• Title/Summary/Keyword: multivariate data

Search Result 1,967, Processing Time 0.042 seconds

Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
    • /
    • v.66 no.4
    • /
    • pp.300-308
    • /
    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Use of Discriminant Analysis to Identify Soil Quality Variation by Land Use (판별분석을 이용한 토지이용별 토양 특성 변화 연구)

  • Ko Kyung-Seok;Kim Jae Gon;Lee Jin-Soo;Kim Tack Hyun;Lee Gyoo Ho;Cho Choon Hee;Oh In Suk;Cheong Young Wook
    • Economic and Environmental Geology
    • /
    • v.38 no.3 s.172
    • /
    • pp.207-219
    • /
    • 2005
  • The physical and chemical characteristics of soils in a small watershed were investigated and the effect of geology and land use on soil quality were examined by using multivariate statistical methods, principal components analysis and discriminant analysis. The soil developed from andesite had finer texture and higher contents of water extractable inorganic components, clay, and mafic minerals than the soil developed from granite. It is considered that the accumulation of salts in the farmland soils indicated by electrical conductivity, contents of cations and anions and pH was caused by fertilizer input during cultivation. The low contents of organic matter in the farmland soils was due to the enhanced oxidation of organic matter by tillage and by the harvest of crops. The contents of inorganic components are increased as following order: upland > orchard > paddy field > forest. The high contents of water soluble $SO_4\;^{2-}$ of paddy soils is due to the oxidation of sulfides mineral formed during the flooding period during the air-dry and extraction. The results of principal components analysis show the difference of soil quality was controlled by geology and land use. PCI indicate the input of fertilizer, mineral weathering and ion exchange reaction by application of nitrogenous fertilizers. The results of two discriminant analyses using water extractable inorganic components and their ratios by land use were also clearly classified by discriminant function 1 and 2. In discriminant analysis by components, discriminant function 1 indicated the effect of fertilizer application and increased as following order: upland > orchard > paddy field > forest soil. The investigated and predicted data for land use from discriminant analysis showed similar results. The discriminant analysis can be used as a useful method certifying the change of land use.

The Effect of Coffee Consumption on Serum Total Cholesterol Level in Healthy Middle-Aged Men (건강한 중년 남성에서 커피 음용 습관이 혈중 총 콜레스테롤 값에 미치는 영향)

  • Shin, Myung-Hee;Kim, Dong-Hyun;Bae, Jong-Myun;Lee, Hyung-Ki;Lee, Moo-Song;Noh, Joon-Yang;Ahn, Yoon-Ok
    • Journal of Preventive Medicine and Public Health
    • /
    • v.27 no.2 s.46
    • /
    • pp.200-216
    • /
    • 1994
  • In present study, the authors investigated the possible effect of coffee consumption on serum cholesterol level in 1017 men between the ages of 40 and 59 years, who were randomly selected from the members of Seoul Cohort Study. Serum total cholesterol data was collected with other serologic indices (e.g. systolic blood pressure, diastolic blood pressure, hight, weight, etc.) through the program of biennial health check-up offered by Korean Medical Insurance Corporation (KMIC). The amount of coffee consumption was assessed by a self-administered questionnaire through mailing. Other confounding factors, such as age, body mass index, cigarette smoking, alcohol consumption, physical activity, and other dietary intake pattern were also determined by the questionnaire. The differences in means of serum total cholesterol in compared to non consumers were $-0.4{\pm}3.56mg/dl$ for those drinking less than 1 cup a day, $-0.6{\pm}3.60mg/dl$ for those drinking 1 cup a day, and $7.1{\pm}3.41mg/dl$ for those drinking more than 2 cups a day. Since smoking interacted the relationship between coffee consumption and serum total choleaterol, we re-analyzed those relationship in smokers and non-smokers separately Other atherogenic behaviors were well correlated with total cholesterol, so we adjusted the mean values of serum total cholesterol through multivariate model selection with age(r=0.12), total cigarette index (cigarette-years; r=0.10), Quetelet's index ($Kg/m^2$, r=0.16), daily calory expenditure (kcal/day, r=0.06), weekly meat and poultry consumption(g/week, r=0.05), weekly fish consumption (g/week, r=0.08), other caffeinated beverage intake (cups/week), and the amount of sugar and prim added to the coffee. Among those variables only age, Quetelet's index, fish consumption, and total cigarette index (in smokers) were remained in the models. After adjustment, the corresponing differences of total cholesterol in smokers were changed to $0.4{\pm}5.24mg/dl,\;-0.5{\pm}4.97mg/dl,\;and\;8.9{\pm}4.78mg/dl$, which were significantly different among themselves (P=0.011). In non-smokers, however, the differences were not statistically significant (P=0.76). Adjusted mean values of systolic blood pressure and diastolic blood pressure were also determined to evaluate the direct effect of coffee to cardiovascular system, but their means were not significantly different by coffee consumption(p=0.18 for SBP, p=0.48 for DBP). Asuming instant coffee in the most popular type of coffee in Korea, the association observed in our study between coffee and serum total cholesterol, especially in smokers, is very interesting finding for the connection between coffee and serum total cholesterol, because only 'boiled coffee' tend to show significant lipid raising effect rather than to other types of coffee, like filtered or espresso, in most of the western countries. We concluded that people who drink coffee more than 2 cups a day have significantly higher serum total cholesterol level than those who never drink coffee, especially in smokers.

  • PDF

Analysis of Surgical Results for the Patients with Pulmonary Metastasis from Colorectal Carcinoma (대장암의 전이성 폐암의 수술 결과에 대한 분석)

  • Sim, Hyung-Tae;Kim, Yong-Hee;Shin, Hong-Ju;Chun, Mi-Sun;Bae, Chi-Hoon;Lee, Eung-Sirk;Park, Seung-Il;Kim, Dong-Kwan
    • Journal of Chest Surgery
    • /
    • v.39 no.11 s.268
    • /
    • pp.838-843
    • /
    • 2006
  • Background: The lung is the most common site of metastatic colorectal cancer comprising 10% of all curative resection of colorectal cancer. The reported 5 year survival rate varies among institutions. The purpose of the present study was to present the retrospective analysis of colorectal metastatic lung cancer surgery at our institution. Material and Method: A total of 61 patients undergoing surgery for metastatic colorectal lung cancer between July 1996 and December 2003 were included in the present study. The stage of the primary colorectal cancer, site of pulmonary metastasis, method of lung resection, the number and size of the metastatic nodules, the recurrence rate, and survival were assessed. Result: The 3 and 5 year survival rates were 66% and 41%, respectively. No significant risk factors were identified among the studied variables by either univariate or multivariate analysis. The mean disease free survival rate was 17 months. The most common recurrent site was lung, and among these patients, 3 underwent a second operation and two are still alive. Conclusion: The results of the above data suggest that pulmonary resection of metastatic lung cancer in select patients after curative resection of colon cancer may be a good therapeutic option with the potential for excellent results.

Clinical Characteristics of Bronchopulmonary Dysplasia by Type and Severity (기관지폐이형성증의 유형 및 중증도에 따른 임상적 특징)

  • Shim, Gyu-Hong;Lee, Hyun-Ju;Kim, Eun-Sun;Lee, Jin-A;Choi, Chang-Won;Kim, Ee-Kyung;Kim, Han-Suk;Kim, Beyong-Il;Choi, Jung-Hwan
    • Neonatal Medicine
    • /
    • v.17 no.1
    • /
    • pp.21-33
    • /
    • 2010
  • Purpose : The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. Methods : Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. Results : Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. Conclusion : The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.

Life-Sustaining Procedures, Palliative Care, and Cost Trends in Dying COPD Patients in U.S. Hospitals: 2005~2014

  • Kim, Sun Jung;Shen, Jay;Ko, Eunjeong;Kim, Pearl;Lee, Yong-Jae;Lee, Jae Hoon;Liu, Xibei;Ukken, Johnson;Kioka, Mutsumi;Yoo, Ji Won
    • Journal of Hospice and Palliative Care
    • /
    • v.21 no.1
    • /
    • pp.23-32
    • /
    • 2018
  • Purpose: Little is known regarding the extent to which dying patients with chronic obstructive pulmonary disease (COPD) receive life-sustaining procedures and palliative care in U.S. hospitals. We examine hospital cost trends and the impact of palliative care utilization on the use of life-sustaining procedures in this population. Methods: Retrospective nationwide cohort analysis was performed using National Inpatient Sample (NIS) data from 2005 and 2014. We examined the receipt of both palliative care and intensive medical procedures, defined as systemic procedures, pulmonary procedures, or surgeries using the International Classification of Diseases, 9th revision (ICD-9-CM). Results: We used compound annual growth rates (CAGR) to determine temporal trends and multilevel multivariate regressions to identify factors associated with hospital cost. Among 77,394,755 hospitalizations, 79,314 patients were examined. The CAGR of hospital cost was 5.83% (P<0.001). The CAGRs of systemic procedures and palliative care were 5.98% and 19.89% respectively (each P<0.001). Systemic procedures, pulmonary procedures, and surgeries were associated with increased hospital cost by 59.04%, 72.00%, 55.26%, respectively (each P<0.001). Palliative care was associated with decreased hospital cost by 28.71% (P<0.001). Conclusion: The volume of systemic procedures is the biggest driver of cost increase although there is a cost-saving effect from greater palliative care utilization.

The Association between Types of Smoking and Periodontal Disease according to the Survey Year Using the Fourth and Fifth Korea National Health and Nutrition Examination Surveys (조사연도에 따른 흡연 유형과 치주질환의 관련성 분석: 제4기, 제5기 국민건강영양조사를 이용하여)

  • Kim, Myoung-Hee;Yoon, Mi-Sook;Lim, Youn-Hee;Lee, Sae-Rom;Kim, So-Yeon;Park, Seon-Ju;Shin, Sun-Jung
    • Journal of dental hygiene science
    • /
    • v.17 no.6
    • /
    • pp.487-494
    • /
    • 2017
  • There is little evidence on the effects of environmental tobacco smoke (ETS) on prevalence of periodontal disease. The aims of this study were to explore the trends of prevalence of periodontal disease and types of exposure to smoke, including ETS according to the survey year, identify factors affecting periodontal disease, and compare the effect size of periodontal disease between active smokers and secondhand smokers. Data on 11,643 individuals were obtained from the fourth and fifth Korean National Health and Nutritional Examination Surveys. Information on exposure to ETS at home and work was self-reported. Severity of periodontal disease was evaluated using the community periodontal index. A multivariate logistic regression analysis was performed to model periodontal disease using types of smoking and the survey year. Overall, the prevalence of periodontal disease was 26.0% (n=3,029) and about 9% of the study population were secondhand smokers. The prevalence of periodontal disease among smokers was significantly increased according to smoking types by year. Active smokers showed a statistically significant adjusted odds ratio (aOR) for having periodontal disease except in the year 2007, whereas secondhand smokers had significant associations only in 2010 (aOR, 1.68; 95% confidence interval, 1.05 to 2.70) compared to non-smokers. For secondhand smokers, the statistical relationship of predicting periodontal disease was weaker than that of active smokers. However, ETS should separately be considered as an important risk factor for periodontal disease. This study suggested the need for further investigation of the impact of ETS on prevalence of periodontal disease using in-depth research designs and objective measurements for assessing periodontal disease and ETS.

Clinical Significance of the Aortic Node in Non-small Cell Lung Cancer of the Left Upper Lobe (좌상엽에 발생한 비소세포형 폐암에서 Aortic Node의 의의)

  • 김대준;김길동;이기종;정경영
    • Journal of Chest Surgery
    • /
    • v.36 no.11
    • /
    • pp.846-851
    • /
    • 2003
  • Background: To clarify the clinical significance of the aortic nodes in resected non-small cell lung cancer of the left upper lobe. Material and Method: One hundred fifty six patients with resected non-small cell lung cancer of the left upper lobe were studied. Patients who received preoperative induction therapy, non-curative operation or defined as operative mortality were excluded from this study. Result: In N2 left upper lobe tumors, aortic nodes comprised 52.7% of the metastatic mediastinal lymph nodes. In single station N2 disease, a frequently metastasized station was aortic node (64.3%). 5-year actuarial survival according to the N status was 65.0% in N0, 30.4% in N1, and 17.9% in N2. There was no statistically significant difference in survival between N1 and N2 diseases (p=0.06). The patients with metastasis to aortic node alone had a comparatively good prognosis (5-year survival: 35.6%) than other N2 diseases (5-year survival: 4.6%) (p=0.01) and had a similar survival outcome as N1 diseases (p=0.97). Considering the aortic node as N1 node, 5-year survival according to the N status was 65.0% in N0, 31.2% in N1, 4.6% in N2 and significant survival difference was observed between N1 and N2 disease (p=0.00). In multivariate analysis, the male sex (hazard ratio 6.892, p=0.011) and the involvement to the aortic node alone (hazards ratio 2.799, p=0.009) were the significant factors affecting postoperative survival. Conclusion: According to the our data, involvement to the aortic node alone in left upper lobe tumors should be grouped with N1 disease because this combined category reflects the surgical outcome more accurately.

Health Condition Assessment Using the Riparian Vegetation Index and Vegetation Analysis of Geumgang mainstream and Mihocheon (수변식생지수를 이용한 금강본류와 미호천의 건강성 평가 및 식생분석)

  • Lee, Seung-Yeon;Jang, Rae-Ha;Han, Young-Sub;Jung, Young-Ho;Lee, Soo-In;Lee, Eung-Pill;You, Young-Han
    • Korean Journal of Environment and Ecology
    • /
    • v.32 no.1
    • /
    • pp.105-117
    • /
    • 2018
  • This study conducted health assessment and multivariate vegetation analysis using the riparian vegetation index in 30 sites of the Geumgang mainstream and Mihocheon to obtain practical data on the river management of the Geumgang. The result showed that the number of plant communities was 54. The flora was 75 families, 185 genera, 243 species, 2 subspecies, 21 varieties, 2 varieties, and 268 taxa. The riparian vegetation index was 38.3 (3.3; G-D1 ~ 66.7; G-U2, G-U4, and G-M3), and the health of the rivers in this area was evaluated as normal (grade C). The health of rivers was the highest in the upper stream of Geumgang mainstream and lowest in the downstream of Geumgang mainstream. The relationship between riparian vegetation index and chlorophyll-a content was low. The riparian vegetation was divided into five groups of Digitaria ciliaris colony group, Salix gracilistyla colony group, Erigeron annuus colony group, the group dominated by Humulus japonicus, Salix koreensis, Miscanthus sacchariflorus, and Phragmites japonica colonies, and the group dominated by Conyza canadensis and Echinochloa crusgalli var. echinata colonies. They had the similar health conditions. The CCA analysis showed that the environmental factors affecting the distribution of vegetation were physical factors such as vegetation area, artificial structure area, waterway area, branch width, channel width, and bank height and the biological factors such as the number of species. As such, it is necessary to maintain the health condition through continuous monitoring where the health condition is high and to apply active measures such as ecological restoration where the health condition is low.

The Prognostic role of Electrocardiographic Signs of Cor Pulmonale in Chronic Obstructive Pulmonary Disease (폐성심을 시사하는 심전도 소견 유.무에 따른 만성폐쇄성 폐질환 환자의 예후)

  • Shin, Moo-Chul;Park, Jae-Yong;Bae, Moon-Seob;Bae, Nack-Cheon;Chae, Po-Hee;Kim, Chang-Ho;Jung, Tae-Hoon
    • Tuberculosis and Respiratory Diseases
    • /
    • v.48 no.6
    • /
    • pp.944-955
    • /
    • 2000
  • Background : In patients with chronic obstructive pulmonary disease(COPD), several factors have been associated with a poor prognosis. These include old age, low $FEV_1$ low diffusing capacity, high alveolar-arterial oxygen pressure difference, and finally cor pulmonale. This study was done to investigate if the ECG signs suggesting cor pulmonale were independent prognostic factors in patients with COPD. Method : We analyzed ECG, pulmonary function data and arterial blood gas values in 61 patients who were admitted through the emergency department with an acute exacerbation of COPD. The ECG signs reflecting cor pulmonale were right strial overloading(RAO), right bundle branch block, right ventricular hypertrophy and low-voltage QRS. The 61 patients were divided into 2 groups ; group I with no ECG signs(n=36) and group II with one or more ECG signs(n=25) suggesting cor, pulmonale. Results : Poor, prognostic factors by univariate analysis were low $FEV_1$, $FEV_1$ % pred., VC % pred., DLco, DLco % pred., $PaO_2$ and $SaO_2$ high $PaCO_2$ presence of ECG signs reflecting cor pulmonale, presence of mental status change, use of mechanical ventilator, and long term use of glucocorticoid. A multivariate analysis indicated that age(risk ratio=1.13, 95% confidence interval 1.05-1.23), DLco % pred. (risk ratio=0,97. 95% confidence interval 0.94-0.99), $PaO_2$ (risk ratio=0.95, 95% confidence interval 0.90-0.99) and RAO(risk ratio=5.27, 95% confidence interval 1.40-19.85) were independent prognostic factors of survival. There was a significant difference in survival between the patients with and without RAO(p=0.038). The survival rates at 1, 2, and 5 years were 94.5%. 81.4%, and 50.0% in patients without RAO and 82.4%, 70.6%, and 27.5% in patients with RAO, respectively. Conclusion : These results suggest that the presence of ECG signs reflecting cor pulmonale is a predictor of survival and that RAO of these ECG signs is a significant independent predictor of survival in patients with COPD.

  • PDF