• Title/Summary/Keyword: Severity scoring systems

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A study on the Severity Scoring Systems of Atopic Dermatitis ; Comparision, Analysis and Establishment (아토피 피부염의 평가방법에 대한 연구 : 비교 분석 및 설립)

  • 윤화정;윤정원;윤소원;고우신
    • The Journal of Korean Medicine
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    • v.23 no.4
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    • pp.15-26
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    • 2002
  • There is much confusion in the field of atopic dermatitis (AD) regarding how to best measuredisease severity objectively. Therefore, we aimed to establish a new adequate scoring system for AD, that should be based on comparisonand analysis of various scoring systems. We report as follows. Methods: We searched for data relating to severity scoring systems for atopic dermatitis in Entrez PubMed From 1990 to 2001 Results and Conclusions: 1. Properties of severity scoring systems were validity, reliability, sensitivity of change and ease of use. 2. The essential items of severity scoring systems were extent. intensity and subjective symptoms. 3. The surface extent of the lesion was evaluated by the percentage of involvement of each of 10 areas. 4. The criteria of severity were divided into intensity and subjective symptoms. Intensity items are erythema, papulation, lichenification, oozing, dryness, excoriations, and pigmentation. The subjective symptom is pruritus, evaluated according to sleep loss. 5. The significant items of severity scoring system were symptomsrather than areas. As it were, we assumed extent accounted for around 30% of each total score, with intensity and subjective symptoms representing 70%.

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Proposal on the Severity Scoring System of Rhinitis ; Comparison, Analysis and Establishment (비염의 평가 방법에 대한 제언 ; 비교 분석 및 설립)

  • Hwang Sun-Yi;Hwang Min-Bo;Lim Jin-Ho;Jee Seon-Young;Kim Sang-Chan;Baek Jung-Han;Lee Sang-Gon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.1
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    • pp.235-244
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    • 2006
  • There is much confusion in the field of Rhinitis regarding how to best measure disease severity objectively, Therefore, we aimed to establish a new adequate scoring system for Rhinitis, that should be based on comparison analysis of various scoring systems. We report as follows. We researched for data relating to severity scoring systems for rhinitis in Entrez PubMed from 1995 to 2005 and in Kiss Kstudy. Results and Conclusions: Properties of severity scoring systems were validity, sensitivity of change and ease of use. The essential items of severity scoring systems were subjective symptoms. The criterion of severity were divided into subjective symptoms and complication and Quality of Life. Intensity items are nasal obstruction, rhinorrhea, sneezing, itching, Postnasal drip, nasal mucosa swelling, nasal mucosa color, complication. Subjective symptoms is difficulty of Life. The significant items of severity scoring system are nasal symptoms. The whole score does with the maximum 30 scores. As it were, we assumed nasal symptoms accounted for around 80% of each total score, with complication and difficulty of Life representing 20%.

Validation of chest trauma scoring systems in polytrauma: a retrospective study with 1,038 patients in Korea

  • Hongrye Kim;Mou Seop Lee;Su Young Yoon;Jonghee Han;Jin Young Lee;Junepill Seok
    • Journal of Trauma and Injury
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    • v.37 no.2
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    • pp.114-123
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    • 2024
  • Purpose: Appropriate scoring systems can help classify and treat polytrauma patients. This study aimed to validate chest trauma scoring systems in polytrauma patients. Methods: Data from 1,038 polytrauma patients were analyzed. The primary outcomes were one or more complications: pneumonia, chest complications requiring surgery, and mortality. The Thoracic Trauma Severity Score (TTSS), Chest Trauma Score, Rib Fracture Score, and RibScore were compared using receiver operating characteristic (ROC) analysis in patients with or without head trauma. Results: In total, 1,038 patients were divided into two groups: those with complications (822 patients, 79.2%) and those with no complications (216 patients, 20.8%). Sex and body mass index did not significantly differ between the groups. However, age was higher in the complications group (64.1±17.5 years vs. 54.9±17.6 years, P<0.001). The proportion of head trauma patients was higher (58.3% vs. 24.6%, P<0.001) and the Glasgow Coma Scale score was worse (median [interquartile range], 12 [6.5-15] vs. 15 [14-15]; P<0.001) in the complications group. The number of rib fractures, the degree of rib fracture displacement, and the severity of pulmonary contusions were also higher in the complications group. In the area under the ROC curve analysis, the TTSS showed the highest predictive value for the entire group (0.731), head trauma group (0.715), and no head trauma group (0.730), while RibScore had the poorest performance (0.643, 0.622, and 0.622, respectively) Conclusions: Early injury severity detection and grading are crucial for patients with blunt chest trauma. The chest trauma scoring systems introduced to date, including the TTSS, are not acceptable for clinical use, especially in polytrauma patients with traumatic brain injury. Therefore, further revisions and analyses of chest trauma scoring systems are recommended.

Clinical Study on the Effects of Auricular Acupuncture Treatment in Allergic Rhinitis Patients (알레르기 비염환자에 대한 이침 치료 증례보고)

  • HwangBo, Min;Jeong, Min-Jeong;Lim, Jung-Hwa;Yang, Gi-Young;Seo, Hyung-Sik
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.23 no.3
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    • pp.216-224
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    • 2010
  • Objective : The purpose of this study was investigated the effect of auricular Acupuncture treatment in Allergic rhinitis patients. Methods : This study was carried out on the 16 allergic rhinitis patients who had been treated at Cheongdogun public health center for The Good-Breath program. The Good-Breath program included auricular acupuncture was performed 2 times a week during 4 weeks. Auricular acupuncture points used were M101(肺), M13(副腎), M16(內鼻), M22(內分泌), M33(額), M55(神門). Patients nasal symptoms and QOL were assessed before and after 4 weeks treatment by the Severity Scoring Systems of Rhinitis(SSSR) and Quality of Life Questionnaire for Korean Rhinitisian(QLQKR). Results : 1. Total Severity Scoring Systems of Rhinitis(SSSR) Scores were significantly improved. but Each items was no significant difference. 2. Among items of QLQKR, Itching worry about western medicine worry about change of environment Role limitation-physical were significantly improved. and Total Quality of Life Questionnaire for Korean Rhinitisian(QLQKR) Scores were significantly improved.

Clinical Investigation of Isolated Chest Injury (흉부 단독손상 환자의 임상적 고찰)

  • Lee, Keung Moo;Kim, Dong Soo;Lee, Suk Woo;Kim, Hoon
    • Journal of Trauma and Injury
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    • v.19 no.1
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    • pp.35-40
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    • 2006
  • Purpose: Injuries are the third leading cause of death in Korea. Isolated chest injury is not uncommon and shows high mortality and morbidity. Several scoring systems are used for triage and stratification for trauma patients, but no standard system is accepted. We aimed to analyze the accuracy of identification of isolated chest injury by using several scoring systems. Methods: We reviewed a total of 75 patients admitted with isolated chest injury between January 2005 and October 2005. Medical records were reviewed by using the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma and Injury Severity Score (TRISS). The scoring systems were compared by using statistics methods. Results: The overall predictive accuracy of the TRISS was 12.5%, 12.0% greater than those of the RTS and the ISS. By using the area under the receiver operating characteristic (AUROC) curve, the TRISS showed an excellent discriminative power (AUROC 0.931) compared to the ISS (AUROC 0.926) and the RTS (AUROC 0.872). Conclusion: Compared with the RTS and the ISS, the TRISS is an easily applied tool with excellent prognostic abilities for isolated chest trauma patients. However, the TRISS, the ISS, and the RTS showed high specificity and low sensitivity, so another scoring system is required for triage and stratification of isolated chest injury patients.

Application of Poisoning aBIG score for Prediction of Fatal Severity in Acute Adult Intoxications (성인 중증 중독환자 예측을 위한 새로운 지표 개발: aBIG score for poisoning)

  • Choe, Michael Sung Pil;Ahn, Jae Yun;Kang, In Gu;Lee, Mi Jin
    • Journal of The Korean Society of Clinical Toxicology
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    • v.12 no.1
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    • pp.14-21
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    • 2014
  • Purpose: The objective of this study was to develop a new scoring tool that is comprehensively applicable and predicts fatality within 24 h of intoxication. Methods: This was a cohort study conducted in two emergency medical centers from 2011 to 2012. We identified factors associated with severe/fatality. Through a discriminant analysis, we devised the aBIG (age, Base deficit, Infection, and Glasgow coma scale) score. To compare the ability of aBIG to predict intoxication severity with that of previous scoring systems such as APACHE II, MODS, SAPS IIe, and SOFA, we determined the receiver operating characteristic curves of each variable in predicting severe-to-fatal toxicity. Results: Compared with the mild/moderate toxicity group (n=211), the severe/fatal group (n=143) had higher incidences of metabolic acidosis, infection, serious mental change, QTc prolongation and hepato-renal failure. Age, base deficit, infection-WBC count, and Glasgow Coma Scale were independently associated with severe/fatal poisoning. These variables were combined into the poisoning "aBIG" score [$0.28{\times}$Age group+$0.38{\times}WBC$ count/$10^3+0.52{\times}$Base deficit+$0.64{\times}$(15-GCS)], which were each calculated to have an area under the curve of 0.904 (95% confidence interval: 0.868-0.933). The aBIG poisoning score had an equivalent level of severity predictability as APACHE II and a superior than MODS, SOFA, and SAPS IIe. Conclusion: We developed a simplified scoring system using the four variables of age, base deficit, infected leukocytosis, and GCS. The poisoning aBIG score was a simple method that could be performed rapidly on admission to evaluate severity of illness and predict fatal severity in patients with acute intoxications.

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Performance of APACHE IV in Medical Intensive Care Unit Patients: Comparisons with APACHE II, SAPS 3, and MPM0 III

  • Ko, Mihye;Shim, Miyoung;Lee, Sang-Min;Kim, Yujin;Yoon, Soyoung
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.216-221
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    • 2018
  • Background: In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model $(MPM)_0$ III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients. Methods: The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and $MPM_0$ III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis. Results: For the APACHE IV, SAPS 3, $MPM_0$ III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for $MPM_0$ III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and $MPM_0$ III (chi-square, 11.128; P=0.133). Conclusions: APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

Systemic Inflammation Response Syndrome Score Predicts the Mortality in Multiple Trauma Patients

  • Baek, Jong Hyun;Kim, Myeong Su;Lee, Jung Cheul;Lee, Jang Hoon
    • Journal of Chest Surgery
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    • v.47 no.6
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    • pp.523-528
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    • 2014
  • Background: Numerous statistical models have been developed to accurately predict outcomes in multiple trauma patients. However, such trauma scoring systems reflect the patient's physiological condition, which can only be determined to a limited extent, and are difficult to use when performing a rapid initial assessment. We studied the predictive ability of the systemic inflammatory response syndrome (SIRS) score compared to other scoring systems. Methods: We retrospectively reviewed 229 patients with multiple trauma combined with chest injury from January 2006 to June 2011. A SIRS score was calculated for patients based on their presentation to the emergency room. The patients were divided into two groups: those with an SIRS score of two points or above and those with an SIRS score of one or zero. Then, the outcomes between the two groups were compared. Furthermore, the ability of the SIRS score and other injury severity scoring systems to predict mortality was compared. Results: Hospital death occurred in 12 patients (5.2%). There were no significant differences in the general characteristics of patients, but the trauma severity scores were significantly different between the two groups. The SIRS scores, number of complications, and mortality rate were significantly higher in those with a SIRS score of two or above (p<0.001). In the multivariant analysis, the SIRS score was the only independent factor related to mortality. Conclusion: The SIRS score is easily calculated on admission and may accurately predict mortality in patients with multiple traumas.

Comparative Analysis of the Accuracy of Severity Scoring Systems for the Prediction of Healthcare Outcomes of Intensive Care Unit Patients (중환자실 환자의 건강결과 예측을 위한 중증도 평가도구의 정확도 비교분석)

  • Seong, Ji-Suk;So, HeeYoung
    • Journal of Korean Critical Care Nursing
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    • v.8 no.1
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    • pp.71-79
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    • 2015
  • Purpose: The purpose of this study was to compare the applicability of the Charlson Comorbidity Index (CCI) and Acute Physiology, Age, Chronic Health Evaluation III (APACHE III) to the prediction of the healthcare outcomes of intensive care unit (ICU) patients. Methods: This research was performed with 136 adult patients (age>18 years) who were admitted to the ICU between May and June 2012. Data were measured using the CCI score with a comorbidity index of 19 and the APACHE III score on the standard of the worst result with vital signs and laboratory results. Discrimination was evaluated using receiver operating characteristic (ROC) curves and area under an ROC curve (AUC). Calibration was performed using logistic regression. Results: The overall mortality was 25.7%. The mean CCI and APACHE III scores for survivors were found to be significantly lower than those of non-survivors. The AUC was 0.835 for the APACHE III score and remained high, at 0.688, for the CCI score. The rate of concordance according to the CCI and the APACHE III score was 69.1%. Conclusion: The route of admission, days in ICU, CCI, and APACHE III score are associated with an increased mortality risk in ICU patients.

A study on Quantitative measure for Simulator Sickness in Driving Simulator (Driving Simulator에서 Simulator Sickness의 정량적 측정에 관한 연구)

  • 김도회;박민용;이근희
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.21 no.48
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    • pp.165-175
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    • 1998
  • The purpose of this study is to propose and to apply new Revised Simulator Sickness Questionnaire(RSSQ) that is effective quantification tool by revising and complementing SSQ because Simulator Sickness Questionnaire(SSQ), which is being used generally to quantify Simulator Sickness has several problems. For this study, we reduced 31 symptoms that are related to Simulator Sickness to 22 symptoms and derived weighting for each other from 15 experts. We developed new RSSQ with 22 symptoms and implemented factor analysis by using 142 RSSQ which is questioned before and after getting on simulator. It was classified to four major symptom groups as the result of the factor analysis. They are Disorientation, Oculomotor, Nausea, and Confuse. The scoring system of RSSQ provides subscales score of Disorientation, Oculomotor, Nausea, and Confuse as well as total severity. The scoring system of RSSQ which is proposed by this study is expected to improve accuracy of measure compared with an existing scoring system of SSQ, and to contribute with understanding the effect of Simulator Sickness more adequately and clearly.

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