• Title/Summary/Keyword: Preventable death rates

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Validation of the International Classification of Diseases l0th Edition Based Injury Severity Score(ICISS) - Agreement of ICISS Survival Probability with Professional Judgment on Preventable Death - (외상환자 중증도 평가도구의 타당도 평가 - ICISS 사망확률과 전문가의 예방가능한 사망에 대한 판단간의 일치도 -)

  • Kim, Yoon;Ah, Hyeong-Sik;Lee, Young-Sung
    • Health Policy and Management
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    • v.11 no.1
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    • pp.1-18
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    • 2001
  • The purpose of the present study was to assess the agreement of survival probability estimated by International Classification of Diseases l0th Edition(ICD-10) based International Classification of Diseases based Injury Severity Score(ICISS) with professional panel's judgment on preventable death. ICISS has a promise as an alternative to Trauma and Injury Severity Score(TRISS) which have served as a standard measure of trauma severity, but requires more validation studies. Furthermore as original version of ICISS was based ICD-9CM, it is necessary to test its performance employing ICD-10 which has been used in Korea and is expected to replace ICD-9 in many countries sooner or later. Methods : For 1997 and 1998 131 trauma deaths and 1,785 blunt trauma inpatients from 6 emergency medical centers were randomly sampled and reviewed. Trauma deaths were reviewed by professional panels with hospital records and survival probability of trauma inpatients was assessed using ICD-10 based ICISS. For trauma mortality degree of agreement between ICISS survival probability with judgment of professional panel on preventable death was assessed and correlation between W-score and preventable death rate by each emergency medical center was assessed. Results : Overall agreement rate of ICISS survival probability with preventable death judged by professional panel was 66.4%(kappa statistic 0.36). Spearman's correlation coefficient between W-score and preventable death rate by each emergency medical center was -0.77(p=0.07) and Pearson's correlation coefficient between them was -0.90(p=0.01). Conclusions : The agreement rate of ICD-10 based ICISS survival probability with of professional panel's judgment on preventable death was similar to TRISS. The W-scores of emergency medical centers derived from ICD-10 based ICISS were highly correlated with preventable death rates of them with marginal statistical significance.

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Early Traumatic Deaths (외상 후 초기사망에 대한 고찰)

  • Paik, Seung-Won;Han, Chul;Hong, Yun-Sik;Choi, Sung-Hyuk;Lee, Sung-Woo;Moon, Sung-Woo;Yoon, Young-Hoon;Yu, Woo-Sung;Kim, Duk-Hwan
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.75-82
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    • 2010
  • Purpose: In Korea, trauma is the $3^{rd}$ most common cause of death. The trauma treatment system is divided into pre-hospital and hospital stages. Deaths occurring in the pre-hospital stage are 50% of the total death, and 20% of those are deaths that are preventable. Therefore, the purpose of our study is to calculate the preventable death rates caused by trauma in our current pre-hospital system, to analyze the appropriateness of the treatment of traumatized patients and to draw a conclusions about the problems we have. Methods: The study was done on traumatized patients who expired at the emergency department from January 1, 2005, to December 31, 2009, at the Korea University Medical Centers in Anam, Guro and Ansan. The data on the patients were reviewed retrospectively based on characteristics, conditions on admission and trauma severity. The patient's RTS (revised trauma score) and ISS (injury severity score) was calculated. Preventable death rate was calculated by TRISS (the trauma score-injury severity score). Results: A total of 168 patients were enrolled. All patients were intubated and underwent CPR. Of the total, 72% patients were male, and traffic accidents were the most common form of trauma (52.4%), falls being second (28.6%). Head injury, solitary or multiple, was the most common cause of death (55.4%). Thirty-eight (38, 22.6%) deaths were preventable. The 22.6% preventable death rate consisted of 15.5% potentially preventable and 7.1% definitely preventable deaths. Based on a logistic regression analysis, the relationship between the time intervals until transfusion and imaging and death was statistically significant in the hospital stage. In the pre-hospital stage, transit time from the site of the injury to the hospital showed a significant relationship with the mortality rate. Conclusion: One hundred sixty-eight (168) patients died of trauma at the 3 hospitals of Korea University Medical Center. The TRISS method was used to calculate the preventable death rate, with a result of 22.6%. The only factor that was significant related to the preventable death rate in the pre-hospital stage was the time from injury to hospital arrival, and the time intervals until transfusion and imaging were the two factors that showed significance in the hospital stage. Shortening the time of treatment in the field and transferring the patient to the hospital as quickly as possible is the most important life-saving step in the pre-hospital stage. In the hospital stage, the primary survey, resuscitation and diagnosis should proceed simultaneously.

Evaluation of Probability of Survival Using Trauma and Injury Severity Score Method in Severe Neurotrauma Patients

  • Moon, Jung-Ho;Seo, Bo-Ra;Jang, Jae-Won;Lee, Jung-Kil;Moon, Hyung-Sik
    • Journal of Korean Neurosurgical Society
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    • v.54 no.1
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    • pp.42-46
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    • 2013
  • Objective : Despite several limitations, the Trauma Injury Severity Score (TRISS) is normally used to evaluate trauma systems. The aim of this study was to evaluate the preventable trauma death rate using the TRISS method in severe trauma patients with traumatic brain injury using our emergency department data. Methods : The use of the TRISS formula has been suggested to consider definitively preventable death (DP); the deaths occurred with a probability of survival (Ps) higher than 0.50 and possible preventable death (PP); the deaths occurred with a Ps between 0.50 and 0.25. Deaths in patients with a calculated Ps of less than 0.25 is considered as non-preventable death (NP). A retrospective case review of deaths attributed to mechanical trauma occurring between January 1, 2011 and December 31, 2011 was conducted. Results : A total of 565 consecutive severe trauma patients with ISS>15 or Revised Trauma Score<7 were admitted in our institute. We excluded a total of 24 patients from our analysis : 22 patients younger than 15 years, and 2 patients with burned injury. Of these, 221 patients with head injury were analyzed in the final study. One hundred eighty-two patients were in DP, 13 in PP and 24 in NP. The calculated predicted mortality rates were 11.13%, 59.04%, and 90.09%. The actual mortality rates were 12.64%, 61.547%, and 91.67%, respectively. Conclusion : Although it needs to make some improvements, the present study showed that TRISS performed well in predicting survival of traumatic brain injured patients. Also, TRISS is relatively exact and acceptable compared with actual data, as a simple and time-saving method.

Dokha: An Emerging Public Health Issue as a Form of Tobacco Smoking in the Middle East

  • John, Lisha Jenny;Muttappallymyalil, Jayakumary
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.12
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    • pp.7065-7067
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    • 2013
  • Background: Tobacco use is one of the leading causes of preventable death across the world today and the smoking rates among men in the Arab world are amongst the highest in the world. Smoking of dokha, a traditional Arab tobacco is common in some of the Middle East countries such as the United Arab Emirates and Iran. This review focuses on the prevalence, pattern and health effects of dokha use in the Middle East. For this purpose an electronic search was performed in the following databases and websites: MEDLINE, EMBASE, Proquest and Google scholar up to December 2012. The search strategy was based on Internet search for the synonyms of dohka or midwakh. From the results of the review it emerged that younger people are the most common users of dokha. Hence effective outreach health education programs, targeting adolescents, especially school students before they take up the habit of smoking, may thus curb the emergence of the problem.

Causes of Child Mortality (1 to 4 Years of Age) From 1983 to 2012 in the Republic of Korea: National Vital Data

  • Choe, Seung Ah;Cho, Sung-Il
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.6
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    • pp.336-342
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    • 2014
  • Objectives: Child mortality remains a critical problem even in developed countries due to low fertility. To plan effective interventions, investigation into the trends and causes of child mortality is necessary. Therefore, we analyzed these trends and causes of child deaths over the last 30 years in Korea. Methods: Causes of death data were obtained from a nationwide vital registration managed by the Korean Statistical Information Service. The mortality rate among all children aged between one and four years and the causes of deaths were reviewed. Data from 1983-2012 and 1993-2012 were analyzed separately because the proportion of unspecified causes of death during 1983-1992 varied substantially from that during 1993-2012. Results: The child (1-4 years) mortality rates substantially decreased during the past three decades. The trend analysis revealed that all the five major causes of death (infectious, neoplastic, neurologic, congenital, and external origins) have decreased significantly. However, the sex ratio of child mortality (boys to girls) slightly increased during the last 30 years. External causes of death remain the most frequent origin of child mortality, and the proportion of mortality due to child assault has significantly increased (from 1.02 in 1983 to 1.38 in 2012). Conclusions: In Korea, the major causes and rate of child mortality have changed and the sex ratio of child mortality has slightly increased since the early 1980s. Child mortality, especially due to preventable causes, requires public health intervention.

Some Epidemiological Measures of Cancer in Kuwait: National Cancer Registry Data from 2000-2009

  • El-Basmy, A.;Al-Mohannadi, S.;Al-Awadi, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.7
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    • pp.3113-3118
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    • 2012
  • Introduction: Cancer is the second cause of death in Kuwaiti people after cardiovascular diseases. This study is the first in the country to describe epidemiological measures related to cancer in this population. Methods: Data obtained from the Kuwait cancer registry included all Kuwaiti patients between years 2000-2009. Analyses were conducted using age-specific rates, the age-standardization-direct method, 95% confidence intervals (95% CI), cumulative risk by the age of 74 years, limited-duration prevalence, mortality and forecasting to year 2029. Results: It was noted that the commonest cancer sites were colorectal with an age standardized incidence rate (ASIR) of 16.1/100,000 in males and breast (49.4/100,000) in the female population. The trend of cancer incidence (1974-2009) showed no statistically significant change. First causes of death due to cancer were female breast 8(6.4-9.6)/100,000 and lung (males) 8.1/100,000 (6.6-10.0). The risk of developing cancer by the age of 74 was 13.4% (1/8) and 14.3% (1/7) in males and females respectively, and the risk of dying from cancer in the same age group was 1/17 and 1/23. By the end of 2009, prevalent cases represented 0.52% of the Kuwaiti population. In the year 2029, the total number of cancer cases is expected to reach 1200 cases compared to 889 cases in 2009. Conclusions and recommendations: The most common cancers in Kuwait (breast, colorectal and lung) are largely preventable. Prompt and effective interventional prevention programs that vigorously involve diet, anti-smoking and physical activity for both sexes are urgently required.

Evaluation of Delhi Population Based Cancer Registry and Trends of Tobacco Related Cancers

  • Yadav, Rajesh;Garg, Renu;Manoharan, N;Swasticharan, L;Julka, PK;Rath, GK
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.6
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    • pp.2841-2846
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    • 2016
  • Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

The Influence of How the Trauma Care System Is Applied at the Trauma Center: The Initial Experience at Single Trauma Center (외상 센터에서의 외상 진료 시스템 도입에 따른 변화: 단일 외상 센터에서의 초기 경험)

  • Kim, Hyung Won;Hong, Tae Hwa;Lee, Seung Hwan;Jung, Myung Jae;Lee, Jae Gil
    • Journal of Trauma and Injury
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    • v.28 no.4
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    • pp.241-247
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    • 2015
  • Purpose: To evaluate the influence of how the trauma care system is applied on the management of trauma patients. Methods: We divided the patients into a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in our institution. We compared the general characteristics, injury severity score, initial response time to the trauma patients, number of preventable deaths, and clinical outcomes between the two groups. Results: The numbers of patients in the pre-trauma system group and the post-trauma system group were 188 and 257, respectively. No differences in the patient's median ages, trauma scores (ISS, RTS, TRISS) and proportions of severe trauma patients (ISS>15) were observed between the two groups. The number and the proportion of patients who were admitted to our hospital were increased in the post-trauma system group. The time interval from trauma CP activation to emergency surgery or angio-embolization, and the patient's time spent in emergency room were shortened in the post-trauma system group. However, the lengths of the ICU stay and the hospital stay, and the number of in-hospital mortalities were not improved in the post-trauma system group. In severe trauma patients (ISS>15), there were no differences between the two groups in the number and the proportion of admitted patients, and the time interval from trauma CP activation to performing a diagnostic and therapeutic procedure was not shortened in the post-trauma system group. Conclusion: Application of the trauma care system has shortened the time between the initial response and patient management. However, this improvement was not enough to result in better clinical outcomes. More trauma physicians, multidisciplinary cooperation, and a well-organized trauma management process will be needed if the maximum efficacy of the trauma system is to be achieved.

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Human Papilloma Virus Detection by INNOLiPA HPV in Prostate Tissue from Men of Northeast Mexico

  • Rodriguez, Martha I Davila;Morales, Cesar V Ignacio;Tovar, Anel R Aragon;Jimenez, Delia Olache;Maldonado, Edmundo Castelan;Miranda, Sandra Lara;Gutierrez, Elva I Cortes
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4863-4865
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    • 2016
  • Background: Prostatic adenocarcinoma by Prosate cancer (PCa) is the most prevalent cancer and the second cause of cancer-related death among men in the Western world. Human papilloma virus (HPV) may be considered as a preventable risk factor. In this study, we assessed the frequencies of HPV infection in prostatic adenocarcinoma and benign prostatic hyperplasia (BPH) cases in Northeast Mexico. Materials and Methods: A total of 87 paraffin-embedded blocks (from 25 and 62 patients with definite diagnoses of BPH and adenocarcinoma, respectively) were selected and subjected to INNOLiPA HPV Genotyping to detect 28 high- and low-risk HPV types. The rates of infection were compared in the two studied groups. Results: INNOLiPA HPV demonstrated great sensitivity for HPV detection on paraffin-embedded tissue. Global prevalence was 14.9% (13/87). HPV infection was positive in 19.4% (12/62) of patients with adenocarcinoma and 4.0% (1/25) of patients with BPH. HPV-11, which is considered to be low risk, was more prevalent. Interestingly, one patient with BPH and six with prostate cancer showed examples considered to be high risk (HPV-18, -51, -52, and -66). Conclusion: A higher rate of HPV infection among Mexican patients with prostatic carcinoma than among those with BPH was observed. HPV infections may thus contribute to the risk of prostate cancer. Further studies are required to elucidate any roles of HPV infection in prostate disease in Mexico and the effect of prevention and treatment of HPV infection on prostatic adenocarcinoma.

Novel Algorithms for Early Cancer Diagnosis Using Transfer Learning with MobileNetV2 in Thermal Images

  • Swapna Davies;Jaison Jacob
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • v.18 no.3
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    • pp.570-590
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    • 2024
  • Breast cancer ranks among the most prevalent forms of malignancy and foremost cause of death by cancer worldwide. It is not preventable. Early and precise detection is the only remedy for lowering the rate of mortality and improving the probability of survival for victims. In contrast to present procedures, thermography aids in the early diagnosis of cancer and thereby saves lives. But the accuracy experiences detrimental impact by low sensitivity for small and deep tumours and the subjectivity by physicians in interpreting the images. Employing deep learning approaches for cancer detection can enhance the efficacy. This study explored the utilization of thermography in early identification of breast cancer with the use of a publicly released dataset known as the DMR-IR dataset. For this purpose, we employed a novel approach that entails the utilization of a pre-trained MobileNetV2 model and fine tuning it through transfer learning techniques. We created three models using MobileNetV2: one was a baseline transfer learning model with weights trained from ImageNet dataset, the second was a fine-tuned model with an adaptive learning rate, and the third utilized early stopping with callbacks during fine-tuning. The results showed that the proposed methods achieved average accuracy rates of 85.15%, 95.19%, and 98.69%, respectively, with various performance indicators such as precision, sensitivity and specificity also being investigated.