• Clinical Endoscopy
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• v.56 no.3
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• pp.340-352
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• 2023

Background/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States. Methods: We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared. Results: From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p<0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management. Conclusions: Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

• The Korean journal of internal medicine
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• v.39 no.1
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• pp.95-109
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• 2024

Background/Aims: Sex differences in the prognosis of heart failure (HF) have yielded inconsistent results, and data from Asian populations are even rare. This study aimed to investigate sex differences in clinical characteristics and long-term prognosis among Korean patients with HF. Methods: A total of 5,625 Korean patients hospitalized for acute HF were analyzed using a prospective multi-center registry database. Baseline clinical characteristics and long-term outcomes including HF readmission and death were compared between sexes. Results: Women were older than men and had worse symptoms with higher N-terminal pro B-type natriuretic peptide levels. Women had a significantly higher proportion of HF with preserved ejection fraction (HFpEF). There were no significant differences in in-hospital mortality and rate of guideline-directed medical therapies in men and women. During median follow-up of 3.4 years, cardiovascular death (adjusted hazard ratio [HR], 1.38; 95% confidence interval [CI], 1.07-1.78; p = 0.014), and composite outcomes of death and HF readmission (adjusted HR, 1.13; 95% CI, 1.01-1.27; p = 0.030) were significantly higher in men than women. When evaluating heart failure with reduced ejection fraction (HFrEF) and HFpEF separately, men were an independent risk factor of cardiovascular death in patients with HFrEF. Clinical outcome was not different between sexes in HFpEF. Conclusions: In the Korean multi-center registry, despite having better clinical characteristics, men exhibited a higher risk of all-cause mortality and readmission for HF. The main cause of these disparities was the higher cardiovascular mortality rate observed in men compared to women with HFrEF.

• Journal of Environmental Health Sciences
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• v.34 no.5
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• pp.361-368
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• 2008

Objective to assess whether exposure to air pollutants is associated with postneonatal infant death, using a timeseries methodology, between 1999 and 2003 in Seoul, Korea.. Methods We investigated the short-term effects of air pollution for 548,725 live births during the study period. The daily count of postneonatal infant deaths from all causes and from SIDS (sudden infant death syndrome) by birth order was analyzed by a Generalized Additive Poisson model, with controlling for the effects of seasonal trends, air temperature, relative humidity, barometric pressure, and day of the week as covariates. Results During the study period, we observed 699 deaths from all causes and 47 deaths from SIDS. We did not find any significant associations between daily mortality and ambient levels of air pollutants except for CO and $NO_2$. The estimated relative risk of postneonatal infant death from all causes was 1.17 (95% CI=1.04-1.32) and 1.16 (95% CI=1.03-1.29) by IQR (interquartile range) for CO and $NO_2$ respectively. Also, we observed no clear trend of the mortality effects of air pollution by birth orders. Conclusion In conclusion, our findings suggest that air pollution, in general, influenced adversely postneonatal infant death from all-cause and SIDS although it was not statistically significant. This study may support that the rationale.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.44-51
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• 2007

Purpose: The purpose of this study was to compare suicide mortality by region in South Korea. Method: Suicide mortality differentials were calculated for several mortality indicators by geographical regions from raw data of the cause of death from KNSO. Results: The results are as follows; the Crude suicide death rate was 22.63 per 100,000. The highest was in Kangwon showing 37.84% whereas, Chungnam, and Jeonbuk followed after. Suicide was 4.4% of all causes of death, but Inchon and Ulsan showed a higher proportion. The male suicide death rate was 31.12 per 100,000 and females 14.09. The ratio of gender suicide mortality was 2.21, per 100,000 and was the highest in Jeju. For age-specific suicide death rates, the rate increased as age advanced, showing 2.33 per 100,000 in 0-19years, 18.68 in 20-39, 30.48 in 40-59, 63.33 in 60 years and over. In Ulsan, Kangwon, and Inchon, age-specific suicide death rates of the 60 and over age group were higher than other regions, Daegu, Busan, and Kangwon showed a higher age-specific suicide mortality of the 40-59 age group, and Kangwon, Jeonnam, and Chungnam had a higher age-specific suicide mortality of the 20-39 age group. Conclusions: Suicide mortality differed by region. These results can be used for a regional health care plan and planning for suicide prevention by regions.

• Journal of Preventive Medicine and Public Health
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• v.57 no.4
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• pp.327-338
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• 2024

Objectives: Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020. Methods: Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020. Results: The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths. Conclusions: Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.

• Korea journal of population studies
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• v.29 no.2
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• pp.27-51
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• 2006

In this paper, I have tested various kinds of methods for mortality projection and chose Lee-Carter method for projection of Korean mortality by age and sex. I reviewed the trends of life tables and life expectancies by age and sex from 2005 to 2050 projected by Lee-Carter method and found that the method was very applicable for Korean mortality projection. The differences between reported and estimated data for the period of 1971-2003 were small enough for both sexes and for all of the age groups. The projected life expectancies in 2051 were 82.73 years for males and 89.41 for females, and the differences decreased from 7.06 years in 2005 to 6.68 years. Because of the limitation of Korean infant mortality rate, I adopted the Japanese estimated IMR in 2050 as Korean object level in 2051. When the time series of IMR become long enough, we can use Korean IMR directly for the mortality projection. In addition, if we can estimate the changes of the main cause of death correctly in future, the mortality projection will be more correct and reliable. This will be available when we can produce a long series of life tables by cause of deaths.

• Tuberculosis and Respiratory Diseases
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• v.68 no.3
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• pp.140-145
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• 2010

Background: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. Methods: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. Results: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). Conclusion: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.

• Vascular Specialist International
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• v.34 no.4
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• pp.94-102
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• 2018

Purpose: Aim of this study is to report real-life experience on the treatment of peripheral artery disease (PAD) with a specific drug-coated balloon (DCB), and to evaluate potential prognostic factors for outcomes. Materials and Methods: This is a retrospective study reporting outcomes in patients with PAD who were treated with the Lutonix DCB during a four-year period. Major outcomes included: all-cause mortality, amputation, clinical improvement, wound healing and target lesion revascularization (TLR). Mean follow-up was $24.2{\pm}2.3$ months. Results: Overall, 149 patients (mean age: $68.6{\pm}8.3$ years; 113 males) were treated, either for intermittent claudication (IC) (n=86) or critical limb ischemia (CLI) (n=63). More than half the target lesions (n=206 in total) were located in the superficial femoral artery and 18.0% were below-the-knee lesions. CLI patients presented more frequently with infrapopliteal (P=0.002) or multilevel disease (P=0.0004). Overall, all-cause mortality during follow-up was 10.7%, amputation-free survival was 81.2% and TLR-free survival was 96.6%. CLI patients showed higher all-cause mortality (P=0.007) and total amputation (P=0.0001) rates as well as lower clinical improvement (P=0.0002), compared to IC patients. Coronary artery disease (CAD), gangrene and infrapopliteal disease were found to be predictors for death whereas CLI and gangrene were found to be predictors for amputation, during follow-up. Conclusion: PAD treatment with Lutonix DCBs seems to be an efficient and safe endovascular strategy yielding promising results. However, CAD, gangrene, CLI and infrapopliteal lesions were found to be independent predictors for adverse outcomes. Larger series are needed to identify additional prognostic factors.

• Journal of Korean Neurosurgical Society
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• v.39 no.1
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• pp.36-39
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• 2006

Objective : The present study attempts to address the change of management results over time during the past 13 years in good-grade patients with intracranial aneurysm. Methods : Six hundred twenty five [Hunt-Hess grade I to III] out of 826 patients with ruptured intracranial aneurysms operated by the same operator within 3 days after the attack from 1990 to 2002 were selected. Since 1998, endovascular aneurysmal occlusion was done in selected cases of 21 patients. The change of management results over time, including rebleeding rate, delayed ischemic neurologic deficit[DIND] as a cause of morbidity and mortality and surgical outcome were examined. Results : The ratio of poor-grade patients in all patients tended to decrease over the years. The early rebleeding rate declined from 5.0% to 1.2% with the use of tranexamic acid and computed tomography angiogram DIND as a cause of mortality and morbidity has decreased from 12.5% in 1990 to approximately 0% currently. Surgical outcome began to improve significantly in 1994 [poor outcome : 25% in 1990, 12.2% in 1994,6.8% in 2002]. Conclusion : These results suggest that the advances in care and increased experience of the operator significantly affect the change of overall outcome, and early detection of the aneurysm is needed for reducing the ratio of poor-grade patients.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.365-372
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• 1993

We analyzed the patients who were admitted to Surgical Intensive Care Unit[SICU] of Kyungpook National University Hospital from January 1987 through December 1991. The results were as followings: The total number of patients for 5 years was 2446 and 1553[63.5%] were male,893[36.5%] were female. The average age was 34.1 years old and the greatest age group was the 1-9 age group.The number of the patients in the Department of Thoracic and Cardiovascular Surgery, which was the highest among all departments,was 1608 [65.7%].Congenital Heart disease was the most common among all diseases.The patients who had undergone any kinds of operations were 89.9% of all patients.The averge stay in SICU was 5.2 days.The overall mortality rate was 12.1% ,which included hopelessly discharged patients and the highest mortality rate occurred in the patients over 80 years old.The highest cause of death was cardiac problem[30.4%]. The next was sepsis.The proportion of patients who had received a mechanical ventilatory support was 35.7% and 52% of those patients belonged to the department of thoracic and cardiovascular surgery.