Background Several previous studies have reported that quality of life (QoL) in hemodialysis patients affects mortality. However, the 36-item Short Form Health Survey, which has been used mainly in previous studies, is complicated in terms of questionnaire composition and interpretation. This study aimed to identify the impact of QoL on mortality in hemodialysis patients using an easier and simpler diagnostic tool.
Methods This retrospective study included 160 hemodialysis patients. QoL was evaluated using the World Health Organization Quality of Life Questionnaire-Brief version (WHOQOL-BREF). Psychosocial factors were evaluated using the Hospital Anxiety and Depression Scale, Multidimensional Scale of Perceived Social Support, Montreal Cognitive Assessment, and Pittsburgh Sleep Quality Index. We also evaluated medical factors, such as dialysis adequacy and laboratory results.
Results The mean hemodialysis vintage was 70.7±38.0 months. The proportion of patients who were elderly was higher in the mortality group than in the surviving group, and the Charlson Comorbidity Index score was also higher in the former group. Of the four domains of the WHOQOL-BREF, the physical health and psychological scores of the mortality group were significantly lower than those of the survival group. When the score in the physical health domain or psychological domain was ≤10, the 10-year mortality rate after hemodialysis initiation increased by approximately 2.3- and 2-fold, respectively.
Conclusion QoL may have a significant effect on mortality in patients undergoing hemodialysis. The WHOQOL-BREF is an instrument that can measure QoL relatively easily and can be used to improve the long-term prognosis of patients undergoing hemodialysis.
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Background To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, Korea.
Methods We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis.
Results During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between study periods; however, the results showed statistically significant differences in the length of ED stay.
Conclusion The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.
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Lung resection has various and commonly occurring postoperative complications. Pulmonary complication is well known as one of the most important among them, exerting a negative influence on the postoperative course and resulting in mortality. Thus, the prevention of pulmonary complication after lung resection is very important. To prevent postoperative pulmonary complication, the perioperative management must be optimal. Perioperative management begins long before the surgery and does not end until the patient leaves the hospital. The goal of perioperative management is to identify the high-risk patients, to provide appropriate intervention, to prevent postoperative complications, and to obtain the best outcomes.
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Bactground:The etiologies of treatment related mortality (TRM) after hematopoietic stem cell transplantation (HSCT) have been variable according to the disease status or the centers. We evlauated the etiologies of TRM for the pediatric patients at Yeungnam University Hospital (YNUH).
Materials and Methods:The records of 66 patients, 19 years of age or younger, who had HSCT at YNUH from September 1995 to August 2007 were reviewed.
Results :Among 66 patients, allogeneic bone marrow transplantation (Allo-BMT) was done in 21 (19 related, 2 unrelated), allogeneic peripheral blood stem cell transplantation (Allo- PBSCT) in 1, cord blood transplantation (CBT) in 12 (1 related, 11 unrelated), autologous peripheral blood stem cell transplantation (Auto-PBSCT) in 32 patients. The TRM rates of Allo-BMT, CBT, and Auto-PBSCT were 19%, 33.3%, and 12.5%, respectively. Among four patients who had TRM after Allo-BMT, two were related transplantation and the others were unrelated. All four patients developed severe acute GVHD of at least grade Ⅲ. Sepsis developed in three patients, acute renal failure (ARF) in two, veno-occlusive disease (VOD) and thrombotic microangiopathy (TMA) in one patient each. All four patients who had TRM after CBT had two mismatches in HLA-A, B, DR, and engraftment syndrome developed in three. Sepsis developed in all four patients, VOD in two, encephalopathy in two, TMA and ARF in one patient each. All four patients who had TRM after Auto-PBSCT developed sepsis and ARF in two, VOD and TMA in one patient each.
Conclusion :Although the number of cases were not large enough for firm conclusion, sepsis was the most common TRM after HSCT. Therefore, prevention and control of sepsis are very important in reducing TRM after HSCT. Outcomes of severe acute GVHD after Allo-BMT and engraftment syndrome after CBT are very poor and contribute for TRM. Continuous effort to reduce the incidence of GVHD and engraftment syndrome are needed.
Premature birth is the single largest cause of perinatal mortality and morbidity in nonanomalous infants in developing countries. Advances in neonatal care have lead to increased survival and reduced short and long term morbidity for preterm infants. but the rate of preterm birth has actually increased. This review provides recent multifactorial approaches to treatment and prevention of preterm birth.