• Journal of Korean Neurosurgical Society
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• v.64 no.3
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• pp.460-468
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• 2021

Objective : Extremely low alanine transaminase (ALT) levels are associated with all-cause mortality in frail elderly individuals; the clinical significance of ALT as a reliable biomarker is now being considered. Predicting mortality with routine tests at the time of diagnosis is important for managing patients after intracranial hemorrhage. We aimed to investigate whether an extremely low ALT level is associated with mortality in the elderly after intracranial hemorrhage. Methods : A retrospective review was performed on 455 patients with intracranial hemorrhage admitted to a university-affiliated tertiary care hospital from February 2014 to May 2019. Multivariate Cox regression analysis was performed for all ages and for each age group to determine whether an extremely low ALT level is an independent predictor of mortality only in the elderly. Results : Overall, 294 patients were enrolled, and the mean age of the subjects was 59.1 years, with 99 (33.8%) aged ≥65 years. The variables associated with all-cause mortality in all subjects were age, C-reactive protein (CRP) levels, hemoglobin (Hb) levels (<11 g/dL), and initial Glasgow coma scale (GCS) scores. In young patients, CRP, low Hb levels, and initial GCS scores were significantly associated with all-cause mortality. However, in the elderly (≥65 years), the variables significantly associated with all-cause mortality were extremely low levels of ALT (<10 U/L) (adjusted hazard ratio, 3.313; 95% confidence interval, 1.232-8.909; p=0.018) and initial GCS scores. Conclusion : Extremely low ALT level (<10 U/L) at the time of diagnosis is a significant risk factor for all-cause mortality in the elderly after intracranial hemorrhage.

• Journal of Korean Public Health Nursing
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• v.32 no.2
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• pp.304-318
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• 2018

Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2831-2834
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• 2014

The aim of this study was to determine the mortality rate and burden of urinary tract cancers among residents of Inner Mongolia. We analyzed mortality data reported by the Death Registry System from 2008 to 2012. The rate of mortality due to urinary tract cancer was 2.04 per 100,000 person-years for the total population, 2.91 for men, and 1.11 for women. Therefore, the mortality rate for men was 2.62-fold the mortality rate for women, constituting a statistically significant difference (p<0.001). Over the period 2008 through 2012, the total potential years of life lost was 1388.1 person-years for men and 777.1 person-years for women, and the average years of life lost were 7.71 years per male decedent and 12.0 years per female decedent. Mortality due to urinary tract cancers is substantially greater among the elderly population. Further, the mortality rate associated with urinary tract cancers is greater for elderly men than it is for elderly women. Therefore, in Inner Mongolia, urinary tract cancers appear to pose a greater mortality risk for men than they do for women.

• Journal of Trauma and Injury
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• v.37 no.3
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• pp.201-208
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• 2024

Purpose: The number of elderly patients with trauma is increasing; therefore, precise models are necessary to estimate the mortality risk of elderly patients with trauma for informed clinical decision-making. This study aimed to develop machine learning based predictive models that predict 30-day mortality in severely injured elderly patients with trauma and to compare the predictive performance of various machine learning models. Methods: This study targeted patients aged ≥65 years with an Injury Severity Score of ≥15 who visited the regional trauma center at Chungbuk National University Hospital between 2016 and 2022. Four machine learning models-logistic regression, decision tree, random forest, and eXtreme Gradient Boosting (XGBoost)-were developed to predict 30-day mortality. The models' performance was compared using metrics such as area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, specificity, F1 score, as well as Shapley Additive Explanations (SHAP) values and learning curves. Results: The performance evaluation of the machine learning models for predicting mortality in severely injured elderly patients with trauma showed AUC values for logistic regression, decision tree, random forest, and XGBoost of 0.938, 0.863, 0.919, and 0.934, respectively. Among the four models, XGBoost demonstrated superior accuracy, precision, recall, specificity, and F1 score of 0.91, 0.72, 0.86, 0.92, and 0.78, respectively. Analysis of important features of XGBoost using SHAP revealed associations such as a high Glasgow Coma Scale negatively impacting mortality probability, while higher counts of transfused red blood cells were positively correlated with mortality probability. The learning curves indicated increased generalization and robustness as training examples increased. Conclusions: We showed that machine learning models, especially XGBoost, can be used to predict 30-day mortality in severely injured elderly patients with trauma. Prognostic tools utilizing these models are helpful for physicians to evaluate the risk of mortality in elderly patients with severe trauma.

• Journal of Korean Neurosurgical Society
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• v.62 no.2
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• pp.243-255
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• 2019

Objective : Although traumatic brain injury (TBI) occurs in people of all age groups, the elderly population is at a particular risk. The proportion of elderly population in the society is markedly increasing and Korea is one of the most rapidly aging societies. Here, we analyzed the data from 904 patients older over 65 years who were registered in the Korean Neuro-Trauma Data Bank System (KNTDBS). Methods : The Korean Society of Neurotraumatology recorded data from 20 institutions between September 2010 and March 2014. This retrospective study examined the clinical epidemiology, sex difference, outcome epidemiology, sociodemographic variables, and outcomes in the geriatric population related to TBI based on data from the KNTDBS. Results : The study included 540 men and 364 women. The age distributions in the male and female groups were statistically significantly different. The most common cause of trauma was a fall and diagnosis was acute subdural hematoma. The incidence was the highest in men aged 80-84 years and in women aged 75-79 years. The most common time of arrival to hospital after TBI was within 1 hour and 119 rescue team provided first aid earliest to patients with TBI. The mortality rate stratified according to the cause of trauma was significantly different, with mortality rates of 3.77% in fall and 11.65% in traffic accident. The mortality rates according the severity of brain injury, Glasgow Coma Scale score, and treatment were statistically significant. Conclusion : To our knowledge, this study is the first to focus on elderly patients with TBI in Korea and particularly investigate mortality and characteristics related to TBI-related death based on data from the KNTDBS. Although the study has some limitations, our results may be used to obtain useful information to study targeted prevention and more effective treatment options for older TBI patients and establish novel treatment guidelines and health polish for the geriatric population.

• Hip & pelvis
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• v.35 no.3
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• pp.164-174
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• 2023

Purpose: This study investigates the relationship between preoperative neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-C-reactive protein ratio (LCR), albumin, and 2-year mortality in elderly patients having hemiarthroplasty for displaced femoral neck fracture (FNF). Materials and Methods: We retrospectively reviewed 284 elderly patients who underwent hemiarthroplasty for Garden type IV FNF from September 2014 to September 2020. Using the receiver operating characteristic curve, optimal cutoff values for LCR, NLR, and albumin were established, and patients were categorized as low or high. Associations with 2-year mortality were evaluated through univariate and multivariate Cox regression analyses. Results: Of the 284 patients, 124 patients (45.9%) died within 2 years post-surgery. The optimal cutoff values were: LCR at 7.758 (specificity 58.5%, sensitivity 25.0%), NLR at 3.854 (specificity 39.2%, sensitivity 40.0%), and albumin at 3.750 (specificity 65.9%, sensitivity 21.9%). Patients with low LCR (<7.758), high NLR (≥3.854), and low albumin (<3.750) had a statistically significant reduced survival time compared to their counterparts. Conclusion: Lower preoperative LCR and albumin levels, along with higher NLR, effectively predict 2-year mortality and 30-day post-surgery complications in elderly patients with Garden type IV FNF undergoing hemiarthroplasty.

• Journal of Preventive Medicine and Public Health
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• v.45 no.1
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• pp.21-28
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• 2012

Objectives: The aim of this study was to investigate whether a medium to high degree of total physical activity and indoor physical activity were associated with reduced all-cause and cardiovascular mortality among elderly Korean women. Methods: A prospective cohort study was done to evaluate the association between physical activity and mortality. The cohort was made up of elderly (${\geq}65$ years of age) subjects. Baseline information was collected with a self-administered questionnaire and linked to death certificates retrieved from a database. Cox proportional hazard models were used to estimate the hazard ratios (HRs) with 95% confidence interval (CI) levels. Results: Women who did not suffer from stroke, cancer, or ischemic heart disease were followed for a median of 8 years (n=5079). A total of 1798 all-cause deaths were recorded, of which 607 (33.8%) were due to cardiovascular disease. The group with the highest level of total physical activity and indoor physical activity was significantly associated to a reduced all-cause mortality (HR, 0.60; 95% CI, 0.51 to 0.71 and HR, 0.58; 95% CI, 0.50 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Additionally, the group with the highest level of total physical activity and indoor physical activity was significantly associated to a lower cardiovascular disease mortality (HR, 0.53; 95% CI, 0.40 to 0.71 and HR, 0.51; 95% CI, 0.39 to 0.67, respectively) compared to the group with the lowest level of total physical activity and indoor physical activity. Conclusions: Our study showed that regular indoor physical activity among elderly Korean women has healthy benefits.

• Journal of Preventive Medicine and Public Health
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• v.56 no.3
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• pp.231-237
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• 2023

Objectives: This study aimed to identify risk factors associated with coronavirus disease 2019 (COVID-19) mortality in pre-elderly and elderly individuals in Jakarta, Indonesia. Methods: We employed a case-control study design, utilizing secondary data from the Epidemiology Surveillance, Immunization Prevention, and Disease Control Sections of the DKI Jakarta Provincial Health Office, collected from December 2020 to January 2021. The study included 188 cases and an equal number of controls. Cases were COVID-19 patients confirmed to have died, as reported by hospitals and communities and subsequently verified by healthcare workers. Control subjects were patients who completed a 14-day isolation period and had been officially declared recovered by healthcare professionals. The dependent variable was the mortality of COVID-19 patients in the January 2021 period. The independent variables consisted of demographic data (age and sex), clinical symptoms (cough, runny nose, anosmia, diarrhea, headaches, abdominal pain, muscle pain, and nausea/vomiting), and comorbidities (hypertension, heart disease, and diabetes). Multivariate analysis was conducted using multiple logistic regression. Results: The multiple logistic regression analysis revealed several factors associated with COVID-19 fatalities in Jakarta: age of 60 years or older (odds ratio [OR], 4.84; 95% CI, 3.00 to 7.80), male (OR, 2.38; 95% CI, 2.41 to 3.68), dyspnea (OR, 3.93; 95% CI, 2.04 to 7.55), anosmia (OR, 0.13; 95% CI, 0.04 to 0.46), and heart disease (OR, 4.38; 95% CI, 1.04 to 18.46). Conclusions: The control and prevention of COVID-19 among elderly individuals require particular vigilance. When a COVID-19 case is detected within this demographic, prompt treatment and medication administration are crucial to mitigate the presenting symptoms.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.616-624
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• 2020

This study analyzed the association between the type of transport accident and the associated mortality of elderly inpatients. The findings will contribute to the development and establishment of a systematic and effective policy according to the type of transport accident to reduce the mortality of inpatients. The data on elderly inpatients with transport accidents was extracted from the 2013-2017 Korean National Hospital Discharge In-depth Survey dataset. The data was analyzed by descriptive statistics analysis, chi-square tests and multiple logistic regression analysis. After adjustment for sociodemographic, disease, injury and policy factors, the elderly inpatient deaths due to transport accidents were significantly higher for pedestrian accidents (OR: 2.522 95%, CI: 1.291-4.972), bicycle/cart accidents (OR: 2.809, 95% CI: 1.328-5.942) and motorcycle accidents (OR: 2.330, 95% CI: 1.226-4.819) rather than that for car accidents. Likewise, elderly inpatients have a higher risk of death from other types of transport accidents than those caused by car accidents. However, Korean policies related to transport accidents of elderly inpatients are concentrated on car accidents. Effective policy is needed according to the characteristics of each type of transport accident to reduce the transport accident mortality of elderly inpatients.

• Journal of Korea Entertainment Industry Association
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• v.13 no.6
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• pp.165-173
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• 2019

This study aims to examine the moderating effects of band circuit training for the mortality improvement of elderly women to provide an effective exercise moderating program for the enhanced quality of life of the elderly. To achieve the purpose of this study, the moderating effects of 8 weeks of band circuit training in the Senior Fitness Tests (SFT) and Sitting Rising Tests (SRT) of elderly women ages 65 and older in Y city were examined and the following results were gained. The functional fitness of elderly women according to the moderating effects of band circuit training (sitting down in a chair and standing up, lifting 2 kg dumbbells, walking in place for 2 minutes, sitting in a chair and bending forward, hand holding behind one's back, walking back and forth for 2.44 m) and the Sitting Rising Test (SRT) displayed statistically significant interaction effects among measurement times and groups and positive improvements were shown in the test group after band circuit training moderation. These research results show that band circuit training moderation has a positive effect on functional fitness and SRT, which are associated with the mortality rate of the elderly, and thus it can be applied as an effective exercise moderation program for the improvement of quality of life through the mortality improvement of the elderly.