• Title/Summary/Keyword: hospital admission

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Comparison of improvement on Low back pain depending on male inpatient's Pulse wave velocity (남성 입원환자들의 맥파속도에 따른 요통 호전도의 비교 연구)

  • Lee, Jin-Hyuk;Sui, Mu-Chang;Min, Kwan-Sik;Lee, Han;Jeong, Ho-Seok
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.4 no.2
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    • pp.39-45
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    • 2009
  • Objectives : The aim of this study is to compare the improvement of Low back pain (LBP) depending on male Inpatient's Brachlalankle Pulse Wave Velocity (baPWV), Method : We evaluated 35 LBP inpatients who took pulse wave velocity test during admission at Jaseng hospital from November 2008 to september 2009. We used applanation tonometry method to measure pulse wave velocity and numerical rating scale to measure patient's improvement. Result : At admission, standard deviation of normal group's NRS was $7.44{\pm}1.67$ and high risk group's was $7.57{\pm}2.09$(P=0.678). After 5 days of admission, standard deviation of normal group's NRS was $5.67{\pm}1.94$ and high risk group's was $6.00{\pm}2.17$(P=0.680). After 10 days of admission, standard deviation of normal group's NRS was $4.00{\pm}1.80$ and high risk group's was $4.95{\pm}1.96$(P=0.281). After 15 days of admission, standard deviation of normal group's NRS was $2.89{\pm}1.62$ and high risk group's was $4.10{\pm}1.92$(P=0.124). At discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504). Comparison between admission and discharge, standard deviation of normal group's NRS was $5.11{\pm}1.69$ and high risk group's was $4.86{\pm}2.08$(P=0.504) Conclusion : Low back patients with high Brachialankle Pulse Wave Velocity, showed slower improvement rate compare to patients within normal rate. But statically, had no significance.

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Hospital Visits from Respiratory Diseases of Early and Late Preterm Infants

  • Park, Sangmi;Nam, Soo Kyung;Lee, Juyoung;Jun, Yong Hoon
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.96-101
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    • 2018
  • Purpose: We aimed to evaluate the respiratory illness-related hospital visits (out-patient clinics, emergency room, and re-admission) of preterm infants, and compare them according to corrected age and prematurity. Methods: We reviewed the medical records of preterm infants born at <37 weeks of gestation admitted to the neonatal intensive care unit (NICU) at Inha University Hospital between January 2012 and June 2015. Infant follow-up appointments in both neonatology and pulmonology out-patient clinics occurred for at least 2 years after NICU discharge. Results: The proportion of infants who visited the hospital due to any respiratory illness was as high as 50% until 12 months of corrected age, and subsequently decreased over time. Hospital admission was significantly higher in early preterm infants (<34 weeks of gestation) compared to late preterm infants (${\geq}34$ and <37 weeks of gestation). The proportion of infants who were re-admitted due to lower respiratory tract illness was significantly higher until 6 months of corrected age compared to the later, and did not differ between early and late preterm infants. Conclusion: The proportion of hospital visits of preterm infants due to respiratory disease was high until 12 months of corrected age. Most notably, the re-admission proportion from lower respiratory tract illness was high under 6 months in both early and late preterm infants. Preterm infants within this age that are visiting the hospital with respiratory symptoms should be carefully observed and followed up.

Pressure Ulcer Prevalence and Risk Factors at the Time of Intensive Care Unit Admission (중환자실 환자의 입실 시 욕창 유병률과 위험요인)

  • Kwak, Hye Ran;Kang, Jiyeon
    • Korean Journal of Adult Nursing
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    • v.27 no.3
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    • pp.347-357
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    • 2015
  • Purpose: This study was conducted to assess the prevalence rate of, and the risk factors for pressure ulcers in critical patients at the time of intensive care unit (ICU) admission. Methods: We reviewed the electronic medical records of 2,107 patients who were admitted to the intensive care units in D university hospital between January 1 and December 31, 2012. The collected date were analyzed by ${\chi}^2$-test, t-test, and multi-variate logistic regression with forward stepwise selection using the SPSS program version 21. Results: The prevalence rate of pressure ulcers at the ICU admission was 23.7%. Risk factors significantly affecting pressure ulcers carrying were the age of 80 years or older (OR=3.70, 95% CI: 1.80~7.60), body weight less than 50 kg (OR=2.82, 95% CI: 1.74~4.56), sedated consciousness (OR=6.10, 95% CI: 3.57~10.40), use of ventilator (OR=1.60, 95% CI: 1.02~2.49), use of vasopressors (OR=1.53, 95% CI: 1.09~2.14), ICU admission via operation room (OR=0.49, 95% CI: 0.29~0.85), and hospital admission from nursing homes (OR=13.65, 95% CI: 3.02~61.72). Conclusion: The findings of this study suggested that the prevention efforts for pressure ulcers should be given in prior to ICU admission. Further research is necessary for developing nursing interventions for preventing pressure ulcers in the pre-ICU stage.

The Usefulness of the Admission Base Deficit as a Marker of Mortality in Severely Injured Patients with Blunt Trauma (둔상성 중증 외상환자에서 내원 초기에 시행한 동맥혈 염기결핍과 예후의 관계)

  • Yu, Byung-Chul;Chung, Min;Lee, Gil-Jae;Lee, Jung-Nam
    • Journal of Trauma and Injury
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    • v.26 no.1
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    • pp.1-5
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    • 2013
  • Purpose: The base deficit (BD) at admission in severely injured patients has been shown to predict the adequacy of resuscitation and outcome, but this relationship is not well established in the Korean experience. The purpose of this study was to define the association between arterial blood gas (ABG) values and the mortality for patients with severe blunt trauma at a developing trauma center in Korea. Methods: A retrospective review of 415 adult patients with severe blunt trauma was conducted using electronic medical records from Jan. 2010 to Dec. 2011. Results: A total of 256 patients had ABG drawn within 1 hour of arrival. Patients who expired displayed a higher lactate level (4.86 vs. 3.31, p<0.0001), a worse BD (-7.99 vs. -5.37, p=0.001), and a lower pH (7.31 vs. 7.34, p=0.011) at arrival compared with those who survived. A statistically significant association was also observed between BD and blood product usage (p=0.001). Conclusion: The base deficit at admission is a useful marker of mortality and outcome in severely injured patients with blunt trauma in Korea.

Patient Severity Classification in a Medical ICU using APACHE Ⅲ and Patient Severity Classification Tool (APACHE Ⅲ를 이용한 중환자 분류도구의 타당도 검증)

  • Lee, Gyeong-Ok;Sin, Hyeon-Ju;Park, Hyeon-Ae;Jeong, Hyeon-Myeong;Lee, Mi-Hye;Choe, Eun-Ha;Lee, Jeong-Mi;Kim, Yu-Ja;Sim, Yun-Gyeong;Park, Gwi-Ju
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1243-1253
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    • 2000
  • The purpose of this study was to verify the validity of the Patient Severity Classification Tool by examining the correlations between the APACHE Ⅲ and the Patient Severity Classification Tool and to propose admission criteria to the ICU. The instruments used for this study were the APACHE Ⅲ developed by Knaus and the Patient Severity Classification Tool developed by Korean Clinical Nurses Association. Data was collected from the 156 Medical ICU patients during their first 24 hours of admission at the Seoul National University Hospital by three trained Medical ICU nurses from April 20 to August 31 1999. Data were analyzed using the frequency, $x^2$, Wilcoxon rank sum test, and Spearman rho. There was statistically significant correlations between the scores of the APACHE III and the Patient Severity Classification Tool. Mortality rate was increased as patients classification of severity in both the APACHE III and the Patient Severity Classification Tool scored higher. The Patient Severity Classification Tool was proved to be a valid and reliable tool, and a useful tool as one of the severity predicting factors, ICU admission criteria, information sharing between ICUs, quality evaluations of ICUs, and ICU nurse staffing.

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A Study on the Development of Readmission Predictive Model (재입원 예측 모형 개발에 관한 연구)

  • Cho, Yun-Jung;Kim, Yoo-Mi;Han, Seung-Woo;Choe, Jun-Yeong;Baek, Seol-Gyeong;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.435-447
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    • 2019
  • In order to prevent unnecessary re-admission, it is necessary to intensively manage the groups with high probability of re-admission. For this, it is necessary to develop a re-admission prediction model. Two - year discharge summary data of one university hospital were collected from 2016 to 2017 to develop a predictive model of re-admission. In this case, the re-admitted patients were defined as those who were discharged more than once during the study period. We conducted descriptive statistics and crosstab analysis to identify the characteristics of rehospitalized patients. The re-admission prediction model was developed using logistic regression, neural network, and decision tree. AUC (Area Under Curve) was used for model evaluation. The logistic regression model was selected as the final re-admission predictive model because the AUC was the best at 0.81. The main variables affecting the selected rehospitalization in the logistic regression model were Residental regions, Age, CCS, Charlson Index Score, Discharge Dept., Via ER, LOS, Operation, Sex, Total payment, and Insurance. The model developed in this study was limited to generalization because it was two years data of one hospital. It is necessary to develop a model that can collect and generalize long-term data from various hospitals in the future. Furthermore, it is necessary to develop a model that can predict the re-admission that was not planned.

Impact of Admission Diagnosis on the Smoking Cessation Rate: A Brief Report From a Multi-centre Inpatient Smoking Cessation Programme in Singapore

  • See, Jason Jia Hao;See, Kay Choong
    • Journal of Preventive Medicine and Public Health
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    • v.53 no.5
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    • pp.381-386
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    • 2020
  • Objectives: Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes. Methods: This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence. Results: A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis. Conclusions: In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient's motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.

The Effect of Physical and Occupational Therapy on Activities of Daily Living in Stroke Inpatients at Least 3 Months After Stroke (발병 후 3개월이 경과한 뇌졸중 환자의 일상생활동작에 물리치료와 작업치료가 미치는 영향)

  • Kim, Won-Ho;Hwang, Myoung-Ok;Park, Eun-Young
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.74-81
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    • 2007
  • The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI${\leq}$74 and MBI${\geq}$75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI${\leq}$74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI${\geq}$75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.

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Retrospective Observation of Liver Function Test in 147 Patients Admitted to Korean Medicine Hospital (한방병원에 입원한 환자 147명의 간기능 검사에 대한 후향적 관찰)

  • Lee, Yu Ri;Cho, Na Kyung;Kim, Kyung Soon;Choi, Hong Sik;Kim, Seung Mo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.6
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    • pp.418-421
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    • 2018
  • The purpose of this study was to evaluate the changes of liver function test before and after treatment in patients admitted to Korean medicine hospital. We checked liver function test level (aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, total bilirubin, direct bilirubin) of 147 patient who admitted in Korean medicine hospital from July 1, 2015 to June 30, 2018. The subjects were selected those who took herbal medicine continuously during the admission period and who performed liver function test on admission and before discharge. And the subjects were excluded those who had a history of liver and biliary disease at the time of admission or who took hepatoprotectants. Aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase significantly decreased compared with the values of admission(p<0.05), but total bilirubin and direct bilirubin were not significantly changed(p>0.05). On admission 31 patients(21.1%) had abnormal liver function and 6 patients(4.1%) had liver injury while 19 patients(12.9%) had abnormal liver function and 6 patients(4.1%) showed liver injury before discharge. This study suggests that herbal medicine may not injure liver function.

The Impact of Weekend Admission and Patient Safety Indicator on 30-Day Mortality among Korean Long-Term Care Insurance Beneficiaries

  • Shin, Jaeyong;Kim, Jae-Hyun
    • Health Policy and Management
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    • v.29 no.2
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    • pp.228-236
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    • 2019
  • Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.