• Title/Summary/Keyword: The length of hospital days

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Thoracoscopic Pneumonectomy (흉강경을 이용한 전폐절제술)

  • 성숙환
    • Journal of Chest Surgery
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    • v.27 no.9
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    • pp.808-811
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    • 1994
  • We reported a successful right pneumonectomy using video assisted thoracoscopy for endobronchial tuberculosis. Thoracoscopic surgery has many advantages in spite of its technical difficulties. These advantages include good cosmetic effects, short hospital stay, decreased postoperative morbidity, and good postoperative pulmonary function.The patient was young unmarried female, and her right lung was nearly total obstructed by endobronchial tuberculous dissemination and secondary pulmonary infection. The procedure was a little complicated by inadequate placements of the thoracoscopic ports and 5cm length utility thoracotomy incision. Minimal pain killer was needed only two days after operation and scar of operative wound was very satisfying. Postoperative course was unusual and the patient was discharged 7 days after operation.

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The Deep Inferior Epigastric Perforator and Pedicled Transverse Rectus Abdominis Myocutaneous Flap in Breast Reconstruction: A Comparative Study

  • Tan, Shane;Lim, Jane;Yek, Jacklyn;Ong, Wei Chen;Hing, Chor Hoong;Lim, Thiam Chye
    • Archives of Plastic Surgery
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    • v.40 no.3
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    • pp.187-191
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    • 2013
  • Background Our objective was to compare the complication rates of two common breast reconstruction techniques performed at our hospital and the cost-effectiveness for each test group. Methods All patients who underwent deep inferior epigastric perforator (DIEP) flap and transverse rectus abdominis myocutaneous (TRAM) flap by the same surgeon were selected and matched according to age and mastectomy with or without axillary clearance. Patients from each resultant group were selected, with the patients matched chronologically. The remainder were matched for by co-morbidities. Sixteen patients who underwent immediate breast reconstruction with pedicled TRAM flaps and 16 patients with DIEP flaps from 1999 to 2006 were accrued. The average total hospitalisation cost, length of hospitalisation, and complications in the 2 year duration after surgery for each group were compared. Results Complications arising from both the pedicled TRAM flaps and DIEP flaps included fat necrosis (TRAM, 3/16; DIEP, 4/16) and other minor complications (TRAM, 3/16; DIEP, 1/16). The mean hospital stay was 7.13 days (range, 4 to 12 days) for the pedicled TRAM group and 7.56 (range, 5 to 10 days) for the DIEP group. Neither the difference in complication rates nor in hospital stay duration were statistically significant. The total hospitalisation cost for the DIEP group was significantly higher than that of the pedicled TRAM group (P<0.001). Conclusions Based on our study, the pedicled TRAM flap remains a cost-effective technique in breast reconstruction when compared to the newer, more expensive and tedious DIEP flap.

The Characteristics of Firefighter Burn Injuries in a Burn Center: A Retrospective Epidemiological Study (소방관 화상 환자의 화상수상특징에 대한 1개 화상전문병원에서의 예비조사)

  • Kim, Hyeongtae;Kang, Gu Hyun;Jang, Yong Soo;Kim, Wonhee;Choi, Hyun Young;Kim, Jae Guk;Kim, Minji;You, Ki Cheol;Kim, Dohern;Yim, Haejun;Bang, Sung Hwan;Lee, Chang Sub
    • Journal of the Korean Burn Society
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    • v.19 no.1
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    • pp.12-15
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    • 2016
  • Purpose: Firefighters are vulnerable to burn injury during firefighting. In extensive fires, conducted heat and radiant heat can cause burn injury even though firefighters are not directly exposed to fire. There has been increasing interest in the health problems of firefighters considerably since Hongje-dong fire of 2001, which claimed the lives of six fireman. However, there have been no studies done on the characteristics of firefighter burn injuries in South Korea. Therefore, we investigated the characteristics of firefighter burn injuries in a burn center. Methods: A retrospective, single-center research was performed between Jan 2006 to Dec 2015. 24 firefighters came to the burn center. The electronic medical records of patients were reviewed. Results: Flame burns (87.5%) were the major cause of burn in firefighter. All the patients suffered second-degree or third-degree burns. Mean burn size was 6.1±6.7%. 22 of 24 patients were hospitalized and 2 of 22 hospitalized patients admitted to intensive care unit. Mean length of hospitalization was 29.1±23.7 days and mean length of intensive care unit hospitalization was 6.0±1.4 days. The face was the site most commonly burned, representing 25.8% of injuries. The hand/wrist, upper extremity, and neck were the next largest groups, with 19.4, 12.9, 11.3% of the injuries, respectively. Conclusion: Firefighter burn injuries occur to predictable anatomic sites with common injury patterns. The burn size was small but, admitted patients need about 30 days of hospitalization.

Effects of Gum-chewing on the Recovery of Bowel Motility and Length of Hospital Stay after Surgery for Colorectal Cancer (껌씹기가 대장.직장암환자의 장 절제술 후 장운동 회복 및 재원일수에 미치는 효과)

  • Kim, Sam-Sook;Lee, Eun-Nam;Kim, Hack-Sun;Kim, Min-Kyoung;Lee, Kyoung-Sun;Nam, Hye-Jin;Kim, Mi-Young
    • Asian Oncology Nursing
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    • v.10 no.2
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    • pp.191-198
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    • 2010
  • Purpose: The purpose of this study was to examine the effects of a gum-chewing on the recovery of bowel motility and days of hospitalization after surgery for colorectal cancer. Methods: This study used a non-equivalent control group and non-synchronized design. Thirty-four patients undergoing abdominal surgery for colorectal cancer were assigned to either gum-chewing group (n=17) or control group (n=17). The patients in the gum-chewing group chewed gum for 10 min three times daily from the first postoperative morning until the day they began oral intake. Outcome variables were time of first flatus, time of first bowel movement, and length of hospital stay. Results: Gum-chewing was effective in enhancing the first passage of flatus, but was not effective in enhancing time of bowel movement and length of hospital stay. Conclusion: Gum-chewing can be utilized as a useful nursing intervention to shorten the time of the first flatus of postoperative colectomy.

병원에서 임종을 맞이한 호스피스 환자의 임상적 고찰

  • Mun, Do-Ho;Choe, Hwa-Suk
    • Korean Journal of Hospice Care
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    • v.3 no.2
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    • pp.55-60
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    • 2003
  • Purpose: The appropriate duration for effective hospice care is estimated about 3 months. However, the length of hospice care of many hospice patients is mostly less than 1 months. This is too short for effective hospice care. Therefore we investigated the reason by clinical considuations include the length of hospie care, duration from diagnosed as terminatlly ill to refer to hospice, the recogntion of hospice of doctors, patients and familis. Methods: This study was designed to retrospective cohot study. The data was obtaind from 50 hospice patients those who died in hospital from July to September in 2003. Results: Out of 50 patient, 30 were male(60%). The median age wes 60years in males and was 61 years in femailes. The most prevalant cancer was colorectal cancer(9 patients, 18%), followed by hepatoma(8 patients, 16%), and stomach cancer(7 patients, 14%). The most prevalent symptom was pain(37 patients 74%) and most prevalant reason of admission was also pain(30 patients, 60%). The most prevalent physician specialty was general internal medicine(21 doctors, 42%), followed by oncology(19 doctors, 38%). The median days form diagnosed terminally ill to refere to hospice was 47 days. The median lengths of hospice care was 23 days and the median admission days was 17. Conclusion: We found that lack of recognition of hospice of doctors, patients and families made the lengths of hospice care too short. If the patient and family go to hospice just after diagnosed as terminally ill, they could get more effective hospice care. To resolve these problems, it is needed education for them constantly.

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A Peripherally Inserted Central Catheter is a Safe and Reliable Alternative to Short-Term Central Venous Catheter for the Treatment of Trauma Patients

  • Ryu, Dong Yeon;Lee, Sang Bong;Kim, Gil Whan;Kim, Jae Hun
    • Journal of Trauma and Injury
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    • v.32 no.3
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    • pp.150-156
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    • 2019
  • Purpose: To determine whether a peripherally inserted central catheter (PICC) meets the goals of a low infection rate and long-term use in trauma patients. Methods: From January 2016 to June 2018, the medical records of patients who underwent central venous catheterization at a level I trauma center were retrospectively reviewed. Data collected included age, sex, injury severity score, site of catheterization, place of catheterization (intensive care unit [ICU], emergency department, or general ward), type of catheter, length of hospital stay during catheterization, types of cultured bacteria, time to development of central line-associated bloodstream infection (CLABSI), and complications. Results: During the study period, 333 central vein catheters (CVC) were inserted with a total of 2,626 catheter-days and 97 PICCs were placed with a total of 2,227 catheter-days. The CLABSI rate was significantly lower in the PICC group when the analysis was limited to patients for whom the catheter was changed for the first time in the ICU after CVC insertion in the ER with similar indication and catheter insertion times (18.6 vs. 10.3/1,000 catheter-days, respectively, p<0.05). The median duration of catheter use was significantly longer in the PICC group than in the CVC group (16 vs. 6 days, respectively, p<0.05). Conclusions: The study results showed that the duration of catheter use was longer and the infection rate were lower in the PICC group than in the CVC group, suggesting that PICC is a safe and reliable alternative to conventional CVC.

Functional Status and Health Care Utilization among Elders with Hip Fracture Surgery from a Fall (낙상후 대퇴골절 수술 노인의 신체기능, 의료이용 및 낙상의 두려움)

  • Oh, Hee-Young;Im, Young-Mi
    • Korean Journal of Adult Nursing
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    • v.15 no.3
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    • pp.432-440
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    • 2003
  • Purpose: The purposes of this study were to examine 1) functional status at 2 months after hip fracture surgery 2) health care utilization after a fall episode and 3) fear of falling experienced during first 2 months after a fall episode. Method: With a convenient sample of 99 elderly from six university or general hospitals with hip fracture from a fall, data were collected at 2-3 days before discharge and at 2 months after hip fracture surgery. Result: 1) At 2 months after hip fracture from a fall, significant proportion (25.3%) of elderly was not able to walk indoors. 2) Average length of hospital stay was 27.6 days with a range of 8 to 86 days. About 51% subjects received physical therapy during hospital stay, and only 6.1% subjects received physical therapy following discharge from the hospital. 3) Significant proportion (72.7%) had fear of falling after the fall episode. About 51% reported that they restricted their activities because they had fear of falling. Conclusion: Fall is a dreaded event which result in loss of independence and restriction of activity. Development and application of fall prevention program is critical especially for those with risk factors of fall.

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A Study on the POE by Residential Characteristics of Child inpatients in a Hospital - Focused on the Caregivers of Child Inpatients - (어린이 환자의 입원기간에 따른 어린이병원 POE 연구 - 어린이 환자의 보호자를 대상으로 -)

  • Ha, Ji-Min;Park, Soo-Been
    • Korean Institute of Interior Design Journal
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    • v.24 no.4
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    • pp.152-160
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    • 2015
  • This paper proposes high quality of healthcare environments for a user-oriented children's hospital by identifying the user needs according to residential characteristics of the child, especially the hospitalization period. Caregivers, mostly parents of children in a children's hospital, participated in a questionnaire survey. The user's demands, satisfaction and hospital environment assessment were measured. A total of 103 copies of the questionnaire were finally collected and analyzed. The data was processed statistically using SPSS WIN 18.0 Version software. The results and conclusions are as follows. 1)The participants were categorized into three groups according to the hospitalization period of the child (less than 7 days, 7-20 days, and more than 21 days). 2)When the patients stayed longer in the hospital, their satisfaction was lower and their demands were higher. The long-term group required a more spacious bathroom for the child inpatients and their caregivers as well as sufficient individual storage spaces that are appropriate for the length of stay. 3)The longer they were hospitalized, the more negative they evaluated the hospital environment. These results suggest that the period of hospitalization is one of the crucial factors that impact the user's satisfaction and demands. Therefore, it is necessary to identify the design factors such as territoriality, privacy, accessability, and aesthetics to improve the satisfaction of the long-term child inpatients and their caregivers.

Analysis of Treatment Response in Patients with Oral Lichen Planus

  • Ju, Hye-Min;Kim, Kyung-Hee;Jeon, Hye-Mi;Ahn, Yong-Woo;Ok, Soo-Min;Jeong, Sung-Hee
    • Journal of Oral Medicine and Pain
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    • v.46 no.2
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    • pp.41-48
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    • 2021
  • Purpose: To evaluate compliance by analyzing and comparing treatment duration, degree of improvement after treatment and treatment response of oral lichen planus (OLP) patients according to characteristics of them and the severity of the lesion. Methods: According to treatment process, 132 subjects with OLP who first visited the Department of Oral Medicine at the Pusan National University Dental Hospital from January 2017 to December 2020were classified into three groups: Treatment completed (CT) group, Under treatment (UT) group, and Dropped out during follow-up (DT) group. The reticulation/keratosis, erythema, and ulceration (REU) scoring system was used to assess the severity of OLP. The degree of improvement after treatment was evaluated in CT group. Results: There were 53 (40.15%) CT, 27 (20.45%) UT and 52 (39.39%) DT. In CT group, according to initial REU score there was a statistical difference in the degree of improvement, but not in the length of time to complete treatment. There was no statistical difference between the days it took for patients to feel symptom relief, and the days of entire treatment among three groups. However, there was a positive correlation between the REU score of gingiva and duration of treatment in DT group. In the CT and DT groups, there was a correlation between the length of time taken to relieve symptoms and the duration of treatment. Conclusions: The severity of the gingival lesion and the initial response to treatment have a large effect on the entire treatment period and prognosis, so it should be considered when explaining the disease prognosis and treatment period to patients, and the clinician needs to focus on initial symptom relief.

Predictors of Intensive Care Unit Morbidity and Midterm Follow-up after Primary Repair of Tetralogy of Fallot

  • Egbe, Alexander C.;Nguyen, Khanh;Mittnacht, Alexander J.C.;Joashi, Umesh
    • Journal of Chest Surgery
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    • v.47 no.3
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    • pp.211-219
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    • 2014
  • Background: Our objectives were to review our institutional early and midterm experience with primary tetralogy of Fallot (TOF) repair, and identify predictors of intensive care unit (ICU) morbidity. Methods: We analyzed perioperative and midterm follow-up data for all cases of primary TOF repair from 2001 to 2012. The primary endpoint was early mortality and morbidity, and the secondary endpoint was survival and functional status at follow-up. Results: Ninety-seven patients underwent primary repair. The median age was 4.9 months (range, 1 to 9 months), and the median weight was 5.3 kg (range, 3.1 to 9.8 kg). There was no early surgical mortality. The incidence of junctional ectopic tachycardia and persistent complete heart block was 2% and 1%, respectively. The median length of ICU stay was 6 days (range, 2 to 21 days), and the median duration of mechanical ventilation was 19 hours (range, 0 to 136 hours). By multiple regression analysis, age and weight were independent predictors of the length of ICU stay, while the surgical era was an independent predictor of the duration of mechanical ventilation. At the 8-year follow-up, freedom from death and re-intervention was 97% and 90%, respectively. Conclusion: Primary TOF repair is a safe procedure with low mortality and morbidity in a medium-sized program with outcomes comparable to national standards. Age and weight at the time of surgery remain significant predictors of morbidity.