• Title/Summary/Keyword: severity score

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Epidemiological Multi-center Study of Blast Injury in Military Centers (군내 폭발손상환자 현황에 대한 다기관연구)

  • Kim, Won Young;Choi, Wook Jin;Lee, Jong Ho;Park, Ha Young;Kim, Dong Ook
    • Journal of Trauma and Injury
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    • v.21 no.2
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    • pp.78-84
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    • 2008
  • Purpose: Recently, the incidence of blast injury has been on the increase worldwide. The purpose of this study was to evaluate and analyze blast injuries in South Korea. Methods: This was a retrospective multi-center study of blast injuries in three tertiary military centers. The medical records of patients with blast injuries from January 2003 to December 2007 were reviewed. The injury severity was evaluated according to the Injury Severity Score (ISS), the Revised Trauma Score (RTS), and the Trauma Score and the Injury Severity Score (TRISS). Results: This study revealed epidemiological data of blast injury in the three tertiary military hospital. A total of 94 cases of blast injury had occurred. Various body regions were involved. The most frequently injured site was the upper extremity (52.1%). The mechanisms for the blast injuries were primary (41.5%), secondary (74.5%), tertiary (7.4%), and quaternary (29.8%). The mean injury-to-hospital arrival time was $3.2{\pm}1.7hour$. The rate of admission was 88.3%, and the rate of ICU admission was 32.5%. Thirty-six (36) cases required an emergency operation. Most were performed by an Orthopedist (55.6%), an Ophthalmologist (19.4%), or a general surgeon (13.9%). The mortality rate from blast injury was 4.3%. Conclusion: This was the first paper to present data on the type of injury, the site of injury, the cause of death, and the mortality from blast injury in South Korea. Chest injury, brain injury, tertiary injury mechanisms, $ISS{\geq_-}16$, and a Maximal Abbreviated Injury Scale Score $(ABI){\geq_-}4$ were significantly associated with death.

Development of a Risk Assessment Tool for Emerging Infectious Diseases (신종감염병의 양적 및 질적 혼합 위험 평가 모델 개발)

  • Woo, Darae;Choi, Eunmi;Choe, Young June;Yeh, Jungyong;Park, Sangshin
    • Health Policy and Management
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    • v.32 no.4
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    • pp.356-367
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    • 2022
  • Background: The emergence of new infectious diseases threatens public health, increasing socioeconomic damage, and national risks. This study aimed to develop an evidence-based risk assessment tool to quickly respond to new infectious diseases. Methods: The risk elements were extracted by reviewing the risk assessment methods of the World Health Organization, United States, Europe, United Kingdom, and Germany, and the validity and priority of elements were determined through expert meetings and Delphi surveys. Then, the scale and level for each risk element were defined and a final score calculation method according to the risk evaluation result was derived. The developed risk assessment tool was verified using data at the time of domestic transmission of an emerging infectious disease. Results: In case of spread of actual infectious diseases, priority is determined based on the criticality of the elements in each area of transmissibility and severity, from which the weighted score of the risk assessment is derived. Then, the risk score for each element was calculated by multiplying the average value of the risk evaluation by its weight and the evaluation risk assessment score for the two areas was calculated. At last, the final score is plotted in a matrix where the x-axis indicates the transmissibility and the y-axis the severity and plotted on the coordinate plane for time series use. Conclusion: With respect to transmissibility and severity, this risk assessment method to respond to new and re-emerging infectious diseases enables rapid and evidence-based evaluation by quantitatively and qualitatively assessing various risk elements.

CT Quantitative Analysis and Its Relationship with Clinical Features for Assessing the Severity of Patients with COVID-19

  • Dong Sun;Xiang Li;Dajing Guo;Lan Wu;Ting Chen;Zheng Fang;Linli Chen;Wenbing Zeng;Ran Yang
    • Korean Journal of Radiology
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    • v.21 no.7
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    • pp.859-868
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    • 2020
  • Objective: To investigate the value of initial CT quantitative analysis of ground-glass opacity (GGO), consolidation, and total lesion volume and its relationship with clinical features for assessing the severity of coronavirus disease 2019 (COVID-19). Materials and Methods: A total of 84 patients with COVID-19 were retrospectively reviewed from January 23, 2020 to February 19, 2020. Patients were divided into two groups: severe group (n = 23) and non-severe group (n = 61). Clinical symptoms, laboratory data, and CT findings on admission were analyzed. CT quantitative parameters, including GGO, consolidation, total lesion score, percentage GGO, and percentage consolidation (both relative to total lesion volume) were calculated. Relationships between the CT findings and laboratory data were estimated. Finally, a discrimination model was established to assess the severity of COVID-19. Results: Patients in the severe group had higher baseline neutrophil percentage, increased high-sensitivity C-reactive protein (hs-CRP) and procalcitonin levels, and lower baseline lymphocyte count and lymphocyte percentage (p < 0.001). The severe group also had higher GGO score (p < 0.001), consolidation score (p < 0.001), total lesion score (p < 0.001), and percentage consolidation (p = 0.002), but had a lower percentage GGO (p = 0.008). These CT quantitative parameters were significantly correlated with laboratory inflammatory marker levels, including neutrophil percentage, lymphocyte count, lymphocyte percentage, hs-CRP level, and procalcitonin level (p < 0.05). The total lesion score demonstrated the best performance when the data cut-off was 8.2%. Furthermore, the area under the curve, sensitivity, and specificity were 93.8% (confidence interval [CI]: 86.8-100%), 91.3% (CI: 69.6-100%), and 91.8% (CI: 23.0-98.4%), respectively. Conclusion: CT quantitative parameters showed strong correlations with laboratory inflammatory markers, suggesting that CT quantitative analysis might be an effective and important method for assessing the severity of COVID-19, and may provide additional guidance for planning clinical treatment strategies.

The Severity of the Pediatric Patients admitted at NICU using Therapeutic Intervention Scoring System (환자분류체계를 이용한 NICU 입원 환아의 중증도)

  • Kim, Moon-Sil;Moon, Sun-Young;Lee, Kyoung-Sook;Jeong, Yu-Kyoung;Kim, Shin-Jeong
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.5-15
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    • 2002
  • This study was attempted to help in explore new direction about classification of the severity of the pediatric patients admitted at NICU. Data were collected from 230 patients who admitted at Neonatal Intensive Care Unit of 3 University hospitals and 1 General hospital during 7 months period from september 1, 2000 to April 30, 2001. The results were as follows: 1. The degree of severity of the pediatric patients admitted at NICU shown ranged 1-102 and averaged 17.7. 2. With the respect to the severity of the pediatric patients admitted at NICU, there were statistically significant relation in passing day(s) to admission(r=-.153, p=.020), hospital day(s)(r-.501, p=.000), gestational age(r=-.354, p=.000), birth weight(r=-.280, p=.000), Apgar score at 1 min and at 5 min(4=-.340, p=.000; r=-.322, p=.000), present body weight(r=-.151, p=.023). 3. The severity of the pediatric patients according to general characteristics, there were significant difference in admitting day of the patients(t=2.339, p=.020), Apgar score at 1min and 5min(F=7.893, p=.000; t=3.568, p=.001).

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The effect of Chiljehyangbuhwan on the abdominal temperature in the primary dysmenorrhea patients (칠제향부환(七製香附丸)이 원발성(原發性) 월경통(月經痛) 환자(患者)의 복부(腹部) 온도(溫度)에 미치는 영향(影響))

  • Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Kyung-Sub;Yoon, Young-Jin
    • Journal of Oriental Medical Thermology
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    • v.4 no.1
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    • pp.29-38
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    • 2005
  • Purpose: We intended to observe the relations between Chiljehyangbuhwan and abdominal temperature according to primary dysmenorrhea severity. Methods: We selected the 100 primary dysmenorrhea patients by the screening tests (first screening test-inquiry, second screening test-clinical test, additionally WHR (Waist-to-Hip ratio) by Inbody 2.0). By the fixed blocked randomization and double blind method, Chiljehyangbuhwan or placebo was administered for 1 menstration period. Finally, 69 patients remainded. Before and after administration, we measured 4 points abdominal temperature (Chon-jung(CV17), Chung-wan(CV12), Kwan-won(CV4), Chung-guk(CV3)) by DITI (DOREX Inc., USA). And then we checked the difference of temperature $({\Delta}T)$ between CV17 and CV12 / CV17 and CV4 / CV17 and CV3 / CV12 and CV4 / CV12 and CV3. After that, we compared ${\Delta}T$ with primary dysmenorrhea severity evaluated by VRS (verbal rating scale) and MVRS (multidimensional verbal rating scale). In dysmenorrhea severity, we standardized scale score and 3-group-severity by score (mild, moderate, severe). For statistics, we used Pearson correlations and Spearman's rho correlations, SPSS 11.0 for windows. Results: In case of MVRS, Chiljehyangbuhwan was correlated to ${\Delta}T$ (CV12 and CV3 / CV12 and CV4). In case of VRS, Chiljehyangbuhwan was not correlated to ${\Delta}T$. Statistically they showed significant result (p<0.05). Conclusion: The primary dysmenorrhea patients showed that severity by MVRS was connected with ${\Delta}T$ (CV12 and CV3 / CV12 and CV4) after Chiljehyangbuhwan administration. So we can consider Chiljehyangbuhwan effects the abdominal temperature according primary dysmenorrhea severity.

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Performance Evaluation of Emergency Medical Center (응급의료센터 성과 평가 기준개발과 적용)

  • Kang, Chul-Hwan;Kim, Yoon;Lee, Pyung-Soo;Kwon, Young-Dae;Kim, Chang-Yup;Shin, Young-Soo
    • Journal of Preventive Medicine and Public Health
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    • v.30 no.4 s.59
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    • pp.884-892
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    • 1997
  • Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate perforance of emergency centers, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.

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The Study of the Severity and Prognosis in Severe Traumatic Patients according to Alcohol Ingestion (중증외상환자에서 알코올 섭취에 따른 중증도와 예후에 대한 연구)

  • Jung, Ho Hyung;Han, Sang Kyoon;Lee, Sung Wha;Park, Sung Wook;Park, Soon Chang;Yeom, Seok Ran;Min, Moon Gi;Kim, Yong In;Ryu, Ji Ho
    • Journal of Trauma and Injury
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    • v.27 no.4
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    • pp.108-114
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    • 2014
  • Purpose: Alcohol ingestion is a significant risk factor for injuries. However, the influence of high blood alcohol concentration about the severe traumatic injury is controversial. The aim of study was to analyze the injury severity, prognosis in severe traumatic patients according to alcohol ingestion. Methods: This study was performed retrospectively with severe traumatic patients (Injury Severity $Score{\geq}16$) who visited the emergency department at Pusan National University Hospital from January 2013 to December 2013. Results: In total 98 severe traumatic patients, blood alcohol concentration (BAC) positive group (BAC>30 mg/dl) is 42 (42.90%) patients and BAC negative group ($BAC{\leq}30mg/dl$) is 56 (57.10% )patients. Head and neck injury is significantly high in BAC positive group (35 patients, 83.3%) compared to BAC negative group (33 patients, 58.9%). Comparison of injury severity, outcome and mortality is not significantly different between two groups. Conclusion: In severe traumatic patients, head and neck injury occurred high in BAC positive group. Alcohol ingestion did not influence injury severity, outcome in severe traumatic patients. However, effort to decreasing injury related to alcohol ingestion and prospective multi-center study is needed.

Effects of Trunk Stability Exercise and Hip Exercise on Lumbar Range of Motion, VAS, Disability Chronic Low Back Pain Patients (체간 안정화 운동과 고관절 운동이 만성 요통 환자의 허리가동범위, 통증, 장애정도에 미치는 영향)

  • Park, Chan-ho;Yang, Yeong-sik;Jeong, Yong-sik
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.28 no.2
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    • pp.45-55
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    • 2022
  • Background: This study compared the effects of trunk stabilization exercise and hip joint exercises on the range of motion of the lumbar spine, pain severity, and severity of disability in patients with chronic lower back pain. Methods: A total of 30 participants were enrolled and divided into group 1 (n=10), group 2 (n=10), and group 3 (n=10) were performed by each group thrice a week for a total of 8 weeks. Group 1 performed warm-up exercise (15 min), trunk stabilization exercise (25 min), finish-up exercise (15mins). Group 2 performed warm-up exercise (15 min), hip exercise (25 mins, finish-up exercise (15mins). Group 3 warm-up exercise (15 min), trunk stabilization and hip exercise (25 min), Finish-up exercise (15 min). Participants were assessed for the range of motion of the lumbar spine, pain severity (visual analog scale score; VAS), and severity of disability (Oswestry disability index score; ODI) before and after the interventions. Results: All three groups showed a significant increase in the range of motion of the lumbar spine, but there was no significant difference among the groups. Moreover, the severity of pain and ODI were significantly decreased in all groups; however, the intergroup differences were non-significant. Conclusion: The results from this study confirmed the effectiveness of trunk stabilization and hip joint exercise in improving the lumbar range of motion, pain severity, and chronic lower back pain in patients. Thus, trunk and pelvic stabilization exercises and hip joint exercise can be used as clinical practices to treat and prevent chronic lower back pain.

Is it Meaningful to Use the Serum Cholinesterase Level as a Predictive Value in Acute Organophosphate Poisoning? (혈청 콜린에스테라제 활성도를 이용하여 유기인계 농약 음독 환자의 증증도를 예측할 수 있는가?)

  • Lee, Sang-Jin;Jung, Jin-Hee;Jung, Koo-Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.2 no.2
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    • pp.72-76
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    • 2004
  • Purpose: Dealing patients with organophosphate poisoning, cholinesterase level has been used as a diagnostic and prognostic value. But there are some controversies that the cholinesterase level is significantly related to the severity or prognosis of acute organophosphate poisoning. We evaluated the correlation between initial serum level of cholinesterase and APACHE II score as an index for severity, and we assessed cholinesterase levels for predicting value of weaning from mechanical ventilation. Method: From August 1996 to March 2003, 23 patients with organophosphate poisoning who needed ventilatory care were enrolled. Retrospective review was done for the serum level of cholinesterase, APACHE II score, and the duration of ventilatory care. The percentage of measured serum cholinesterase to median normal value was used to standardize cholinesterase levels from different laboratories. Result: There were tendencies that the lower initial serum of cholinesterase, the higher the APACHE II score (r=0.297) and the longer the duration of mechanical ventilation (r=-0.204), but they were not significant (p=0.264 and p=0.351 respectively). In 9 patients whose serum cholinesterase level were checked at the time of weaning, mean of measured cholinesterase level was $10.3\pm7.60\%$ of normal value. Conclusion: There was no significant relationship between initial level of serum cholinesterase and severity or duration of mechanical ventilation. General health status of patient, amount of ingestion, toxicity of agent should be considered as important factors for severity of poisoning. And the decision of weaning should be based not solely on the cholinesterase level but on the consideration of general and respiratory state of individual patients.

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A Clinical Study on Atopic Dermatitis (아토피 피부염에 대한 임상적 연구)

  • 남봉수;조재훈;김윤범;채병윤
    • The Journal of Korean Medicine
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    • v.21 no.4
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    • pp.204-215
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    • 2000
  • Objectives: This study was conducted to establish the study form of atopic dermatitis in oriental medicine, to find out the effect of herbal medicine and to compare Bangpungtongsungsan group with symptom-complexes prescription group. Methods: We gave scores(1-3) to the 37 outpatients who visited the dept. of Ophthalmotolaryngology & Dermatosurgery of the Kyunghee Oriental Medical Center from June 1,2000 to September 30, 2000. According to transformed the G. Rajka, T. Langeland and Jon M. Hanifin standard. We checked the Eosinophil count, IgE and the scores (intensity: the degree of itching, course: the degree of itching during a year, extent: erythema, lichenification, scaling. dryness, erosion' oozing). After herbal treatment for 6 weeks, we checked the above factors again in the same way. In treatment, we divided the patients into Bangpungtongsungsan group and Symptom-complexes group for cross-comparison. Results: There were 19 patients we could check by score and 14 patients by laboratory. 1. In the 14 lab cases, the number of abnormal value of Eosinophil count and IgE was decreased but it was not significant. 2. In the 19 cases by score, clinical severity of the intensity of itching, lichenification, scaling' dryness was significantly decreased between the before- and after-herbal treatment periods (P<0.01, P<0.01, P<0.05). 3. In 19 cases, clinical severity of erythema, erosion. oozing was decreased after herbal treatment but it was not significant(p>0.05). 4. In point of total score, clinical severity of atopic dermatitis was significantly decreased after herbal treatment(p<0.01). 5. There was no significant difference between Bangpungtongsungsan group and Symptom-complexes group(P<0.05). Conclusions: Although more study is needed, these results indicate that herbal treatment is effective on atopic dermatitis.

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