• Journal of Korean Public Health Nursing
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• v.15 no.2
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• pp.239-248
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• 2001

The purpose of this study was to analyze risk factors for nosocomial pneumonia in patients admitted to NS ICU, and to provide a basic data to decrease respiratory nosocomial infection rate engendered from medical environments in NS ICU. The study site was the NS ICU at a university hospital located in Seoul, Korea. The subjects were 31 patients diagnosed with nosocomial pneumonia, who were selected from the initial list of 300 potential subjects who had been a) admitted between September 1999 and January 2000, and September 2000 and January 2001, b) resided at the NS ICU over 72 hours. The diagnostic standard of nosocomial pneumonia was based on the nosocomial infection guides of C university hospital. The data were analyzed using frequencies and logistic regression analysis. The sputums obtained from the subjects were cultivated and causal viruses were separated. The results were as follows: 1. The nosocomial pneumonia rate was $10.3\%$. There were 7 types of causal viruses separated from the sputum. and the most prevalent type of virus was MRSA as $62.2\%$. 2. The factors significantly influencing the incidence of nosocomial pneumonia included age, the residential duration at the NS ICU, GCS scores, diabetes mellitus, insertion of tracheal tube and its duration, tracheostomy and its length of insertion, the use of artificial ventilator and the length of its use, and the insertion of naso-gastic tube. The most significant risk factor among these was the insertion of tracheal tube (odds ratio=18.684. $95\%$ CI=6.849-50.974), followed by the use of tracheostomy (odds ratio=15.419, $95\%$ CI=6.615-35.942), the insertion of naso-gastric tube (odds ratio=14.875, $95\%$ CI=6.396-34.595), and the use of artificial ventilator (odds ratio=13.000. $95\%$ CI=5.633­30.001). 3. Regarding the use of the mechanical aids, the insertion of tracheal tube resulted in 12.968 times increase of the nosocomial pneumonia rate, and the use of artificial ventilator lead 6.714 times increase of the nosocomial pneumonia rate. One point increase of the GCS score resulted in the 1.210 times increase of the nosocomial pneumonia rate. For patients who had tracheal tube, tracheostomy, and artificial ventilator, one day increase of their residential duration at NS ICU lead 1.073 times increase of the nosocomial pneumonia rate. 4. In terms of duration of the mechanical aid usage, one day increase in the use of artificial ventilator engendered 1.080 times increase in the nosocomial pneumonia rate. One day increase of the residential duration at the NS ICU lead 1.604 times increase in the nosocomial pneumonia rate. As one point of the GCS score increased, 0.876 times decrease of the nosocomial pneumonia rate was reported. These study findings show that the risk factors significantly influencing the incidence of nosocomial pneumonia include the use of tracheal tube, tracheostomy, naso-gastic tube, and artificial ventilator. It is recommended that nurses working at NS ICU should pay more attention to the patients with these factors as the risky group for the nosocomial pneumonia, and thus make more active efforts to provide nosocomial pneumonia prevention strategies for them. In further studies patients admitted to the different types of ICUs such as internal medicine or surgery unit ICU will be also included, and more wide investigation of nosocomial pneumonia risk factors will be conducted through one-year longitudinal follow up.

• Korean Journal of Transplantation
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• v.31 no.4
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• pp.182-192
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• 2017

Background: In recent years, introduction of novel immunosuppressive agents and its proper implementation for clinical practice have contributed to improving clinical outcomes of kidney transplantation (KT). Here, we report clinical outcomes of KTs and related risk factors. Methods: From July 1998 to June 2016, 354 KTs (182 from living and 172 from deceased donors) have been performed at Ulsan University Hospital. We retrospectively reviewed the clinical characteristics and outcomes of KT recipients, then estimated graft and patient survival rate were estimated and analyzed risk factors using Cox-regression. Results: The median follow-up period was 53 months (range; 3 to 220 months). The mean ages of recipients and donors were 45.0 years (SD, 12.5) and 44.7 years (SD, 13.6) years, respectively. During follow-up, 18 grafts were lost and 5- and 10-year death-censored graft survival was 96.7% and 91.5%, respectively. Biopsy-proven acute rejection (BPAR) occurred in 71 patients (55 cases of acute cellular rejection and 16 of antibody-mediated rejection). Cox-regression analysis showed that BPAR was a risk factor related to graft loss (hazard ratio [HR], 14.38; 95% confidence interval [CI], 3.79 to 54.53; P<0.001). In addition, 15 patients died, and the 5- and 10-year patient survival was 97.2% and 91.9%, respectively. Age ≥60 years (HR, 6.03; 95% CI, 1.12 to 32.61; P=0.037) and diabetes (HR, 6.18; 95% CI, 1.35 to 28.22; P=0.019) were significantly related to patient survival. Conclusions: We experienced excellent clinical outcomes of KT in terms of graft failure and patient survival despite the relatively high proportion of deceased donors. Long-term and short-term clinical outcomes have improved in the last two decades.

• Journal of Nutrition and Health
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• v.41 no.8
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• pp.742-753
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• 2008

The purpose of this study is to investigate risk factors of pre-hypertension and hypertension in rural residents. Nine hundred and ninety four subjects aged 40-70 yrs in Chungnam-do participated in this study. The subjects (n = 824) were classified into three groups of hypertensive, pre-hypertensive, and normotensive according to the Joint National Committee (JNC)-7 criteria. The weight, body mass index (BMI), waist-hip ratio (WHR), and serum total protein, albumin, BUN, and triglyceride (TG) were positively correlated with SBP and DBP. After adjusted by age, sex and BMI, the total protein, albumin and TG were significantly correlated with SBP and DBP (p < 0.01). There was no significant difference in eating habits according to the level of blood pressure. The serum albumin, creatinine, Glu-FBS, Glu-PP l20, and triglyceride were higher in both prehypertensive and hypertensive group than in the normotensive group. However, mean serum cholesterol was not different among three blood pressure groups. In this study, the common risk factors of pre-hypertension and hyper-tension were male, age of fifties, lower education level, ex-smoking, higher drinking frequency, higher BMI, body fat %, waist circumference, WHR, serum albumin and diabetes, even though the degree of risks in these variables were higher in the hypertensive group. The higher BUN was a risk factor of prehypertension, while the family history, prediabetes, serum total protein, Glu-PP l20 and higher alcohol drinking amount were the risk factors of hypertension. This result suggests that maintaining good health habit and normal range of blood parameters as well as controlling body weight have to be paid attention in order to prevent hypertention, and further reseasch on the relationship of blood pressure and BUN are needed.

• The Korean Journal of Food And Nutrition
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• v.31 no.3
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• pp.425-434
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• 2018

Metabolic syndrome is a risk factor for cardiovascular and type 2 diabetes. This study was conducted to examine the relevance between nutrition intake, meal quality, and high-sensitivity C-reactive protein in Koreans with metabolic syndrome. The 2,536 subjects, aged 19~64, who participated in 2015 National Nutrition Survey were included in this study. The 24-hour recall method was employed to analyze nutrition intake and dietary quality. Subjects were grouped into either the non-metabolic syndrome group (n=1,938) or the metabolic syndrome group (n=598). Total males and females were divided into 3 groups according to the high-sensitivity C-reactive protein (hs-CRP) level to study its relationship to metabolic syndrome and its components, including odds ratio (OR) and confidence interval (CI). Results showed the homeostasis model assessment of insulin resistance (HOMA-IR) value was higher in the metabolic syndrome group (3.37) than non-metabolic syndrome group (1.57) (p<0.001). In the Index of Nutrition Quality, males in the non-metabolic syndrome group showed higher niacin (p<0.05) than males in metabolic syndrome group. Females in the non-metabolic syndrome group had higher vitamin $B_1$ (p<0.01), vitamin $B_2$ (p<0.001), niacin (p<0.05), calcium (p<0.001), and phosphate (p<0.01). Female in the high hs-CRP group showed high OR in blood glucose component (OR 2.488, 95% CI: 1.269~4.879) and metabolic syndrome risk (OR 2.856, 95% CI: 1.292~6.314). Females in the middle hs-CRP group had high triglycerides component (OR 2.956, 95% CI: 1.920~4.551), compared to the low hs-CRP group. The study showed females with higher hs-CRP had a higher risk of metabolic syndrome.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.210-228
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• 2002

Background: The purpose of this research was to examine the fall incidence rate and its related factors of fall in inpatients. Methods: The data were collected from the 138 fall incident reports in one tertiary hospital in Seoul from April 1st 1999 to September 30th 2001. The Fall Incident Report Form was originally developed based on that of Massachusetts General Hospital revised in 1995. And this was modified for this survey by the collaborating work of QI team including researcher and department of nursing service of this particular hospital. The contents of Fall Incident Form were general characteristics of patient. factors related to fall. types and places of fall. circumstances, nursing interventions. and outcome. Results: 1) The incidence rate of fall was 0.08% of total discharged patients and 0.081 per 1000 patient-day. This incidence rate is much lower than that of several hospitals in USA. This finding might result from the different incidence report system of each hospital. 2) The characteristics of fall-prone patient were found as follows. They were mostly over 60 years old, in alert mental status, ambulatory with some assistance, and dependent on ambulatory device. The types of diseases related high incidence rate were cerebrovascular disease(3.2), hypertension(1.6), cardiovascular disease(1.4), diabetes(1.3) and liver disease(0.6). 3) The majority of fall events usually occurred m bed. bedside(walking or standing) and bathroom in patient room. Usually they were up on their own when they fell. And there were more falls of elderly occurred during night time than day or evening. 4) 63.8% of fall events resulted in physical injuries such as fracture and usually the patients had diagnostic procedures and some treatment(ex. suture) which caused additional cost to the patients and their families. 5) The found risk factors of fall were drugs(antihypertensive drug, diuretics) and environmental factors like too high bed height, long distance of bedside table and lamp switch, and slippery tile of bathroom floor. Conclusion: Considering these results, every medical and nursing staff should be aware of the risk factors of patients in hospital, and should intervene more actively the preventive managements, specially for the elderly patients during night. Therefore, it is recommended that the development of Fall Prevention Programs based on these results.

• Journal of Chest Surgery
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• v.39 no.6 s.263
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• pp.449-455
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• 2006

Background: Female sex was known to be a risk factor for mortality after coronary bypass grafting (CABG), and women showed higher in-hospital mortality than men. Material and Method: Between 1992 and 1996, 147 consecutive patients (98 men and 49 women) undergoing CABG were included in the study. Most patients had undergone CABG with left internal thoracic artery and saphenous vein under cardiopulmonary bypass. We examined the influence of gender on survival after CABG and looked for risk factors for survival. Result: There was no in-hospital mortality in women, but 3 death (3.0%) in men. During the mean follow-up period of $138.5{\pm}23.0$ months, mortality was lower in women than in men (20.4% vs 44.9%, p=0.004), and the most common cause of death in women was chronic renal failure (40%). Survival in women at 1, 5, 10, and f4 years was 100%, $98.0{\pm}2.0%,\;81.2{\pm}5.6%,\;and\;78.4{\pm}6.1%$, respectively, which was better than in men (p=0.004). Although preoperative left ventricular ejection fraction was higher in women than in men, this did not affect early and long-term survival difference between two sexes (p=0.15). Risk factor for long-term survival in women was diabetes (p=0.033) and in men number of diseased coronary artery (p=0.006). Conclusion: Long-term survival after CABG was better in women than men. Risk factor for long-term survival in women was morbid disease rather than cardiac disease.

• Journal of Chest Surgery
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• v.43 no.6
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• pp.642-647
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• 2010

Background: It is very important to obtain vascular access that resists repeated punctures and maintains an adequate blood flow for performing hemodialysis in patients with ESRD. This study was designed to identify the risk factors that may influence the patency rate of arteriovenous fistula (AVF) using perforating vein on antecubital fossa. Material and Method: We analyzed 205 cases of AVF in 195 patients who underwent hemodialysis access surgery on antecubital fossa in our hospital from May 2006 to December 2009. Result: The patency rate of AVF from 6 months after surgery using perforating vein was 75.91%. The risk factors that influence the patency rate was age. There was no statistic difference between used vessels. Conclusion: The patency of the AVF using perforating vein on antecubital fossa was comparable. The condition of sex and location and presence or absence of diabetes and hypertension and other cardio-neurovascular disease did not make statistically significant effect on the AVF patency rate. The age was an independent risk factor for patency rate.

• The Journal of the Society of Stroke on Korean Medicine
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• v.6 no.1
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• pp.17-23
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• 2005

1. Purpose : The purpose of this study was done to compare the sex, past history, hematologic relationship between the Cerebral infarction patients and the Cerebral hemorrhage patients. 2. Methods : We selected the two study groups. The one is 20 Cerebral infarction patients and the other 20 Cerebral hemorrhage patients with confirmed by Brain CT or MRI. We made an investigation into past history. We examined and made a comparative study of CBC, LFT, Na, K, Cl in the both group. 3. Result & Conclusion : In the Cerebral hemorrhage group, there were many patients with Hypertension and Diabetes mellitus than the Cerebral infarction group. In the Cerebral infarction group, there were many patients with abnormal RBC count with no significant. Also, ESR is higher than the other group. Between the Cerebral infarction and the other group, we discovered significant cases with abnormal triglyceride, ALP in the Cerebral infarction group(p<0.05). Abnormal triglyceride is known one of important risk factor of Cerebral infarction, but this study was significant in the Cerebral hemorrhage group. Also, ALP was significant in the Cerebral hemorrhage group. Therefore more extensive research is needed.

• Journal of Korean Neurosurgical Society
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• v.63 no.4
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• pp.504-512
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• 2020

Objective : An important factor during pituitary adenoma surgery is to preserve pituitary stalk (PS) as this plays a role in reduction of the risk of postoperative diabetes insipidus. The hypothalamic-hypophyseal tract (HHT) projects through the PS to the posterior pituitary gland. To reconstruct white matter fiber pathways, methods like diffusion tensor imaging (DTI) tractography have been widely used. In this report we attempted to predict the position of PS using DTI tractography and to assess its intraoperative correlation during surgery of pituitary adenomas. Methods : DTI tractography was used to tract the HHT in nine patients before craniotomy for pituitary adenomas. The DTI location of the HHT was compared with the PS position identified at the time of surgery. DTI fiber tracking was carried out in nine patients prior to the planned craniotomy for pituitary adenomas. In one patient, the PS could not be identified during the surgery. In the other eight patients, a comparison was made between the location of the HHT identified by DTI and the position of the PS visualized at the time of surgery. Results : The position of the HHT identified by DTI showed consistency with the intraoperative position of the PS in seven patients (88.9% concordance). Conclusion : This study shows that DTI can identify the position of the HHT and thus the position of the PS with a high degree of reliability.

• Journal of Nutrition and Health
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• v.35 no.10
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• pp.1060-1069
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• 2002

High insulin level is known to be a risk factor of coronary heart disease. High insulin level with normal glycemic control is known to be an indicator for insulin resistance. This study was aimed to find out the influencing factors for the fasting serum insulin levels in elderly females with normal glycemic control. One hundred thirty-eight older females aged over 60 years without diabetes medication and high blood HBA1c level were examined on the serum fasting insulin concentration, anthropometry and asked about nutrient intake and exercise habits. The elderly were categorized into 3 group according to the fasting insulin level. The high insulin group was in a state of hyperinsulinemia. Except vitamin C, the nutrient intakes showed no difference according to fasting serum insulin level. But the intakes of calorie and protein per kg body weight were significantly lower in the high insulin group. The intakes of most nutrients except vitamin B$_1$, C and niacin were lower than the korean RDA in all the insulin group. Especially, the intakes of vitamin B$_1$ and Ca were below 75% of the korean RDA. Weight, BMI, body fat percent, body fat mass and fat-free mass, circumferences of waist and hip, WHR of elderly females were significantly higher in the group with the highest insulin level. The body fat percent in the highest insulin group was 35.8%. showing a state of obesity. The high insulin group showed higher proportion of low exercise frequencies per week and short exercise duration. Therefore, the mean energy expenditure for exercise were lower in this group, showing a state of very low exercise activity. Age and waist circumference in elderly females could explain to the 14.5% variances of the fasting insulin level according to multiple stepwise regression. It can be concluded that aging and central body fat deposition influence independently the serum fasting insulin level in elderly females with normal glucose level.