Disorder Interview Schedule for DSM-IV (ADISIV). Among them, 80 subjects could be evaluated by means of Panic Disorder Severity Scale (PDSS) at follow-up interview after twelve months. Treatment continuation was also examined at follow-up interview. Results : At initial intake, 80 patients were classified into 22% with mild, 33% with moderate-to-marked, and 45% with severe symptoms on the basis of their PDSS total score. At twelve months, 20% of patients reached remission, 65% had mild and 15% had moderate-to-marked symptoms. Initial panic symptom severity, presence of agoraphobia, panic symptom duration before diagnosis, number of comorbid Axis I disorders were associated with significantly higher PDSS total score at twelve months. Forty six percent of total patients continued medication and 23% have stopped treatment by clinician's recommendation and 31% have selfdiscontinued their medication. At twelve months, all three groups were improved but self-discontinuation group had significantly higher PDSS total score. Conclusion : In the one-year naturalistic outcome study of panic disorder patients, high percentage of patients achieved remission or had mild symptoms.

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Prognostic factors for outcome of surgical treatment in medication-related osteonecrosis of the jaw

  • Shin, Woo Jin;Kim, Chul-Hwan
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.4
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    • pp.174-181
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    • 2018
  • Objectives: The number of patients with medication-related osteonecrosis of the jaw (MRONJ) is increasing, but treatment remains controversial. Published papers and systematic reviews have suggested that surgical treatment is effective in patients with MRONJ. The purpose of this study was to determine whether preoperative University of Connecticut Osteonecrosis Numerical Scale (UCONNS), other serologic biomarkers, and size of necrosis are prognostic factors for outcome of surgical treatment in MRONJ. Materials and Methods: From January 2008 to December 2016, 65 patients diagnosed with MRONJ at the Department of Oral and Maxillofacial Surgery in College of Dentistry, Dankook University who required hospitalization and surgical treatment were investigated. Patient information, systemic factors, and UCONNS were investigated. In addition, several serologic values were examined through blood tests one week before surgery. The size of osteolysis was measured by panoramic view and cone-beam computed tomography in all patients. With this information, multivariate logistic regression analysis with backward elimination was used to examine factors affecting postoperative outcome. Results: In multivariate logistic analysis, higher UCONNS, higher C-reactive protein (CRP), larger size of osteolysis, and lower serum alkaline phosphate were associated with higher incidence of incomplete recovery after operation. This shows that UCONNS, CRP, serum alkaline phosphate, and size of osteolysis were statistically significant as factors for predicting postoperative prognosis. Conclusion: This study demonstrated that CRP, UCONNS, serum alkaline phosphate, and size of osteolysis were statistically significant factors in predicting the prognosis of surgical outcome of MRONJ. Among these factors, UCONNS can predict the prognosis of MRONJ surgery as a scale that includes various influencing factors, and UCONNS should be used first as a predictor. More aggressive surgical treatment and more definite surgical margins are needed when the prognosis is poor.

The efficacy of selective nerve root block for the long-term outcome of postherpetic neuralgia

  • Doo, A Ram;Choi, Jin-Wook;Lee, Ju-Hyung;Kim, Ye Sull;Ki, Min-Jong;Han, Young Jin;Son, Ji-Seon
    • The Korean Journal of Pain
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    • v.32 no.3
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    • pp.215-222
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    • 2019
  • Background: Several nerve blocks can reduce the incidence of postherpetic neuralgia (PHN) as well as relieve acute zoster-related pain, but the long-term outcome of PHN has not been clearly determined. This study investigated the efficacy of selective nerve root block (SNRB) for herpes zoster (HZ) on the long-term outcome of PHN. Methods: We prospectively conducted an interview of patients who had undergone an SNRB for HZ from January 2006 to December 2016 to evaluate their long-term PHN status. The relationship between the time from HZ onset to the first SNRB and the long-term outcome of PHN was investigated. Results: The data of 67 patients were collected. The patients were allocated to acute ($SNRB{\leq}14days$, n = 16) or subacute (SNRB > 14 days, n = 51) groups. The proportions of cured patients were 62.5% and 25.5% in the acute and subacute groups (P = 0.007), respectively. In logistic regression, an SNRB >14 days was the significant predictor of PHN (adjusted odd ratio, 3.89; 95% confidence interval, 1.02-14.93; P = 0.047). Kaplan-Meier analysis revealed that time from the SNRB to the cure of PHN was significantly shorter in the acute group ($2.4{\pm}0.7yr$) than in the subacute group ($5.0{\pm}0.4yr$; P = 0.003). Conclusions: An early SNRB during the acute stage of HZ (within 14 days) appears to decrease the incidence and shorten the duration of PHN, with a median of 5.0 years of follow-up.

Modified TRISS: A More Accurate Predictor of In-hospital Mortality of Patients with Blunt Head and Neck Trauma (Modified TRISS: 둔상에 의한 두경부 외상 환자에서 개선된 병원 내 사망률 예측 방법)

  • Kim, Dong Hoon;Park, In Sung
    • Journal of Trauma and Injury
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    • v.18 no.2
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    • pp.141-147
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    • 2005
  • Purpose: Recently, The new Injury Severity Score (NISS) has become a more accurate predictor of mortality than the traditional Injury Severity Score (ISS) in the trauma population. Trauma Score Injury Severity Score (TRISS) method, regarded as the gold standard for mortality prediction in trauma patients, still contains the ISS as an essential factor within its formula. The purpose of this study was to determine whether a simple modification of the TRISS by replacing the ISS with the NISS would improve the prediction of in-hospital mortality in a trauma population with blunt head and neck trauma. Objects and Methods: The study population consisted of 641 patients from a regional emergency medical center in Kyoungsangnam-do. Demographic data, clinical information, the final diagnosis, and the outcome for each patient were collected in a retrospective manner. the ISS, NISS, TRISS, and modified TRISS were calculated for each patients. The discrimination and the calibration of the ISS, NISS, modified TRISS and conventional TRISS models were compared using receiver operator characteristic (ROC) curves, areas under the ROC curve (AUC) and Hosmer-Lemeshow statistics. Results: The AUC of the ISS, NISS, modified TRISS, and conventional TRISS were 0.885, 0.941, 0.971, and 0.918 respectively. Statistical differences were found between the ISS and the NISS (p=0.008) and between the modified TRISS and the conventional TRISS (p=0.009). Hosmer-Lemeshow chi square values were 13.2, 2.3, 50.1, and 13.8, respectively; only the conventional TRISS failed to achieve the level of and an excellent calibration model (p<0.001). Conclusion: The modified TRISS is a more accurate predictor of in-hospital mortality than the conventional TRISS in a trauma population of blunt head and neck trauma.

Impact of Early Enteral Nutrition on In-Hospital Mortality in Patients with Hypertensive Intracerebral Hemorrhage

  • Lee, Jeong-Shik;Jwa, Cheol-Su;Yi, Hyeong-Joong;Chun, Hyoung-Joon
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.99-104
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    • 2010
  • Objective : We conducted this study to evaluate the clinical impact of early enteral nutrition (EN) on in-hospital mortality and outcome in patients with critical hypertensive intracerebral hemorrhage (ICH). Methods : We retrospectively analyzed 123 ICH patients with Glasgow Coma Scale (GCS) score of 3-12. We divided the subjects into two groups : early EN group (< 48 hours, n = 89) and delayed EN group ($\geq$ 48 hours, n = 34). Body weight, total intake and output, serum albumin, Creactive protein, infectious complications, morbidity at discharge and in-hospital mortality were compared with statistical analysis. Results : The incidence of nosocomial pneumonia and length of intensive care unit stay were significantly lower in the early EN group than in the delayed EN group (p < 0.05). In-hospital mortality was less in the early EN group than in the delayed EN group (10.1% vs. 35.3%, respectively; p = 0.001). By multivariate analysis, early EN [odds ratio (OR) 0.229, 95% CI : 0.066-0.793], nosocomial pneumonia (OR = 5.381, 95% CI : 1.621-17.865) and initial GCS score (OR = 1.482 95% CI : 1.160-1.893) were independent predictors of in-hospital mortality in patients with critical hypertensive ICH. Conclusion : These findings indicate that early EN is an important predictor of outcome in patients with critical hypertensive ICH.

Optimization of Predictors of Ewing Sarcoma Cause-specific Survival: A Population Study

  • Cheung, Min Rex
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.10
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    • pp.4143-4145
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    • 2014
  • Background: This study used receiver operating characteristic curve to analyze Surveillance, Epidemiology and End Results (SEER) Ewing sarcoma (ES) outcome data. The aim of this study was to identify and optimize ES-specific survival prediction models and sources of survival disparities. Materials and Methods: This study analyzed socio-economic, staging and treatment factors available in the SEER database for ES. 1844 patients diagnosed between 1973-2009 were used for this study. For the risk modeling, each factor was fitted by a Generalized Linear Model to predict the outcome (bone and joint specific death, yes/no). The area under the receiver operating characteristic curve (ROC) was computed. Similar strata were combined to construct the most parsimonious models. Results: The mean follow up time (S.D.) was 74.48 (89.66) months. 36% of the patients were female. The mean (S.D.) age was 18.7 (12) years. The SEER staging has the highest ROC (S.D.) area of 0.616 (0.032) among the factors tested. We simplified the 4-layered risk levels (local, regional, distant, un-staged) to a simpler non-metastatic (I and II) versus metastatic (III) versus un-staged model. The ROC area (S.D.) of the 3-tiered model was 0.612 (0.008). Several other biologic factors were also predictive of ES-specific survival, but not the socio-economic factors tested here. Conclusions: ROC analysis measured and optimized the performance of ES survival prediction models. Optimized models will provide a more efficient way to stratify patients for clinical trials.

Predictive Factors for Use of Complementary·Alternative Therapies in Rheumatoid Arthritis Patients (류마티스 관절염 환자의 보완대체요법 이용에 대한 예측 요인)

  • Lee, Eun-Nam;Son, Haeng-Mi
    • Korean Journal of Adult Nursing
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    • v.14 no.2
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    • pp.184-193
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    • 2002
  • Purpose: The purpose of this study was to assess the characteristics of the user of complementary alternative therapies(CAT) and to identify the important predictive factors associated with them. Method: This study included 142 patients attending outpatient rheumatology clinics of D Hospital in Busan between July and August in 2001. The multiple logistic regression model was developed to estimate the likelihood of user or nonuser of CAT. Result: The duration of illness and chance score of health locus of control were found to be significant factors through the estimated coefficients of using CAT. Duration of illness is longer and chance score of health locus of control is higher in patients who have used CAT in past than that of nonuser. When the model performance was evaluated by comparing the observed outcome with predicted outcome, the model correctly identified 95% of user of CAT and 31% of nonuser. Conclusion: In this survey, duration of illness and chance score of health locus of control are found to be significant factors in predicting utilization of CAT. Nurses who care for rheumatoid arthritis patients should take consideration into health locus of control in planning health education programs.

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What are the most important prognostic factors in patients with residual rectal cancer after preoperative chemoradiotherapy?

  • Kim, Sol-Min;Yoon, Ghilsuk;Seo, An Na
    • Journal of Yeungnam Medical Science
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    • v.36 no.2
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    • pp.124-135
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    • 2019
  • Background: We aimed to establish robust histoprognostic predictors on residual rectal cancer after preoperative chemoradiotherapy (CRT). Methods: Analyzing known histoprognostic factors in 146 patients with residual disease allows associations with patient outcome to be evaluated. Results: The median follow-up time was 77.8 months, during which 59 patients (40.4%) experienced recurrence and 41 (28.1%) died of rectal cancer. On univariate analysis, residual tumor size, ypT category, ypN category, ypTNM stage, downstage, tumor regression grade, lymphatic invasion, perineural invasion, venous invasion, and circumferential resection margin (CRM) were significantly associated with recurrence free survival (RFS) or/and cancer-specific survival (CSS) (all p<0.005). On multivariate analysis, higher ypTNM stage and CRM positivity were identified as independent prognostic factors for RFS (ypTNM stage, p=0.024; CRM positivity, p<0.001) and CSS (p=0.022, p=0.017, respectively). Furthermore, CRM positivity was an independent predictor of reduced RFS and CSS, irrespective of subgrouping according to downstage (non-downstage, p<0.001 and p<0.001; downstage, p=0.002 and p=0.002) or lymph node metastasis (non-metastasis, p<0.001 and p=0.001; metastasis, p<0.001 and p<0.001). Conclusion: CRM status may be as powerful as ypTNM stage as a prognostic indicator for patient outcome in patients with residual rectal cancer after preoperative CRT.