1.Occurrences and Results of Acute Kidney Injury after Endovascular Aortic Abdominal Repair?
Jeahong LEE ; Keun Myoung PARK ; Sungteak JUNG ; Wonpyo CHO ; Kee Chun HONG ; Yong Sun JEON ; Soon Gu CHO ; Jung Bum LEE
Vascular Specialist International 2017;33(4):135-139
PURPOSE: Acute kidney injury (AKI) is an important postoperative complication that may impact mortality and morbidity. The incidence of AKI after elective endovascular aneurysm repair (EVAR) is not known well. The aim of this study is to assess the incidence of AKI after elective EVAR and examine the impact of AKI. MATERIALS AND METHODS: Data were collected and analyzed retrospectively from 78 elective EVARs for abdominal aortic aneurysm (AAA) among 102 total cases of conventional EVAR performed in Inha University Hospital from 2009 to 2015. The primary endpoint was incidence and risk factors of AKI. Secondary endpoints included drop in estimated glomerular filtration rate (eGFR) and the mortality of AKI. RESULTS: We included 78 patients (17 females, 21%; mean age, 73.9±12.5 years; mean AAA diameter, 59.3±8.9 cm), 11 (14.1%) of whom developed AKI. Within 48 hours, those with AKI experienced a decrease in eGFR from 65.5±21.2 to 51.2±19.6 mL/kg/1.73 m2, and those without AKI showed a change from 73.1±9.2 to 74.2±10.7 mL/kg/1.73 m2. There were no patients who required dialysis during follow-up (mean, 24.2±18.0 months). Development of AKI was related to operation time (odds ratio [OR], 2.024; 95% confidence interval [CI], 1.732–4.723; P < 0.010) and contrast dose (OR, 3.192; 95% CI, 2.182–4.329; P < 0.010). There were no differences in mortality between the 2 groups (P=0.784). CONCLUSION: The incidence of AKI after EVAR was related to operation time and contrast dose, but was not associated with medium-term mortality.
Acute Kidney Injury
;
Aneurysm
;
Aortic Aneurysm
;
Aortic Aneurysm, Abdominal
;
Dialysis
;
Endovascular Procedures
;
Female
;
Follow-Up Studies
;
Glomerular Filtration Rate
;
Humans
;
Incidence
;
Mortality
;
Postoperative Complications
;
Retrospective Studies
;
Risk Factors
2.ICT-Based Comprehensive Health and Social-Needs Assessment System for Supporting Person-Centered Community Care
Myonghwa PARK ; Eun Jeong CHOI ; Miri JEONG ; Nayoung LEE ; Minjung KWAK ; Mihyun LEE ; Eun Chung LIM ; Haesung NAM ; Dongil KIM ; Hanwool KU ; Bong Seok YANG ; Junsik NA ; Joong Shik JANG ; Ji Young KIM ; Wonpyo LEE
Healthcare Informatics Research 2019;25(4):338-343
OBJECTIVES: This study developed an information and communication technology (ICT)-based comprehensive health and social-needs assessment (CHSNA) system based on the International Classification of Functioning, Disability, and Health (ICF) with the aim of enhancing person-centered community care for community residents and supporting healthcare professionals and social workers who provide healthcare and social services in the community. METHODS: Items related to a CHSNA tool were developed and mapped with ICF codes. Experts validated the CHSNA system design and process using the Delphi method, and a pilot test of the initial version of the system was conducted. RESULTS: The following three steps of CHSNA were embedded in the system, which had a user-friendly screen and images: basic health assessment, life and activity assessment, and in-depth health assessment. The assessment results for the community residents were presented with visualized health profiles, including images, graphs, and an ICF model. CONCLUSIONS: The developed CHSNA system can be used by healthcare professionals, social workers, and community residents to evaluate the reasoning underlying health and social needs, to facilitate the identification of more appropriate healthcare plans, and to guide community residents to receive the best healthcare services. A CHSNA system can improve the implementation of standardized terminology utilizing the ICF and the accuracy of needs assessments of community residents.
Classification
;
Community Health Services
;
Decision Support Techniques
;
Delivery of Health Care
;
Methods
;
Needs Assessment
;
Patient-Centered Care
;
Social Work
;
Social Workers