2.Prenatal ultrasonographic findings of esophageal atresia: potential diagnostic role of the stomach shape
Chi-Son CHANG ; Yunsun CHOI ; Seo-yeon KIM ; Cheonga YEE ; Mina KIM ; Ji-Hee SUNG ; Sanghoon LEE ; Suk-Joo CHOI ; Soo-young OH ; Jeong-Meen SEO ; Cheong-Rae ROH
Obstetrics & Gynecology Science 2021;64(1):42-51
Objective:
We investigated prenatal sonographic characteristics of esophageal atresia (EA) with advancing gestation. We focused on the degree of polyhydramnios and the stomach shape.
Methods:
This study included 27 EA cases (EA group) and 81 idiopathic polyhydramnios cases (non-EA group). The non-EA group consisted of cases without any fetal structural anomaly, musculoskeletal disorder, chromosomal abnormality, or maternal diabetes. Both groups included only singleton pregnancies. Amniotic fluid index (AFI) and width/length (W/L) ratio as well as the product of width and length (W×L) of stomach were serially assessed during gestation and compared between the 2 groups. To predict EA using W/L ratio and W×L, receiver operating characteristic curve analysis was performed.
Results:
Polyhydramnios was evident in 77.8% of EA cases. We observed 25.9% and 22.2% EA cases with an absent stomach and a small visible stomach, respectively. After 28 weeks, the EA group manifested significantly higher AFI than the non-EA group. After 32 weeks, W/L ratio in the EA group tended to be lower than that in the non-EA group (32–36 weeks: 1.36 vs. 1.72, P=0.092; >36 weeks: 1.43 vs. 1.63, P=0.024). To predict EA, the calculated area under the curve for W/L ratio was 0.651 after 32 weeks. The diagnosis of EA using a cut-off value of W/L ratio <1.376 showed sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio to be 84.6%, 52.9%, 1.796, and 0.081, respectively.
Conclusion
A low W/L ratio of stomach after 32 weeks with progressive idiopathic polyhydramnios may be used to predict EA.
3.Prevalence of Malnutrition in Hospitalized Patients: a Multicenter Cross-sectional Study
Min Chang KANG ; Ji Hoon KIM ; Seung Wan RYU ; Jae Young MOON ; Je Hoon PARK ; Jong Kyung PARK ; Jong Hoon PARK ; Hyun Wook BAIK ; Jeong Meen SEO ; Myoung Won SON ; Geun Am SONG ; Dong Woo SHIN ; Yeon Myung SHIN ; Hong yup AHN ; Han Kwang YANG ; Hee Chul YU ; Ik Jin YUN ; Jae Gil LEE ; Jae Myeong LEE ; Jung Hwa LEE ; Tae Hee LEE ; Haejun YIM ; Hyun Jeong JEON ; Kyuwhan JUNG ; Mi Ran JUNG ; Chi Young JEONG ; Hee Sook LIM ; Suk Kyung HONG ;
Journal of Korean Medical Science 2018;33(2):e10-
BACKGROUND: Malnutrition is associated with many adverse clinical outcomes. The present study aimed to identify the prevalence of malnutrition in hospitalized patients in Korea, evaluate the association between malnutrition and clinical outcomes, and ascertain the risk factors of malnutrition. METHODS: A multicenter cross-sectional study was performed with 300 patients recruited from among the patients admitted in 25 hospitals on January 6, 2014. Nutritional status was assessed by using the Subjective Global Assessment (SGA). Demographic characteristics and underlying diseases were compared according to nutritional status. Logistic regression analysis was performed to identify the risk factors of malnutrition. Clinical outcomes such as rate of admission in intensive care units, length of hospital stay, and survival rate were evaluated. RESULTS: The prevalence of malnutrition in the hospitalized patients was 22.0%. Old age (≥ 70 years), admission for medical treatment or diagnostic work-up, and underlying pulmonary or oncological disease were associated with malnutrition. Old age and admission for medical treatment or diagnostic work-up were identified to be risk factors of malnutrition in the multivariate analysis. Patients with malnutrition had longer hospital stay (SGA A = 7.63 ± 6.03 days, B = 9.02 ± 9.96 days, and C = 12.18 ± 7.24 days, P = 0.018) and lower 90-day survival rate (SGA A = 97.9%, B = 90.7%, and C = 58.3%, P < 0.001). CONCLUSION: Malnutrition was common in hospitalized patients, and resulted in longer hospitalization and associated lower survival rate. The rate of malnutrition tended to be higher when the patient was older than 70 years old or hospitalized for medical treatment or diagnostic work-up compared to elective surgery.
Cross-Sectional Studies
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Hospitalization
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Humans
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Intensive Care Units
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Korea
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Length of Stay
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Logistic Models
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Malnutrition
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Multivariate Analysis
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Nutrition Assessment
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Nutritional Status
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Prevalence
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Risk Factors
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Survival Rate