BACKGROUND: Hemodialysis patients are increasing every year and bloodstream infections (BSIs) are a major cause of morbidity and mortality in patients receiving hemodialysis. As the domestic studies have not explored the incidence of BSIs, the distribution and current situation of microorganism and so on this study was carried out to determine the incidence and epidemiological risk factors of the BSIs in hemodialysis patients. A distribution of pathogenic organism of the BSIs was investigated. METHODS: This study was carried out for those 275 patients with hemodialysis for 12 months the patients who underwent hemodialysis in the hemodialysis center within the university hospital. Data was collected by structural questionnaire, medical record review. The definition for BSIs was based on that of CDC. RESULTS: A total of 59 BSIs occurred during 123,502 dialysis sessions. The bloodstream infection rate per 1,000 dialysis sessions was 0.48 overall and varied markedly by the type of vascular access: 0.1 for arteriovenous fistulas, 0.54 for arteriovenous grafts. 2.57 for permanent catheters and 5.39 for temporary catheters. The most common pathogen isolated from the BSIs was MSSA and MRSA 18.0%, Streptococcus species 11.5%. In a logistic regression analysis, immunosuppressive therapy (OR=8.081, p=0.001), case of starting hemodialysis in the intensive care unit (OR=4.855, p=0.043) were associated independently with BSIs. CONCLUSION: Based on this study, continuous study and effort together with interest in BSIs, and the study on BSIs in hemodialysis patients should be further continued in the years to come. Surveillance for BSIs is recommended as a routine activity in hemodialysis center.
Arteriovenous Fistula ; Bacteremia ; Catheters ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Dialysis ; Humans ; Incidence ; Intensive Care Units ; Logistic Models ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Renal Dialysis* ; Risk Factors ; Streptococcus ; Transplants ; Surveys and Questionnaires

PURPOSE: This study was performed to provide the basic data in the establishment of preventive countermeasures for injury by analyzing the characteristics of injury, and risk factors of injury. METHODS: From 2,059 injury patients among 19,947 patients admitted between January and December, 2004 at a university hospital located in Gyeonggi-do, 500 injury patients were sampled randomly by systematic sampling. A total of 500 questionnaires was collected and used for this study. The statistical SPSS was used to analyze data that included chi-square, fisher's exact test. RESULTS: Injury patients among total admission patients was 10.3%. In both general characteristics of injury and non-injury patients, gender, age, length of stay was significant. As the cause of injury were compared with those of injury external causes, type, place, site, and time of injury were significant. As the cause of injury were compared with the characteristics of related-injury, surgery, multiple injuries, mental history, consciousness at the time emergency room visit, length stays were significant. CONCLUSION: With regard to general characteristics, injury external causes, injury-related causes, and factors such as sex, age, occupation, and educational background were related to each other. Injury does not occur by accident or unexpectedly. Therefore, if preventive attention is focused on individuals with high risk factors of injury, the incidence rate will be diminished.
Consciousness ; Emergency Service, Hospital ; Gyeonggi-do ; Humans ; Incidence ; Length of Stay ; Multiple Trauma ; Occupations ; Risk Factors ; Wounds and Injuries ; Surveys and Questionnaires

PURPOSE: The study analyzed and categorized the colorectal cancers related medical journals published in Korea by the name of the journal, research materials, study method, statistical method and by content of study for the quality improvement of colorectal cancers related studies. METHODS: The authors reviewed a total of 567 colorectal cancer-related studies published in the Korean medical journals during the period 1967 and 2004 and kept in the National Assembly Library. The distribution of research materials, study method, statistical method and content of these studies were analyzed by the 5 year publication interval. RESULTS: By study period, the number of published studies steeply increase during the period between 2000 and 2004. As the research materials, hospital patients(64.6%) and In-vitro(16.6%) were the most prevalently used research materials, but health adults were the lowest research materials by only taking up 0.4%. In study methods, patient follow up studies(28.7%) and human in vitro experimental(27.9%) were prevalent, and human in vitro experimental were relatively the most popular performed studies during the years of 1990-1994. As the statistical method, life table and survival analysis(27.0%) were the mostly performed methods, and the use of statistical method was applied in nearly all studies. The contents of the studies mainly focused on the patient prognostic estimations(27.6%) of therapeutic safety & efficacy(25.6%), but only the 4.1% of risk factors studies. Among the 109 studies which analyzed the survival term 78.9% of the studies mainly used the 5 year term in the analysis of survival rates. CONCLUSION: The results of the study could be utilized as the basic data for the quality improvement of further colorectal cancers related studies.
Adult ; Colorectal Neoplasms* ; Follow-Up Studies ; Humans ; Korea ; Life Tables ; Publications ; Quality Improvement ; Research Design ; Risk Factors ; Survival Rate

BACKGROUND: Ventilator-associated pneumonia (VAP) is the most severe form of nosocomial infection. However the actual incidence of pneumonia associated with ventilator is not known. The purpose of this study is to examine the incidence of VAP, find out related risk factors, and establish effective preventive measures. METHODS: The medical records of 172 consecutive patients, who have been admitted to the intensive care unit (ICU) from January 2005 to October 2005 and were subjected to mechanical ventilation for more than 48 hours, have been reviewed retrospectively. VAP was defined according to the definition of CDC (1992). The statistical software SPSS (version 12.0) was used to conduct descriptive and comparative analysis including Chi-square, student's t-test, and logistic regression. RESULTS: The incidence was 163 per 1,000 persons and 19.0 per 1,000 ventilator use patient-days. The significant risk factors for VAP were type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-8.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173). VAP developed 3.04 (+/-0.88) days after initiating mechanical ventilation. Causative agents of VAP were Acinetobacter baumanii (35.2%), MRSA (18.8%), Enterobacter aerogenes (12.4%), Klebsiella pneumonia (9.4%), Staphylococcus aureus (6.3%), Burkholderia (6.3%), Serratia marcesceus (6.3%), Stenotrophomonas (3.1%), and Pseudomonas (3.1%) spp. CONCLUSION: Type of ICU (surgical ICU, OR=5.942, 95% CI=1.894-18.644) and duration of ventilator use (OR=3.603, 95% CI=1.810-7.173) were considered to increase the incidence of VAP. Further study with larger number of cases and preventive measures would be necessary to identify risk factors related to the ventilator-associated pneumonia.
Acinetobacter ; Burkholderia ; Centers for Disease Control and Prevention (U.S.) ; Cross Infection ; Enterobacter aerogenes ; Humans ; Incidence ; Critical Care ; Intensive Care Units ; Klebsiella ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pneumonia, Ventilator-Associated ; Pseudomonas ; Respiration, Artificial ; Retrospective Studies ; Risk Factors ; Serratia ; Staphylococcus aureus ; Stenotrophomonas ; Tertiary Care Centers ; Ventilators, Mechanical

BACKGROUND: Despite prophylactic preoperative managements, surgical site infection (SSI) still has a significant influence on the mortality and morbidity of surgical patients because of an increased number of immunocompromised patients, prolonged anesthesia or an increased use of various operative equipments. In the end, it leads to an increase in hospital days and medical expenses. Therefore, we tried to find out significant risk factors for SSI in a general hospital. METHODS: The study was carried out on the 1,239 patients who underwent a surgical operation in a general hospital, and the incidence rate and risk factors of SSI were analyzed. RESULTS: Among the 1,239 patients, 33 (2.7%) had SSI and the incidence rate was 26.6 per 1,000 person. Of these, 27 (81.8%) and 6 (18.2%) developed an infection before and after discharge, respectively. The influencing factors of SSI were the dirty wound, the frequency of re-operation, the duration of preoperative hospitalization, and the duration of the operation. The most common pathogen isolated from the surgical site was Staphylococcus aureus (27.2%). CONCLUSION: To prevent SSI, a professional group must be established to manage surgical sites and wounds, and the patients should be covered by strict standardized knowledge and guidance.
Anesthesia ; Cross Infection ; Hospitalization ; Hospitals, General* ; Humans ; Immunocompromised Host ; Incidence ; Mortality ; Risk Factors* ; Staphylococcus aureus ; Wounds and Injuries

PURPOSE: Despite of the development of recent medical technology, bloodstream infection (BSI) still has significant influences on mortality and morbidity of patients admitted to the ICU. The BSI has the second most frequent site. Especially BSI in ICU have higher infection rate than general ward. This study was investigated the incidence rate of the nosocomial BSI, risk factors and bacterial pathogens of BSI in ICU for a general hospital. METHODS: This study was carried out for those 443 patients in ICU of general hospital during the period from March 2002 to February 2003. The definition for BSI was based on that of CDC. Data was collected by questionnaire, medical record review. The statistical SPSS(ver. 10.0) was used to analyze data that included chi-square, t-test and logistic regression. RESULTS: In the incidence rates of the BSI were 76.7 in 1,000 per patients, 7.0 in per 1,000 patients days and 32.1 in per 1,000 patients with central lines, 3.2 in per 1,000 cental line days. In the incidence rates of the BSI by type of ICU showed MICU 10.1, SICU 2.9 in per 1,000 patients days. The significant risk factors were identified as type of ICU(OR=5.119, p=0.001), length of stay(OR=1.039, p=0.001). The causal microbes of the BSI were CNS 35.5%, MRSA 23.6%. The bacterial pathogens of central catheter-related BSI were CNS 50%, MRSA 50%. CONCLUSION: The occurrence of ICU-acquired infection was significantly related to the increase in morbidity and mortality. Ongoing targeted surveillance and infection control strategies is necessary to control this problem.
Centers for Disease Control and Prevention (U.S.) ; Hospitals, General* ; Humans ; Incidence ; Infection Control ; Intensive Care Units* ; Critical Care* ; Logistic Models ; Medical Records ; Methicillin-Resistant Staphylococcus aureus ; Mortality ; Patients' Rooms ; Risk Factors ; Surveys and Questionnaires

BACKGROUND: This is a theory verification study in which the theory of planned behavior (TPB) of Ajzen is applied to predict operating room (OR) infection control behavior. The study was carried out to know the path of attitude, subjective norm, perceived behavioral control, and intention towards OR infection control behavior. METHODS: A total of 178 OR nurses working at 13 hospitals in Seoul were the subjects of this study. A questionnaire survey was performed; the data were collected from April 6 to April 19, 2005 and analyzed with t-test, ANOVA, multiple regression, and person's correlation using SPSS program. Using AMOS, the factors of TPB were analyzed with path analysis. RESULTS: The total mean of infection control behavior of OR nurses was 4.37 points out of possible 5.0, and asepsis/operating instrument sterilization had 4.69, which was the highest among all areas of infection control behavior. In case of the relation between attitude, subjective norm, perceived behavior control, and intention, there was the strongest relation of cause and effect (path coefficient 0.38, 39%). In case of intention, perceived behavior control, and behavior, the relation of cause and effect between intention and behavior was path coefficient 0.17 and behavior was path coefficient 0.19. The degree of explanation was 10%. CONCLUSION: We should try to improve environment management in behavior area, and through this study, the importance of education was verified.
Behavior Control ; Cross Infection ; Education ; Infection Control* ; Intention ; Operating Rooms* ; Seoul* ; Sterilization ; Surveys and Questionnaires

BACKGROUND: This is a theory verification study in which the theory of planned behavior (TPB) of Ajzen is applied to predict operating room (OR) infection control behavior. The study was carried out to know the path of attitude, subjective norm, perceived behavioral control, and intention towards OR infection control behavior. METHODS: A total of 178 OR nurses working at 13 hospitals in Seoul were the subjects of this study. A questionnaire survey was performed; the data were collected from April 6 to April 19, 2005 and analyzed with t-test, ANOVA, multiple regression, and person's correlation using SPSS program. Using AMOS, the factors of TPB were analyzed with path analysis. RESULTS: The total mean of infection control behavior of OR nurses was 4.37 points out of possible 5.0, and asepsis/operating instrument sterilization had 4.69, which was the highest among all areas of infection control behavior. In case of the relation between attitude, subjective norm, perceived behavior control, and intention, there was the strongest relation of cause and effect (path coefficient 0.38, 39%). In case of intention, perceived behavior control, and behavior, the relation of cause and effect between intention and behavior was path coefficient 0.17 and behavior was path coefficient 0.19. The degree of explanation was 10%. CONCLUSION: We should try to improve environment management in behavior area, and through this study, the importance of education was verified.
Behavior Control ; Cross Infection ; Education ; Infection Control* ; Intention ; Operating Rooms* ; Seoul* ; Sterilization ; Surveys and Questionnaires

OBJECTIVES: This study was performed to provide the basic data for establishing countermeasures for preventing injury by analyzing the incidence rates, the risk factors, the characteristics of the injury and the utilization of medical care for mild injury that lasted for two weeks. METHODS: We examined the injury survey data among the National Health and Nutrition Survey data. The definition of mild injury that lasted for two weeks was that the injury that caused pain at least once a day for two weeks or the injury for which the usual daily activity of the injured person was severely affected. We used statistical analysis methods such as chi-square test and multiple logistic regression analysis. RESULTS: The incidence rate of injury that lasted for two weeks was 4.7 per 1,000 persons. On the multiple logistic regression, the children and adolescents (OR=3.80, 95%CI=1.63-8.84) had higher rates of injuries than the adults, and the middle and high school (OR=0.51, 95%CI=0.31-0.85) and college(OR=0.34, 95%CI=0.17-0.68) students had lower rates of injuries than the elementary school students. The unemployed (OR=0.39, 95%CI=0.20-0.73) and others (OR=0.38, 95%CI=0.21-0.70) had lower rates of injuries than the blue collar workers. The major causes of injuries were found to be falling and slipping, and the most prevalent place of occurrence was near or at home. CONCLUSIONS: A prevention program needs to be developed and continuous education must be offered to the children, adolescents and blue collar workers.
Adolescent ; Adult ; Child ; Female ; Humans ; Incidence ; Korea/epidemiology ; Male ; Middle Aged ; *Nutrition Surveys ; Risk Factors ; Trauma Severity Indices ; Wounds and Injuries/classification/*epidemiology

Hypertension is one of the most well known risk factors for cerebrovascular or coronary heart disease and is a major public health problem. Early detection and treatment of hypertension are essential, but the compliance of treatment on hypertension is not easy to archive. Hypertensive workers are being detected by the annual screening under the Labour Standard Law in Korea but the solidified control system for them is not existing. This study about workers' Motive- Belief-Action in non-drug and drug treatment of their hypertension would be worthwhile to interpret how the workers actually behave in coping with hypertension, and also would be advisable to construct the follow-up program in Korea. In the field research process two criteria were used to select sample group. The first criterion included the workers who were screened to be hypertensive with their blood pressure above 160/95 in this survey. The second one was used to classify study-group respondents who had known their hypertension by successive annual screening. From such criteria a total of 156 male workers were sampled in 21 industries, the author interviewed them using the structured questionnaire which consisted of Belief-Motive-Action items about non-drug and drug treatment for hypertension with open-ended question on symptom of hypertension. The summary is as follows: 1) Sixty-one percent of respondents had ever checked their blood pressure somewhere besides the annual screening. 2) Most respondents(97.2%) complained no symptoms of hypertension at all. 3) Belief level of non-drug treatment was relatively high (82.1%-64.7%), but motive (55.1%-28.2%) and action (38.5%-16.7%) levels were low. 4) Belief level of drug treatment was relatively lower than that of non-drug treatment, blue collar workers showed higher action level of drug treatment than white collar workers, and correlation coefficient between belief and motive on drug treatment was lower in group of not-recognizing their family history of hypertension than recognized group. Such findings indicated that belief on drug treatment of hypertensive workers would be problematic. 5) White collar workers showed significant lower correlation coefficients between Motive and Action of salt restriction, restriction of fatty diet and relaxation than blue collar workers. 6) Mild hypertension group showed low levels of Motive and Action of non-drug treatment (salt restriction, restriction of fatty diet and relaxation) and also showed low correlation coefficient between Belief and Motive of above non-drug treatment.
Archives ; Blood Pressure ; Compliance ; Coronary Disease ; Surveys and Questionnaires ; Diet ; Follow-Up Studies ; Humans ; Hypertension ; Jurisprudence ; Korea ; Male ; Mass Screening ; Public Health ; Surveys and Questionnaires ; Relaxation ; Risk Factors ; Sick Role*