Journal of Preventive Medicine and Public Health

Original Article

COVID-19 Vaccination and Clinical Outcomes at a Secondary Referral Hospital During the Delta Variant-dominant Period in West Sumatra, Indonesia: Didan Ariadapa Rahadi, Elfira Yusri, Syandrez Prima Putra, Rima Semiarty, Dian Pertiwi, Cimi Ilmiawati; J Prev Med Public Health. 2023;56(3):221-230. Published online May 31, 2023; DOI: https://doi.org/10.3961/jpmph.23.077

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Objectives
The second wave of coronavirus disease 2019 (COVID-19) cases in Indonesia, during which the Delta variant predominated, took place after a vaccination program had been initiated in the country. This study was conducted to assess the impact of COVID-19 vaccination on unfavorable clinical outcomes including hospitalization, severe COVID-19, intensive care unit (ICU) admission, and death using a real-world model.
Methods
This single-center retrospective cohort study involved patients with COVID-19 aged ≥18 years who presented to the COVID-19 emergency room at a secondary referral teaching hospital between June 1, 2021 and August 31, 2021. We used a binary logistic regression model to assess the effect of COVID-19 vaccination on unfavorable clinical outcomes, with age, sex, and comorbidities as confounding variables.
Results
A total of 716 patients were included, 32.1% of whom were vaccinated. The elderly participants (≥65 years) had the lowest vaccine coverage among age groups. Vaccination had an effectiveness of 50% (95% confidence interval [CI], 25 to 66) for preventing hospitalization, 97% (95% CI, 77 to 99) for preventing severe COVID-19, 95% (95% CI, 56 to 99) for preventing ICU admission, and 90% (95% CI, 22 to 99) for preventing death. Interestingly, patients with type 2 diabetes had a 2-fold to 4-fold elevated risk of unfavorable outcomes.
Conclusions
Among adults, COVID-19 vaccination has a moderate preventive impact on hospitalization but a high preventive impact on severe COVID-19, ICU admission, and death. The authors suggest that relevant parties increase COVID-19 vaccination coverage, especially in the elderly population.

Summary

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Changes in the intrinsic severity of severe acute respiratory syndrome coronavirus 2 according to the emerging variant: a nationwide study from February 2020 to June 2022, including comparison with vaccinated populations
Boyeong Ryu, Eunjeong Shin, Dong Hwi Kim, HyunJu Lee, So Young Choi, Seong-Sun Kim, Il-Hwan Kim, Eun-Jin Kim, Sangwon Lee, Jaehyun Jeon, Donghyok Kwon, Sungil Cho
BMC Infectious Diseases.2024;[Epub] CrossRef

Special Article

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD): A Korean Chronic Kidney Disease Cohort: Kook-Hwan Oh, Sue K. Park, Jayoun Kim, Curie Ahn; J Prev Med Public Health. 2022;55(4):313-320. Published online July 1, 2022; DOI: https://doi.org/10.3961/jpmph.22.031

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Abstract Summary PDF Supplementary Material

The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) was launched in 2011 with the support of the Korea Disease Control and Prevention Agency. The study was designed with the aim of exploring the various clinical features and characteristics of chronic kidney disease (CKD) in Koreans, and elucidating the risk factors for CKD progression and adverse outcomes of CKD. For the cohort study, nephrologists at 9 tertiary university-affiliated hospitals participated in patient recruitment and follow-up. Biostatisticians and epidemiologists also participated in the basic design and structuring of the study. From 2011 until 2016, the KNOW-CKD Phase I recruited 2238 adult patients with CKD from stages G1 to G5, who were not receiving renal replacement therapy. The KNOW-CKD Phase II recruitment was started in 2019, with an enrollment target of 1500 subjects, focused on diabetic nephropathy and hypertensive kidney diseases in patients with reduced kidney function who are presumed to be at a higher risk of adverse outcomes. As of 2021, the KNOW-CKD investigators have published articles in the fields of socioeconomics, quality of life, nutrition, physical activity, renal progression, cardiovascular disease and outcomes, anemia, mineral bone disease, serum and urine biomarkers, and international and inter-ethnic comparisons. The KNOW-CKD researchers will elaborate a prediction model for various outcomes of CKD such as the development of end-stage kidney disease, major adverse cardiovascular events, and death.

Summary

Korean summary
KNOW-CKD 코호트 연구는 전국적 규모의 다기관 만성콩팥병 장기 추적 코호트 연구로서 2011년 질병관리청의 후원으로 시작된 연구이다. 이 연구는 우리나라 만성콩팥병의 임상적인 경과와 합병증, 신기능 악화 정도와 심혈관계 사건, 사망 등 주요 사건의 발생 위험 요인들을 규명하고자 기획되었다. 궁극적으로 KNOW-CKD 연구는 말기신부전으로의 진행과 사망, 심혈관계 주요 사건 등 만성콩팥병의 예후 예측 모델을 구축하는 것을 목표로 한다.

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Kidney Health Plan 2033 in Korea: bridging the gap between the present and the future
Do Hyoung Kim, Young Youl Hyun, Jin Joo Cha, Sua Lee, Hyun Kyung Lee, Jong Wook Choi, Su-Hyun Kim, Sang Youb Han, Cheol Whee Park, Eun Young Lee, Dae Ryong Cha, Sung Gyun Kim, Chun Soo Lim, Sun-Hee Park
Kidney Research and Clinical Practice.2024; 43(1): 8. CrossRef
Associations between Chronic Kidney Disease and Migraine Incidence: Findings from a Korean Longitudinal Big Data Study
Mi Jung Kwon, Jwa-Kyung Kim, Min-Jeong Kim, Dae Myoung Yoo, Na-Eun Lee, Kyeong Min Han, Nan Young Kim, Ho Suk Kang, Hyo Geun Choi, Eun Soo Kim
Journal of Personalized Medicine.2024; 14(4): 356. CrossRef
Characteristics of Patients with Heart Failure and Advanced Chronic Kidney Disease (Stages 4–5) Not Undergoing Renal Replacement Therapy (ERCA-IC Study)
Sandra Valdivielso Moré, Miren Vicente Elcano, Anna García Alonso, Sergi Pascual Sanchez, Isabel Galceran Herrera, Francesc Barbosa Puig, Laia C. Belarte-Tornero, Sonia Ruiz-Bustillo, Ronald O. Morales Murillo, Clara Barrios, Joan Vime-Jubany, Nuria Farre
Journal of Clinical Medicine.2023; 12(6): 2339. CrossRef

Original Article

Construction of the Mobility to Participation Assessment Scale for Stroke (MPASS) and Testing Its Validity and Reliability in Persons With Stroke in Thailand: Jiraphat Nawarat, Kanda Chaipinyo; J Prev Med Public Health. 2022;55(4):334-341. Published online June 13, 2022; DOI: https://doi.org/10.3961/jpmph.21.605

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Abstract PDF: Objectives
This study was conducted to develop the Mobility to Participation Assessment Scale for Stroke (MPASS) and assess its content validity, internal consistency, inter-rater and intra-rater reliability, and convergent validity in people with stroke living in the community.
Methods
The MPASS was developed using published data on mobility-related activity and participation timing in elderly individuals, and then reviewed by community physical therapists. Content validity was established by reaching a consensus of experienced physical therapists in a focus group. The MPASS was scored for 32 participants with stroke (mean age 61.75±4.92 years) by 3 individual testers. Reliability was examined using the intraclass correlation coefficient (ICC), internal consistency using the Cronbach alpha coefficient (α), and convergent validity using the Pearson correlation coefficient (r) to compare the MPASS to the Modified Rivermead Mobility Index as a referent test of mobility.
Results
The MPASS consists of 8 items, and its scoring system provides information on the ability of people with stroke to reach a movement level enabling them to live in society, including interactions with other people and safe living in the community. The inter-rater and intra-rater reliability were excellent (ICC, 0.948; 95% confidence interval [CI], 0.893 to 0.982 and ICC, 0.967; 95% CI, 0.933 to 0.989, respectively). Internal consistency was good (α=0.877). The convergent validity was moderate (r=0.646; p<0.001).
Conclusions
The newly developed MPASS showed acceptable construct validity and high reliability. The MPASS is suitable for use in people with stroke, especially those who have been discharged and live in the community with the ability to initiate sitting.; Summary

Special Article

Cohort Profile: Korean Tuberculosis and Post-Tuberculosis Cohort Constructed by Linking the Korean National Tuberculosis Surveillance System and National Health Information Database: Dawoon Jeong, Hee-Yeon Kang, Jinsun Kim, Hyewon Lee, Bit-Na Yoo, Hee-Sun Kim, Hongjo Choi; J Prev Med Public Health. 2022;55(3):253-262. Published online April 22, 2022; DOI: https://doi.org/10.3961/jpmph.21.635

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We aimed to review the current data composition of the Korean Tuberculosis and Post-Tuberculosis Cohort, which was constructed by linking the Korean Tuberculosis Surveillance System (KNTSS; established and operated by the Korean Disease Control and Prevention Agency since 2000) and the National Health Information Database (NHID; established by the National Health Insurance Service in 2012). The following data were linked: KNTSS data pertaining to patients diagnosed with tuberculosis between 2011 and 2018, NHID data of patients with a history of tuberculosis and related diseases between 2006 and 2018, and data (obtained from the Statistics Korea database) on causes of death. Data from 300 117 tuberculosis patients (177 206 men and 122 911 women) were linked. The rate of treatment success for new cases was highest in 2015 (86.7%), with a gradual decrease thereafter. The treatment success rate for previously treated cases showed an increasing trend until 2014 (79.0%) and decreased thereafter. In total, 53 906 deaths were confirmed among tuberculosis patients included in the cohort. The Korean Tuberculosis and Post-Tuberculosis Cohort can be used to analyze different measurement variables in an integrated manner depending on the data source. Therefore, these cohort data can be used in future epidemiological studies and research on policy-effect analysis, treatment outcome analysis, and health-related behaviors such as treatment discontinuation.

Summary

Korean summary
TB Post 코호트(Korean Tuberculosis and Post-Tuberculosis Cohort)는 한국의 결핵 모니터링 및 관리에 대한 인구집단 수준에서의 새로운 근거를 마련하고자 구축한 우리나라 결핵 환자 코호트입니다. 국가 결핵감시체계의 일환으로 구축된 질병관리청의 결핵신고자료와 국민건강보험공단의 국민건강정보DB 자료, 통계청 사망원인 자료의 연계로 구축되었으며, 각 자료원이 보유한 정보를 활용하여 통합적인 결핵 환자 연구가 가능할 것으로 기대하고 있습니다. 결핵의 정책 효과 연구뿐만 아니라, 치료 성공, 실패, 중단 등 치료결과에 대한 영향 요인 및 환자들의 건강 관련 행태에 대한 역학 연구 등 향후 다양한 연구에 활용될 수 있을 것으로 기대됩니다.

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A Quasi-experimental Study on the Effect of Pre-entry Tuberculosis Screening for Immigrants on Treatment Outcomes in South Korea: A Difference-in-Differences Analysis
Sarah Yu, Dawoon Jeong, Hee-Yeon Kang, Young Ae Kang, Gyeong In Lee, Hongjo Choi
Journal of Epidemiology and Global Health.2024;[Epub] CrossRef
Relationship between metformin use and mortality in tuberculosis patients with diabetes: a nationwide cohort study
Eunki Chung, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Heejin Kim, Heesun Kim, Hongjo Choi, Young Ae Kang
The Korean Journal of Internal Medicine.2024; 39(2): 306. CrossRef
Sex differences in the impact of diabetes mellitus on tuberculosis recurrence: a retrospective national cohort study
Dararat Eksombatchai, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang
International Journal of Infectious Diseases.2023; 127: 1. CrossRef
Nationwide Treatment Outcomes of Patients With Multidrug/Rifampin-Resistant Tuberculosis in Korea, 2011–2017: A Retrospective Cohort Study (Korean TB-POST)
Hongjo Choi, Jeongha Mok, Young Ae Kang, Dawoon Jeong, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Doosoo Jeon
Journal of Korean Medical Science.2023;[Epub] CrossRef
Prevalence and associated factors of diabetes mellitus among patients with tuberculosis in South Korea from 2011 to 2018: a nationwide cohort study
Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeong Mi Seo, Hongjo Choi, Young Ae Kang
BMJ Open.2023; 13(3): e069642. CrossRef
Impact of Anti-Tuberculosis Drug Use on Treatment Outcomes in Patients with Pulmonary Fluoroquinolone-Resistant Multidrug-Resistant Tuberculosis: A Nationwide Retrospective Cohort Study with Propensity Score Matching
Hongjo Choi, Dawoon Jeong, Young Ae Kang, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Jeongha Mok
Tuberculosis and Respiratory Diseases.2023; 86(3): 234. CrossRef
Retreatment after loss to follow-up reduces mortality in patients with multidrug/rifampicin-resistant tuberculosis
Hongjo Choi, Jeongha Mok, Young Ae Kang, Dawoon Jeong, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Doosoo Jeon
ERJ Open Research.2023; 9(4): 00135-2023. CrossRef
Association between diabetes mellitus and cause of death in patients with tuberculosis: A Korean nationwide cohort study
Se Hyun Kwak, Dawoon Jeong, Jeongha Mok, Doosoo Jeon, Hee-Yeon Kang, Hee Jin Kim, Hee-Sun Kim, Hongjo Choi, Young Ae Kang, Frederick Quinn
PLOS ONE.2023; 18(12): e0295556. CrossRef

Original Articles

Adverse Birth Outcomes Among Pregnant Women With and Without COVID-19: A Comparative Study From Bangladesh: Sumaya Binte Masud, Faiza Zebeen, Dil Ware Alam, Mosharap Hossian, Sanjana Zaman, Rowshan Ara Begum, Mohammad Hayatun Nabi, Mohammad Delwer Hossain Hawlader; J Prev Med Public Health. 2021;54(6):422-430. Published online October 21, 2021; DOI: https://doi.org/10.3961/jpmph.21.432

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Abstract PDF

Objectives
Pregnant women are especially vulnerable to respiratory infections such as coronavirus disease 2019 (COVID-19), but insufficient research has investigated pregnancy and its outcomes in women with COVID-19. This cross-sectional study compared birth outcomes related to COVID-19 between Bangladeshi pregnant women with and without COVID-19.
Methods
The study was conducted at 3 tertiary referral hospitals in Dhaka, Bangladesh, from March to August 2020. Pregnant women admitted for delivery at these hospitals with laboratory results (reverse-transcription polymerase chain reaction) were analyzed. Using convenience sampling, we included 70 COVID-19-positive and 140 COVID-19-negative pregnant women. Trained and experienced midwives conducted the interviews. Data were analyzed using the t-test, the chi-square test, and univariate and multivariable linear and logistic regression.
Results
Pregnant women with COVID-19 were more likely to give birth to a preterm baby (adjusted odds ratio [aOR], 2.15; 95% confidence interval [CI], 1.06 to 4.37) and undergo a cesarean section (aOR, 3.27; 95% CI, 1.51 to 7.07). There were no significant differences in birth weight, premature rupture of membranes, and the Apgar score at 1 minute or 5 minutes post-delivery between women with and without COVID-19. All the newborn babies who were born to COVID-19-positive women were COVID-19-negative.
Conclusions
Our study suggests that pregnant women with COVID-19 were more likely to give birth to a preterm baby and undergo a cesarean section. For this reason, physicians should be particularly cautious to minimize adverse birth outcomes among pregnant women with COVID-19 and their newborn babies.

Summary

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SARS-CoV-2 infection by trimester of pregnancy and adverse perinatal outcomes: a Mexican retrospective cohort study
Rakesh Ghosh, Juan Pablo Gutierrez, Iván de Jesús Ascencio-Montiel, Arturo Juárez-Flores, Stefano M Bertozzi
BMJ Open.2024; 14(4): e075928. CrossRef
COVID-19 vaccine decision-making among pregnant and lactating women in Bangladesh
Rupali J. Limaye, Prachi Singh, Alicia Paul, Berhaun Fesshaye, Clarice Lee, Eleonor Zavala, Sydney Wade, Hasmot Ali, Hafizur Rahman, Shirina Akter, Ruth Karron, Towfida Jahan Siddiqua
Vaccine.2023; 41(26): 3885. CrossRef
The coronavirus disease 2019 infection in pregnancy and adverse pregnancy outcomes: a systematic review and meta-analysis
Yeonsong Jeong, Min-A Kim
Obstetrics & Gynecology Science.2023; 66(4): 270. CrossRef
Sources of COVID-19 Vaccine Promotion for Pregnant and Lactating Women in Bangladesh
Berhaun Fesshaye, Sydney A. Wade, Clarice Lee, Prachi Singh, Eleonor Zavala, Hasmot Ali, Hafizur Rahman, Towfida Jahan Siddiqua, Shirina Atker, Ruth A. Karron, Rupali J. Limaye
Vaccines.2023; 11(8): 1387. CrossRef
Impact of SARS-CoV-2 infection in pregnant women and their babies: clinical and epidemiological features
María José Vidal, Èrica Martínez-Solanas, Sergi Mendoza, Núria Sala, Mireia Jané, Jacobo Mendioroz, Pilar Ciruela
Gaceta Sanitaria.2023; 37: 102332. CrossRef
An outbreak of infection due to severe acute respiratory corona virus-2 in a neonatal unit from a low and middle income setting
Firdose Lambey Nakwa, Reenu Thomas, Alison van Kwawegen, Nandi Ntuli, Karabo Seake, Samantha Jane Kesting, Noela Holo Bertha Kamanga, Dikeledi Maureen Kgwadi, Neema Chami, Tshiamo Mogajane, Claude Ondongo-Ezhet, Thulisile Nelly Maphosa, Stephanie Jones, V
Frontiers in Pediatrics.2022;[Epub] CrossRef

Exploratory Study of Dimensions of Health-related Quality of Life in the General Population of South Korea: Seon-Ha Kim, Min-Woo Jo, Minsu Ock, Sang-il Lee; J Prev Med Public Health. 2017;50(6):361-368. Published online November 2, 2017; DOI: https://doi.org/10.3961/jpmph.16.076

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Abstract PDF Supplementary Material

Objectives
This study aimed to explore dimensions in addition to the 5 dimensions of the 5-level EQ-5D version (EQ-5D-5L) that could satisfactorily explain variation in health-related quality of life (HRQoL) in the general population of South Korea.
Methods
Domains related to HRQoL were searched through a review of existing HRQoL instruments. Among the 28 potential dimensions, the 5 dimensions of the EQ-5D-5L and 7 additional dimensions (vision, hearing, communication, cognitive function, social relationships, vitality, and sleep) were included. A representative sample of 600 subjects was selected for the survey, which was administered through face-to-face interviews. Subjects were asked to report problems in 12 health dimensions at 5 levels, as well as their self-rated health status using the EuroQol visual analogue scale (EQ-VAS) and a 5-point Likert scale. Among subjects who reported no problems for any of the parameters in the EQ-5D-5L, we analyzed the frequencies of problems in the additional dimensions. A linear regression model with the EQ-VAS as the dependent variable was performed to identify additional significant dimensions.
Results
Among respondents who reported full health on the EQ-5D-5L (n=365), 32% reported a problem for at least 1 additional dimension, and 14% reported worse than moderate self-rated health. Regression analysis revealed a R2 of 0.228 for the original EQ-5D-5L dimensions, 0.200 for the new dimensions, and 0.263 for the 12 dimensions together. Among the added dimensions, vitality and sleep were significantly associated with EQ-VAS scores.
Conclusions
This study identified significant dimensions for assessing self-rated health among members of the general public, in addition to the 5 dimensions of the EQ-5D-5L. These dimensions could be considered for inclusion in a new preference-based instrument or for developing a country-specific HRQoL instrument.

Summary

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Developing and testing culturally relevant bolt-on items for EQ-5D-5L in Chinese populations: a mixed-methods study protocol
Zhuxin Mao, Jingzhi Fan, Fanni Rencz, Zhihao Yang, Nan Luo, Pei Wang
BMJ Open.2024; 14(1): e081140. CrossRef
Population Norms for the EQ-5D-5L, PROPr and SF-6D in Hungary
Anna Nikl, Mathieu F. Janssen, Balázs Jenei, Valentin Brodszky, Fanni Rencz
PharmacoEconomics.2024; 42(5): 583. CrossRef
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Sarah Dewilde, Glenn Philips, Sandra Paci, Jon Beauchamp, Silvia Chiroli, Casey Quinn, Laura Day, Mark Larkin, Jacqueline Palace, Sonia Berrih-Aknin, Kristl G Claeys, Srikanth Muppidi, Renato Mantegazza, Francesco Saccà, Andreas Meisel, Guillaume Bassez,
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Eun Sil Her, Jung Kyu Park, Yun Kyoung Oh, Hsin-Yen Yen
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A Review of the Types and Characteristics of Healthy Life Expectancy and Methodological Issues
Young-Eun Kim, Yoon-Sun Jung, Minsu Ock, Seok-Jun Yoon
Journal of Preventive Medicine and Public Health.2022; 55(1): 1. CrossRef
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Jeehee Pyo, Minsu Ock, Bohyun Park, Nam-eun Kim, Eun Jeong Choi, Hyesook Park, Hyeong Sik Ahn
Journal of Korean Medical Science.2021;[Epub] CrossRef
Methods Used to Identify, Test, and Assess Impact on Preferences of Bolt-Ons: A Systematic Review
Alexandra J.L.M. Geraerds, Gouke J. Bonsel, Mathieu F. Janssen, Aureliano Paolo Finch, Suzanne Polinder, Juanita A. Haagsma
Value in Health.2021; 24(6): 901. CrossRef
Patient-reported impact of myasthenia gravis in the real world: protocol for a digital observational study (MyRealWorld MG)
Sonia Berrih-Aknin, Kristl G Claeys, Nancy Law, Renato Mantegazza, Hiroyuki Murai, Francesco Saccà, Sarah Dewilde, Mathieu F Janssen, Emma Bagshaw, Hara Kousoulakou, Mark Larkin, Jon Beauchamp, Trevor Leighton, Sandra Paci
BMJ Open.2021; 11(7): e048198. CrossRef
The Association between Alcohol Drinking Patterns and Health-Related Quality of Life in the Korean Adult Population: Effects of Misclassification Error on Estimation of Association
Eun Sook Lee, Boyoung Kim
International Journal of Environmental Research and Public Health.2020; 17(21): 7758. CrossRef
Quality of life in patients receiving percutaneous coronary intervention and optimal medical therapy in Ho Chi Minh City, Vietnam
Thao Thanh Nguyen, Quyen Gia To, Anh Do Nguyen, Tien The Nguyen, Van-Anh Ngoc Huynh, Kien Gia To
MedPharmRes.2020; 4(4): 1. CrossRef
A systematic review of the development and testing of additional dimensions for the EQ-5D descriptive system
Krittaphas Kangwanrattanakul, Wiraphol Phimarn
Expert Review of Pharmacoeconomics & Outcomes Research.2019; 19(4): 431. CrossRef

Variations in the Hospital Standardized Mortality Ratios in Korea: Eun-Jung Lee, Soo-Hee Hwang, Jung-A Lee, Yoon Kim; J Prev Med Public Health. 2014;47(4):206-215. Published online July 31, 2014; DOI: https://doi.org/10.3961/jpmph.2014.47.4.206

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Abstract PDF

Objectives
The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care.
Methods
All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities.
Results
For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR.
Conclusions
We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.

Summary

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Functional training and timed nutrition intervention in infectious medical patients
M Holst, L N Søndergaard, M D Bendtsen, J Andreasen
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Review

Air Pollution Exposure and Health Effects in Fetus.: Bo Eun Lee, Hye sook Park, Young Ju Kim, Eun Ae Park, Yun Chul Hong, Eun Hee Ha; J Prev Med Public Health. 2004;37(4):291-299. Published online November 30, 2004

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Abstract PDF: As there have been growing concerns about the adverse effects of air pollution on birth outcome, studies for this area has been carried out in different populations and sites. We reviewed the epidemiologic studies that evaluated the effects of air pollution on birth outcome such as low birth weight and preterm births. We identified the air pollution exposure during pregnancy was related with low birth weight and preterm birth, although there are differences among studies for the critical period of vulnerability. The biological mechanisms whereby air pollution might influence health of fetus are not clearly established. The exposure to carbon monoxide (CO) during pregnancy could increase fetal carboxyhemoglobin and result in tissue hypoxia. On the other hand, ambient particles less than 10 micrometer in aerodynamic diameter (PM10) could lead to inflammation and increase blood viscosity. Controlling for potential confounders and valid assessment of exposure are the methodological issues remained in these epidemiologic studies. In the future, more studies are needed to investigate the effect of air pollution on preterm birth or stillbirths, considering the various exposure period and the biological mechanism.; Summary

English Abstract

Impact of an Early Hospital Arrival on Treatment Outcomes in Acute Ischemic Stroke Patients.: Young Dae Kwon, Sung Sang Yoon, Hyejung Chang; J Prev Med Public Health. 2007;40(2):130-136.; DOI: https://doi.org/10.3961/jpmph.2007.40.2.130

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Abstract PDF

OBJECTIVES
Recent educational efforts have concentrated on patient's early hospital arrival after symptom onset. The purpose of this study was to evaluate the time interval between symptom onset and hospital arrival and to investigate its relation with clinical outcomes for patients with acute ischemic stroke. METHODS: A prospective registry of patients with signs or symptoms of acute ischemic stroke, admitted to the OO Medical Center through emergency room, was established from September 2003 to December 2004. The interval betwee symptom onset and hospital arrival was recorded for each eligible patient and analyzed together with clinical characteristics, medication type, severity of neurologic deficits, and functional outcomes. RESULTS: Based on the data of 256 patients, the median interval between symptom onset and hospital arrival was 13 hours, and 22% of patients were admitted to the hospital within 3 hours after symptom onset. Patients of not-mild initial severity and functional status showed significant differences between arrival hours of 0-3 and later than 3 in terms of their functional outcomes on discharge. Logistic regression models also showed that arrival within 3 hours was a significant factor influencing functional outcome (OR=5.6; 95% CI=2.1, 15.0), in addition to patient's initial severity, old age, cardioembolism subtype, and referral to another hospital. CONCLUSIONS: The time interval between symptom onset and hospital arrival significantly influenced treatment outcome for patients with acute ischemic stroke, even after controlling for other significant clinical characteristics. The findings provided initiatives for early hospital arrival of patients and improvement of emergency medical system.

Summary

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Hyong-Hu Park, Mun-Joo Cho, In-Chul Im, Jin-Soo Lee
Journal of the Korean Society of Radiology.2016; 10(8): 645. CrossRef
The Visiting Time of Acute Cerebral Stroke Patients in a City and Its Influencing Factors
英方
Nursing Science.2016; 05(04): 81. CrossRef
Stroke Education: Discrepancies among Factors Influencing Prehospital Delay and Stroke Knowledge
Yvonne TeuschI, Michael Brainin
International Journal of Stroke.2010; 5(3): 187. CrossRef
Notfall Schlaganfall
T. Steigleder
Notfall + Rettungsmedizin.2008; 11(3): 166. CrossRef

Original Articles

Association of Hospital Procedure Volume with Post-Transplant Survival for Allogeneic Bone Marrow Transplantation.: Choon Seon Park, Hee Kyung Moon, Hye Young Kang, Yoo Hong Min, Woo Hyun Cho; J Prev Med Public Health. 2004;37(1):26-36.

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Abstract PDF: OBJECTIVE
To examine the association between hospital procedure volume and treatment outcomes following allogeneic bone marrow transplantation (allo-BMT). METHODS: Out of 1, 050 patients who received allo-BMTs between 1998 and 2000 in 21 Korean hospitals, 752 with first allo-BMT and complete data were included in this study. Study subjects were divided into the following three groups according to cumulative hospital experience of all-BMTs during the study period: low (< 30 cases), medium (30-49) and high (> or =50 cases) volume. Patient outcome was defined as early survival at day 100 and one-year survival. Multiple logistic regression analyses were performed to examine the association between hospital experience and survival at day 100 and one year. RESULTS: When the low volume group was defined as the reference group, the adjusted relative risks (RR) of survival at day 100 for the high volume group were 2.46 (95% CI, 1.13-5.36) for all patients, 2.61 (1.04-6.57) for those with leukemia, and 2.20 (0.47-10.32) for those with aplastic anemia. For one-year survival, adjusted RR for the high volume group were 2.52 (1.40-4.51) for all patients, 1.99 (1.01-3.93) for leukemia, and 6.50 (1.57-26.80) for aplastic anemia. None of the RR for the medium volume group was statistically significant. Patient factors showing significant relationship with survival were donor-recipient relation, human leukocyte antigen matching status, time from diagnosis to transplant, and disease stage. CONCLUSION: The study results suggest that the cumulative experience of hospitals in providing allo-BMT is positively associated with patient survival.; Summary

Maternal Working Conditions on Adverse Pregnancy Outcomes: A Prospective Cohort Study.: Jung Jin Cho, Ji Yong Kim, Jin Joo Chung, Kyung Sim Ko; Korean J Prev Med. 2002;35(3):197-204.

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Abstract PDF: OBJECTIVES
To evaluate the association between working conditions and adverse pregnancy outcomes in Korea. METHODS: We obtained data on health history, lifestyle, housework and working conditions, such as shift work, hours standing, working time, job demand, lifting at work and at home, between August and September 2000, from self-reported questionnaires. A group of 344, occupationally active, pregnant women from 51 industries were studied. Of the women studied, 328 women were further interviewed by telephone between November 2000 and September 2001. Result : Compared with daytime work, shift work increased the risk for preterm birth (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62) and low birth weight (an adjusted risk ratio of 2.74, 95% CI=1.02-2.62). A significantly increased risk was found for prolonged standing, with an adjusted risk ratio of preterm births of 6.80 (95% CI=2.01-23.0). There were no significant differences in the incidence of spontaneous abortion between the occupational working conditions, with the exception of a previous history of spontaneous abortion. CONCLUSION: These findings suggest that maternal working conditions, such as shift work and prolonged standing, contribute significantly to preterm birth and low birth weight.; Summary

Time Series Observations of Outcome Variables and the Factors Associated with the Improvement in the Patient Outcomes of Cataract Surgery.: Han Joong Kim, Eun Cheol Park, Yoon Jung Choi, Hyung Gon Kang; Korean J Prev Med. 2001;34(2):175-181.

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Abstract PDF: OBJECTIVES
To compare the multiple outcomes of patients with cataract surgery at perioperative time, 3-4 months and 12 months after surgery and to assess patient outcomes associated with visual improvement(visual acuity of operated eye, visual function-14(VF-14), symptom score). METHODS: For this assessment, a prospective study was conducted with 389 patients who had undergone cataract surgery for either one eye or both eyes. The surgery was performed by 20 ophthalmologists who were practicing at university hospitals and general hospitals. Patients were interviewed and clinical data were obtained. Doctors were questioned with self-reported questionnaire forms. Medical records were examined in order to measure variables related to the surgical process such as surgical methods and ocular comorbidity. The survey was conducted at 4 stages : preoperative time(389 cases), perioperative time(344 cases, 88.4%), postoperative 3-4 months (343 cases, 88.2%), and postoperative 12 months (281 cases, 72.2%). After excluding cases with incomplete data, 198 cases were enrolled in the study. Patient outcomes was measured for any improvement in the functional outcomes(visual acuity of operated eye, visual function, symptom score) at postoperative 3-4 months. RESULTS: The visual acuity(operated, weighted average), symptom score, VF-14 score, satisfaction with vision, and subjective health status were shown to be improved at the perioperative time, postoperative 3-4 months and 12 months. An improvement in the Snellen visual acuity score was observed in 190 patients(96.0%), whereas improvements of the VF-14 score and cataract symptom score were observed in 151 patients(76.3%) and 179 patients(90.4%), respectively. All three outcome measures demonstrated improvement in 137 patients(69.2%). The improvement of the three functional outcomes at 3-4 months after receiving surgery was associated with a lower level of visual function and a higher level of cataract symptom score at perioperative time, as well as a greater experience level of the surgeon. CONCLUSIONS: In this study, the estimates of the proportion of patients benefiting from cataract surgery varied with the outcome measure of benefit. Preoperative VF-14 score, a measure of functional impairment related to vision, and symptom score may be better measures of the benefit derived from cataract surgery than the change in visual acuity.; Summary

Relationship between Percutaneous Transluminal Coronary Angioplasty Volume and Associated Immediate Outcome.: Young Ho Khang, Yong Ik Kim, Chang Yup Kim, Young Sung Lee, Sunmean Kim, Jin Seok Lee, Byung Hee Oh; Korean J Prev Med. 2001;34(1):9-20.

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Abstract PDF: OBJECTIVES
To explore the relationship between Percutaneous Transluminal Coronary Angioplasty (PTCA) volume and the associated immediate outcome. METHODS: A total of 1,379 PTCAs were performed in 25 hospitals in Korea between October 1 and December 31 in 1997. Data from 1,317 PTCAs (95.5%) were collected through medical record abstraction. Inter-observer reliability of the data was examined using the Kappa statistic on a subsample of 110 PTCA procedures from five hospitals. Intra-observer reliability of the data was also examined. PTCA success and immediate adverse outcomes were selected as the outcome variables. A successful PTCA was defined as a case that shows less than 50% diameter stenosis and more than 20% reduction of diameter stenosis. Immediate adverse outcomes included deaths during the same hospitalization, emergency coronary artery bypass graft (CABG) within 24 hours after PTCA, and acute myocardial infarction within 24 hours after PTCA. The numbers of PTCAs performed in 1997 per hospital were used as the volume variables. RESULTS: Without adjusting for patient risk factors that may affect outcomes, procedures at high volume hospitals (200 cases per year) had a greater success rate (P=0.001) than low volume hospitals. There was a marginally significant difference (P=0.070) in major adverse outcome rates between high and low volume hospitals. After adjusting for risk factors, there were significant differences in procedural failure and major adverse outcome rates between high and low volume hospitals. CONCLUSIONS: After adjusting for patient clinical risk factors, the hospital volume of PTCA was associated with immediate outcomes. It is recommended that a PTCA volume per year be established in order to improve the immediate outcome of this procedure in Korea.; Summary

Treatment Process and Outcomes of Brain Injuried ER Patients.: Hye Ryeon Hong, Ki Nam Jin, Dong Woo Lee, Jae Su Kim; Korean J Prev Med. 1998;31(3):481-489.

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Abstract PDF: Injuries and infectious diseases have been the most important public health problems since the beginning of human life. Injuries result in death of about 30,000 people each year in South Korea. In terms of years of life lost, injuries are considerably more costly than either heart disease or cancer. In terms of cost - both the direct costs of care and the indirect costs to individuals, families, and societies of a diminished life - injuries are among the most expensive of all social problems. The main purposes of this study are (1) to describe the outcomes as well as treatment process of brain injured patients and (2) to identify the factors impacting on length of stay during hospitalization and hospital fees. The research method used in this study was to review the medical records of five hundreds brain injured cases using systemic random sampling. The multiple logistic regression was administered to identify the factors impacting on the outcomes. The results are as follow: (1) the consultation rate was found to be 72.9% while referral rate was 11.2%; (2) nearly 30% of the respondents were hospitalized over 30 days; (3) multiple logistic regression analyses revealed that the determinants influencing LOS were number of consultations, number of lab tests, and surgery; (4) the determinants of hospital fee were severity of brain injury, gender of patients, number of consultations, number of lab tests, and surgery.; Summary

The Study on Volume Relationships in Several Diseases.: Sunhee Lee, Yonggweon Jwa; Korean J Prev Med. 1994;27(4):793-806.

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Abstract PDF: Investigating the existence of volume-outcome relationships for specific disease groups relates directly to the policy issue of whether, and how, specific inpatient services should be regionalized. This study examined whether medical costs and lengths of stay as outcomes were affected by changes in volume within hospitals. Based on the claims data obtained from National Federation of Medical Associations, each six disease categories from medical and surgical conditions were selected and 29,720 cases from 1,266 hospitals were analyzed. Main findings of the research can be summarized as follows: 1. Analyzing volume and cost per case relationship, tonsillectomy class 1, hernia procedure class 0, appendectomy and cesarean section class 0,1 in surgical conditions showed negative relationship significantly. In cases of medical conditions, costs per case in respiratory neoplasm class 2, COPD class 1, 2, digestive malignancy were also related to volume negatively. 2. Comparing volume with length of stay per case, lens procedure class 0, hernia procedure class 0, appendectomy class 0,1 cesarean section class 1 in surgical conditions showed negative relationships significantly. In medical conditions, volume of respiratory neoplasm class 2, COPD class 1,2, digestive malignancy class 0 were associated with negatively. 3. within same disease categories, changes in cost and length of stay per case to volume were more remarkable in severe cases. These results suggested a significant inverse relationship between disease cases and cost, length of stay per case as outcome variables.; Summary

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