Heart failure (HF) is a major cause of mortality and morbidity in South Korea, imposing substantial physical, emotional, and financial burdens on patients and society. Despite the high burden of symptom and complex care needs of HF patients, palliative care and hospice services remain underutilized in South Korea due to cultural, institutional, and knowledge-related barriers. This position statement from the Korean Society of Heart Failure emphasizes the need for integrating palliative and hospice care into HF management to improve quality of life and support holistic care for patients and their families. By clarifying the role of palliative care in HF and proposing practical referral criteria, this position statement aims to bridge the gap between HF and palliative care services in South Korea, ultimately improving patient-centered outcomes and aligning treatment with the goals and values of HF patients.

Purpose: Results of initial endoscopic biopsy of gastric lesions often differ from those of the final pathological diagnosis. We evaluated whether an artificial intelligence-based gastric lesion detection and diagnostic system, ENdoscopy as AI-powered Device Computer Aided Diagnosis for Gastroscopy (ENAD CAD-G), could reduce this discrepancy. Materials and Methods: We retrospectively collected 24,948 endoscopic images of early gastric cancers (EGCs), dysplasia, and benign lesions from 9,892 patients who underwent esophagogastroduodenoscopy between 2011 and 2021. The diagnostic performance of ENAD CAD-G was evaluated using the following real-world datasets: patients referred from community clinics with initial biopsy results of atypia (n=154), participants who underwent endoscopic resection for neoplasms (Internal video set, n=140), and participants who underwent endoscopy for screening or suspicion of gastric neoplasm referred from community clinics (External video set, n=296). Results: ENAD CAD-G classified the referred gastric lesions of atypia into EGC (accuracy, 82.47%; 95% confidence interval [CI], 76.46%–88.47%), dysplasia (88.31%; 83.24%– 93.39%), and benign lesions (83.12%; 77.20%–89.03%). In the Internal video set, ENAD CAD-G identified dysplasia and EGC with diagnostic accuracies of 88.57% (95% CI, 83.30%– 93.84%) and 91.43% (86.79%–96.07%), respectively, compared with an accuracy of 60.71% (52.62%–68.80%) for the initial biopsy results (P<0.001). In the External video set, ENAD CAD-G classified EGC, dysplasia, and benign lesions with diagnostic accuracies of 87.50% (83.73%–91.27%), 90.54% (87.21%–93.87%), and 88.85% (85.27%–92.44%), respectively. Conclusions ENAD CAD-G is superior to initial biopsy for the detection and diagnosis of gastric lesions that require endoscopic resection. ENAD CAD-G can assist community endoscopists in identifying gastric lesions that require endoscopic resection.

This report presents the latest statistics on the stroke population in South Korea, sourced from the Clinical Research Collaborations for Stroke in Korea-National Institute for Health (CRCS-K-NIH), a comprehensive, nationwide, multicenter stroke registry. The Korean cohort, unlike western populations, shows a male-to-female ratio of 1.5, attributed to lower risk factors in Korean women. The average ages for men and women are 67 and 73 years, respectively.Hypertension is the most common risk factor (67%), consistent with global trends, but there is a higher prevalence of diabetes (35%) and smoking (21%). The prevalence of atrial fibrillation (19%) is lower than in western populations, suggesting effective prevention strategies in the general population. A high incidence of large artery atherosclerosis (38%) is observed, likely due to prevalent intracranial arterial disease in East Asians and advanced imaging techniques.There has been a decrease in intravenous thrombolysis rates, from 12% in 2017–2019 to 10% in 2021, with no improvements in door-to-needle and door-to-puncture times, worsened by the coronavirus disease 2019 pandemic. While the use of aspirin plus clopidogrel for noncardioembolic stroke and direct oral anticoagulants for atrial fibrillation is well-established, the application of direct oral anticoagulants for non-atrial fibrillation cardioembolic strokes in the acute phase requires further research. The incidence of early neurological deterioration (13%) and the cumulative incidence of recurrent stroke at 3 months (3%) align with global figures. Favorable outcomes at 3 months (63%) are comparable internationally, yet the lack of improvement in dependency at 3 months highlights the need for advancements in acute stroke care.

OBJECTIVES: This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI). METHODS: We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index). RESULTS: Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant. CONCLUSIONS In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Purpose: Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems.To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program. Methods: K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation. Results: Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea. Conclusion This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.

OBJECTIVES: This study investigated the associations between several obesity-related anthropometric indices and mortality in middle-aged and elderly populations to compare the indices’ predictive ability with that of the body mass index (BMI). METHODS: We analyzed data on 12 indices calculated from 19,805 community-based cohort participants (average age, 63.27 years; median follow-up, 13.49 years). Each index was calculated using directly measured values of height, weight, waist circumference (WC), and hip circumference (HC). We calculated hazard ratios (HRs) and 95% confidence intervals (CIs) for each index using Cox regression and evaluated mortality prediction with the Harrell concordance index (c-index). RESULTS: Adding anthropometric indices to the basic mortality model (c-index, 0.7723; 95% CI, 0.7647 to 0.7799) significantly increased the predictive power of BMI (c-index, 0.7735; 95% CI, 0.7659 to 0.7811), a body shape index (ABSI; c-index, 0.7735; 95% CI, 0.7659 to 0.7810), weight-adjusted waist index (WWI; c-index, 0.7731; 95% CI, 0.7656 to 0.7807), and waist to hip index (WHI; c-index, 0.7733; 95% CI, 0.7657 to 0.7809). The differences between the BMI model and the other 3 models were not statistically significant. CONCLUSIONS In predicting all-cause mortality, the ABSI, WWI, and WHI models based on WC or HC had stronger predictive power than conventional risk factors but were not significantly different from the BMI model.

Purpose: To compare the postoperative changes between unilateral medial rectus resection and lateral rectus recession and evaluate surgical outcomes of unilateral one-muscle surgery in basic intermittent exotropia under 25 prism diopters (PD) with a larger near than distance deviation. Methods: This study was conducted on patients with basic intermittent exotropia under 25 PD and a larger near than distance deviation. A retrospective analysis was conducted on 23 patients who underwent unilateral medial rectus resection (Group 1) and 32 patients who underwent unilateral lateral rectus recession (Group 2) as primary surgery. The angle of deviation at near and distance was measured at 1 week, 1 month, 3 months, 6 months, and 1 year postoperatively. Surgical success was defined as within 4 PD of esophoria or 10 PD of exophoria at 1 year after surgery. Results: The mean preoperative deviation angle was 20.18 ± 2.55 PD for Group 1 and 19.30 ± 2.77 PD for Group 2, while the mean near-distance disparity was 6.83 ± 2.67 PD for Group 1 and 5.18 ± 1.56 PD for Group 2. At 1 year postoperatively, the mean distance deviation angle was 9.43 ± 5.82 PD for Group 1 and 5.94 ± 6.49 PD for Group 2. The mean near-distance disparity at 1 year was 0.91 ± 3.96 PD for Group 1 and 0.81 ± 2.07 PD for Group 2. The success rates at 1 year were 65.2% for Group 1 and 72.7% for Group 2 (p = 0.362). Both groups showed effective reductions in the postoperative angle of deviation and near-distance disparity with no significant difference between the groups. Conclusions Unilateral medial rectus resection and lateral rectus recession both effectively manage basic intermittent exotropia under 25 PD with larger near than distance deviation as the primary surgery.