1.Sex-Specific Differences and Risk Factors for Postoperative Urinary Retention after Spine Surgery with TIVA
Ansun JEONG ; Mira HAN ; Noah HONG ; Hae Chan SONG ; Tae Joon KIM ; Sung Bae PARK
Journal of Korean Neurosurgical Society 2026;69(1):112-123
Objective:
: To identify sex-specific risk factors for postoperative urinary retention (POUR) in patients undergoing spine surgery with total intravenous anesthesia (TIVA) and explore differences between male and female patients.
Methods:
: A retrospective chart review was conducted on 446 adult patients (268 males, 178 females) who underwent spine surgery with TIVA from January 1, 2019 to December 31, 2023. Propensity score matching was applied to adjust for confounding variables, resulting in 328 matched patients (164 males and 164 females). Multivariable logistic regression analyses were performed to identify independent risk factors for POUR. Residual urine volume ≥300 mL was used to define POUR.
Results:
: Male patients had a higher incidence of POUR compared to female patients. Significant risk factors for POUR in males included myelopathy (adjusted odds ratio [aOR], 5.17; 95% confidence interval [CI], 1.11–24.15), benign prostatic hyperplasia (BPH) (aOR, 2.63; 95% CI, 1.02–6.78), and prolonged anesthesia time ≥240 minutes (aOR, 2.54; 95% CI, 1.13–5.72). No significant risk factors were found in female patients. Myelopathy and prolonged anesthesia were associated with an increased risk of POUR across the overall population.
Conclusion
: Male sex, myelopathy, BPH, and prolonged anesthesia time are significant risk factors for POUR following spine surgery with TIVA. Given these findings, particular attention should be paid to myelopathy, a history of BPH, and anesthesia time in male patients.
2.Sex Disparity in Cancer and Non-cancer Mortality among Korean Cancer Survivors
Ansun JEONG ; Soyeoun KIM ; Somin JEON ; Boyoung PARK
Journal of Cancer Prevention 2025;30(4):196-204
This study assessed sex disparities in the causes of death (CODs), both related to cancer and non-cancer, in a nationwide database of cancer survivors in South Korea. Our database included cancer cases diagnosed in Korea between 2009 and 2016, and their CODs up to 2021. Deaths were classified into three categories: index-cancer, non-index-cancer, and non-cancer causes.Male-to-female age-standardized mortality ratios (M/F SMRs) were computed by dividing the male-specific mortality rate by the corresponding female-specific rate. Out of a total of 279,104 (49.0%) recorded deaths in male survivors and 141,674 (27.9%) deaths in female survivors, the M/F SMRs showed an elevated mortality risk in males, both for cancer-related causes (1.46, 95% CI 1.45-1.47) and non-cancer CODs (1.75, 95% CI 1.74-1.77). Among non-cancer CODs, the most significant sex disparity in mortality risk was evident in deaths attributed to chronic lower respiratory diseases (CLRDs), with an SMR of 4.51 (95% CI 4.30-4.73), followed by mortalities due to intentional self-harm (suicide) (2.95, 95% CI 2.85-3.05) and transportation accidents (SMR 2.86, 95% CI 2.67-3.04). Subgroup analysis focusing on survivors of common cancer sites indicated a relatively consistent pattern in index cancer deaths, but the M/F SMRs for non-index cancer and non-cancer deaths demonstrated variability across different cancer sites. Our study underscores an overall elevated mortality risk in male cancer survivors compared to female counterparts. Although deaths stemming from primary cancer remain a substantial concern for both sexes, disparities in non-cancer deaths warrant considerable attention, particularly in relation to CLRD and intentional self-harm (suicide) among male survivors.
3.Validation of self-reported morbidities in the Korean Atomic Bomb Survivor Cohort
Ansun JEONG ; Somin JEON ; Seong-geun MOON ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Epidemiology and Health 2024;46(1):e2024058-
OBJECTIVES:
This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR).
METHODS:
Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the area under the curve, and the kappa coefficient.
RESULTS:
The mean±standard deviation age was 62.1±18.7 years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8 and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma.
CONCLUSIONS
The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.
4.Validation of self-reported morbidities in the Korean Atomic Bomb Survivor Cohort
Ansun JEONG ; Somin JEON ; Seong-geun MOON ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Epidemiology and Health 2024;46(1):e2024058-
OBJECTIVES:
This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR).
METHODS:
Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the area under the curve, and the kappa coefficient.
RESULTS:
The mean±standard deviation age was 62.1±18.7 years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8 and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma.
CONCLUSIONS
The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.
5.Validation of self-reported morbidities in the Korean Atomic Bomb Survivor Cohort
Ansun JEONG ; Somin JEON ; Seong-geun MOON ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Epidemiology and Health 2024;46(1):e2024058-
OBJECTIVES:
This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR).
METHODS:
Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the area under the curve, and the kappa coefficient.
RESULTS:
The mean±standard deviation age was 62.1±18.7 years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8 and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma.
CONCLUSIONS
The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.
6.Validation of self-reported morbidities in the Korean Atomic Bomb Survivor Cohort
Ansun JEONG ; Somin JEON ; Seong-geun MOON ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Epidemiology and Health 2024;46(1):e2024058-
OBJECTIVES:
This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR).
METHODS:
Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the area under the curve, and the kappa coefficient.
RESULTS:
The mean±standard deviation age was 62.1±18.7 years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8 and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma.
CONCLUSIONS
The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.
7.Comparison of Proportional Mortality Between Korean Atomic Bomb Survivors and the General Population During 1992–2019
Ansun JEONG ; Seong-geun MOON ; Yunji HAN ; Jin-Wu NAM ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Journal of Korean Medical Science 2023;38(13):e110-
Background:
Atomic bombs dropped on Hiroshima and Nagasaki in Japan in August 1945 were estimated to have killed approximately 70,000 Koreans. In Japan, studies on the health status and mortality of atomic bomb survivors compared with the non-exposed population have been conducted. However, there have been no studies related to the mortality of Korean atomic bomb survivors. Therefore, we aimed to study the cause of death of atomic bomb survivors compared to that of the general population.
Methods:
Of 2,299 atomic bomb survivors registered with the Korean Red Cross, 2,176 were included in the study. In the general population, the number of deaths by age group was calculated from 1992 to 2019, and 6,377,781 individuals were assessed. Causes of death were categorized according to the Korean Standard Classification of Diseases. To compare the proportional mortality between the two groups, the P value for the ratio test was confirmed, and the Cochran-Armitage trend test and χ 2 test were performed to determine the cause of death according to the distance from the hypocenter.
Results:
Diseases of the circulatory system were the most common cause of death (25.4%), followed by neoplasms (25.1%) and diseases of the respiratory system (10.6%) in atomic bomb survivors who died between 1992 and 2019. The proportional mortality associated with respiratory diseases, nervous system diseases, and other diseases among atomic bomb survivors was higher than that of the general population. Of the dead people between 1992 and 2019, the age at death of survivors who were exposed at a close distance was younger than those who were exposed at a greater distance.
Conclusion
Overall, proportional mortality of respiratory diseases and nervous system diseases was high in atomic bomb survivors, compared with the general population. Further studies on the health status of Korean atomic bomb survivors are needed.
8.Cohort Study Protocol: A Cohort of Korean Atomic Bomb Survivors and Their Offspring
Seong-geun MOON ; Ansun JEONG ; Yunji HAN ; Jin-Wu NAM ; Mi Kyung KIM ; Inah KIM ; Yu-Mi KIM ; Boyoung PARK
Journal of Preventive Medicine and Public Health 2023;56(1):1-11
In 1945, atomic bombs were dropped on Hiroshima and Nagasaki. Approximately 70 000 Koreans are estimated to have been exposed to radiation from atomic bombs at that time. After Korea’s Liberation Day, approximately 23 000 of these people returned to Korea. To investigate the long-term health and hereditary effects of atomic bomb exposure on the offspring, cohort studies have been conducted on atomic bomb survivors in Japan. This study is an ongoing cohort study to determine the health status of Korean atomic bomb survivors and investigate whether any health effects were inherited by their offspring. Atomic bomb survivors are defined by the Special Act On the Support for Korean Atomic Bomb Victims, and their offspring are identified by participating atomic bomb survivors. As of 2024, we plan to recruit 1500 atomic bomb survivors and their offspring, including 200 trios with more than 300 people. Questionnaires regarding socio-demographic factors, health behaviors, past medical history, laboratory tests, and pedigree information comprise the data collected to minimize survival bias. For the 200 trios, whole-genome analysis is planned to identify de novo mutations in atomic bomb survivors and to compare the prevalence of de novo mutations with trios in the general population. Active follow-up based on telephone surveys and passive follow-up with linkage to the Korean Red Cross, National Health Insurance Service, death registry, and Korea Central Cancer Registry data are ongoing. By combining pedigree information with the findings of trio-based whole-genome analysis, the results will elucidate the hereditary health effects of atomic bomb exposure.

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