PURPOSE: This study aims to analyse the epidemiologic characteristics of burn in the elderly and to discusses a possible prevention program for this population. METHODS: A retrospective review of all medical records of elderly patients (above 60 years old) admitted with burns to the burn center of the Hanil General Hospital from January 1996 to December 2007 was carried out. Patient demographics, etiology, extent, and type of burn, seasonal variation, and mortality rates were reviewed. RESULTS: A total of 537 elderly patients (mean age of 69.8 years, median age of 68 years, range 60~97 years) was admitted. The gender ratio of the patients was 1:.5 with 217 men and 320 women. The most common causes were scald burn (44.9%) and flame burn (35.4%). The average total body area burned was 13.5% (range 0~95%). Twenty six patients (4.8%) died. CONCLUSION: In elderly patients, scald burns are more common in women but flame burns are more common in men. The mortality rate is higher in flame burns and men
Aged ; Burn Units ; Burns ; Demography ; Female ; Hospitals, General ; Humans ; Male ; Medical Records ; Retrospective Studies ; Seasons

PURPOSE: This study aims to analyse the difference in bacteriology and antibiotics resistance on colonization of burn wound by the change of burn wound dressing. METHODS: A retrospective review of all medical records of patients admitted with burns to the burn center of the Hanil General Hospital in 2002 when the conservative wound dressing was managed and in 2009 when the advanced wound dressing was carried out. Patient demographics, extent and type of burn, mortality rates were reviewed. Isolation and identification of microorganisms was done using the standard procedure. Disc diffusion tests were performed for all the isolates for antimicrobial susceptibility. RESULTS: A total of 456 patients in 2002 and a total of 208 patients in 2009 were admitted. Of them, 27 patients in 2002 (Group A) and 35 patients in 2009 (Group B) have the result of colonization on burn wound by surface swab culture after post admission day 7. Mean age was 43.59+/-3.64 (Group A), 49.46+/-2.79 (Group B). The sex ratio of the patients was 1:0.4 with 20 men and 7 women (Group A), 1:0.5 with 24 men and 11 women (Group B). The mean admission day was 61.46+/-12.02 (Group A), 61.62+/-7.55 (Group B). The average value of total body area burned was 32.30+/-4.43 (Group A), 10.40+/-1.73 (Group B). A total of 3 patients (Group A) has inhalation burn. Three patients (Group A) and one patient (Group B) died. The most common cause of burn was flame burn (59.3%) (Group A), scald burn (48.6%) (Group B). The frequency of resistant microorganisms causing colonization on burn wound was 44.44% (Group A), 22.86% (Group B). CONCLUSION: In group managed with the conservative burn dressing, the resistant microorganisms and pathogens are more frequent than in the advanced burn dressing group. However there was no statistically significant. Ongoing data collection and reanalysis is required.
Anti-Bacterial Agents ; Bacteriology ; Bandages ; Burn Units ; Burns ; Burns, Inhalation ; Colon ; Data Collection ; Demography ; Diffusion ; Female ; Hospitals, General ; Humans ; Male ; Medical Records ; Retrospective Studies ; Sex Ratio

PURPOSE: There have been several studies addressing the correlation between central venous pressure (CVP) and ultrasonographic findings of the inferior vena cava (IVC). We performed the present study to discover the degree of correlation between CVP and the area of IVC as measured with ultrasound, and to determine which portion of the IVC shows the best correlation with CVP. METHODS: The present study was prospectively performed in emergency medical center of Chonnam National University Hospital from March 1 to October 31, 2006. Two intrahepatic portions and one extrahepatic portion of the IVC were evaluated. RESULTS: All tested areas of the IVC, and the collapsibility indices measured at each location, showed a substantial correlation with CVP. However, in multiple logistic regression analysis performed to identify the location best correlated with CVP, the area of the IVC just below the hepatic vein-IVC junction proved to be the only location to correlate with CVP with statistic significance. CONCLUSION: Measurement of IVC area using ultrasound can yield important information about a patient's volume status, especially in patients for whom central venous catheter insertion is contraindicated. We suggest that the portion of the IVC just below the hepatic vein-IVC junction is the optimal locatin for area measurement to estimate CVP.
Central Venous Catheters ; Central Venous Pressure* ; Emergencies ; Humans ; Jeollanam-do ; Logistic Models ; Prospective Studies ; Ultrasonography* ; Vena Cava, Inferior*

PURPOSE: Neurological outcome prediction is an important aspect of post-resuscitation care in cardiac arrest survivors. The appearance of high serum neuron specific enolase (NSE) is known to be associated with ischemic brain injury and poor neurological outcome. The application of therapeutic hypothermia to cardiac arrest survivors has been shown to improve neurological outcomes. As such, we investigated the predictive value of serial serum NSE levels in patients who were resuscitated from cardiac arrest. METHODS: This study included 123 cardiac arrest survivors who were treated by therapeutic hypothermia from January 2008 to June 2011. Blood samples used for evaluating NSE were collected at return of spontaneous circulation (ROSC) at 6, 24 and 48 hours after initiation of therapeutic hypothermia. Neurological outcome was graded as 'good' or 'poor' at discharge and assessed according to the Cerebral Performance Category scale (CPC). A poor outcome was defined as a CPC value of 3-5. RESULTS: Receiver operating characteristic (ROC) analysis revealed NSE cut-off values of 53.9 microg/L (sensitivity 14.6%), 48.5 microg/L (sensitivity 30.6%), 80.0 microg/L (sensitivity 40.0%), and 52.7 microg/L (sensitivity 55.5%) for poor outcomes with a specificity of 100%, measured at ROSC of 6, 24 and 48 hours after initiation of therapeutic hypothermia, respectively. The poor outcome group showed significant change in NSE concentration over time (p=0.002), while the good outcome group did not. CONCLUSION: Detection of NSE at the cut-off value, 48 hr after initiation of therapeutic hypothermia was a specific but moderately sensitive marker of poor outcome at discharge. Single measurements of NSE should be cautiously interpreted, but NSE change over time was helpful in predicting the neurologic outcome.
Brain Injuries ; Dinucleoside Phosphates ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Neurons ; Phosphopyruvate Hydratase ; Prognosis ; ROC Curve ; Sensitivity and Specificity ; Survivors

PURPOSE: Neurological outcome prediction is an important aspect of post-resuscitation care in cardiac arrest survivors. The appearance of high serum neuron specific enolase (NSE) is known to be associated with ischemic brain injury and poor neurological outcome. The application of therapeutic hypothermia to cardiac arrest survivors has been shown to improve neurological outcomes. As such, we investigated the predictive value of serial serum NSE levels in patients who were resuscitated from cardiac arrest. METHODS: This study included 123 cardiac arrest survivors who were treated by therapeutic hypothermia from January 2008 to June 2011. Blood samples used for evaluating NSE were collected at return of spontaneous circulation (ROSC) at 6, 24 and 48 hours after initiation of therapeutic hypothermia. Neurological outcome was graded as 'good' or 'poor' at discharge and assessed according to the Cerebral Performance Category scale (CPC). A poor outcome was defined as a CPC value of 3-5. RESULTS: Receiver operating characteristic (ROC) analysis revealed NSE cut-off values of 53.9 microg/L (sensitivity 14.6%), 48.5 microg/L (sensitivity 30.6%), 80.0 microg/L (sensitivity 40.0%), and 52.7 microg/L (sensitivity 55.5%) for poor outcomes with a specificity of 100%, measured at ROSC of 6, 24 and 48 hours after initiation of therapeutic hypothermia, respectively. The poor outcome group showed significant change in NSE concentration over time (p=0.002), while the good outcome group did not. CONCLUSION: Detection of NSE at the cut-off value, 48 hr after initiation of therapeutic hypothermia was a specific but moderately sensitive marker of poor outcome at discharge. Single measurements of NSE should be cautiously interpreted, but NSE change over time was helpful in predicting the neurologic outcome.
Brain Injuries ; Dinucleoside Phosphates ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Neurons ; Phosphopyruvate Hydratase ; Prognosis ; ROC Curve ; Sensitivity and Specificity ; Survivors