Background: This report presents annual data from the surgical site infection (SSI) module of the Korean National Healthcare-associated Infections Surveillance System (KONIS) from July 2021 to June 2022. Methods: Surveillance of 20 surgeries (e.g., stomach, colon, rectal, gallbladder surgery, knee replacement, hip replacement, craniotomy, ventricular shunts, spinal fusion, laminectomy, cardiac artery bypass grafting - incision in the chest site only and incisions both the chest and donor site, cardiac, prostatectomy, abdominal hysterectomy, vaginal hysterectomy, appendectomy, thoracic, cesarean section, and head and neck surgeries) associated with SSI was performed between July 1, 2021, and June 30, 2022, according to the KONIS Manual 2020. Results: A total of 133,281 surgical cases were collected and 1,100 SSIs were identified, resulting in a SSI rate of 0.83%. The SSI rates for 30-day surveillance surgeries were 1.9% for stomach, 2.82% for colon, 1.88% for rectal, 0.29% for gallbladder, 0.25% for lumbar laminectomy, 0.33% for cesarean section, 0.67% for abdominal hysterectomy, 0.74% for vaginal hysterectomy, 0.23% for prostatectomy, 1.39% for appendectomy, and 0.06% for thoracic surgeries. Neck surgery could not be analyzed due to no reported cases. The SSI rates for the 90-day surveillance surgeries were 0.16% for knee replacement, 0.54% for hip replacement, 0.89% for spinal fusion, 0.70% for craniotomy, 0.92% for ventricular shunt, 1.13% for cardiac, 1.80% for cardiac artery bypass grafting (chest only incision), and 1.64% for cardiac artery bypass grafting (chest and leg incision) surgeries. In total, 608 strains were isolated and cultured from 1,286 infections. Conclusion Compared with the incidence of SSI (1.06%) in 2018, the overall incidence decreased, and most site-specific infection rates decreased or remained the same.

Objectives: This study aimed to demonstrate the bone mineral density (BMD) and body composition in postmenopausal women with knee osteoarthritis (OA) who underwent surgical treatment, such as total knee arthroplasty, osteotomy, or meniscectomy. Methods: A total of 254 women with OA aged 50 years who underwent surgical treatment were enrolled in this study. We evaluated obesity-related factors, muscle components, and BMD using dual-energy X-ray absorptiometry. Results: No significant differences were noted in the BMD of the hip joint between the symptomatic side of the leg with knee OA and the contralateral side. However, when comparing the BMD of each component, the results indicated a significantly higher BMD in the obesity group based on body mass index (BMI). When defining sarcopenic obesity (SO) using various indicators of obesity (BMI, the estimated visceral adipose tissue area, android/gynoid ratio, and total body fat percentage), the prevalence of SO in the OA group who underwent surgical treatment ranged from 22.0% to 49.6%. Conclusions This study investigated obesity-related factors in patients with advanced knee OA who underwent surgery, revealing a high prevalence of overweight/obese individuals, the presence of SO, and a complex relationship between obesity, body composition, and bone density, highlighting the potential protective effects of weight-bearing on bone health while exploring the impact of sarcopenia on bone density differences in the context of OA. Depending on various definitions of obesity, diverse proportions of SO in patients with OA have been observed, and further detailed research is required to understand its impact on the condition.

Background: The purpose of this study was to describe the distinct cognitive trajectories for 8 years according to living arrangement among community-dwelling older adults using the Korean longitudinal study of ageing. Methods: We analyzed data from a final sample of 3,049 community-dwelling older adults aged 65 years or older who participated in at least three cognitive function measures in an 8-year period (2012-2020). Cognitive function was assessed by Korean mini mental state examination. Latent class growth model analysis was applied to determine the number and shape of trajectories of older adults according to living arrangement.Multinomial logistic regression analysis was used to determine risk factors for cognitive function trajectories. Results: We identified five trajectory patterns in cognitive function among older adults living alone; ‘high-stable (35.6%)’, ‘high-declining (32.5%)’, ‘moderate-steep declining (6.2%)’, ‘low-stable (18.9%)’, and ‘low declining (6.8%)’. In older adults living with family, there were four trajectory patterns; ‘high-stable (46.4%)’, ‘high-declining (32.0%)’, ‘low-stable (15.9%)’, and ‘low-declining (5.7%)’. Age, instrumental activities of daily living, and depression were common factors of cognitive changes in both older adults living alone and those living with family members. However, monthly incomes was only associated with the risk of cognitive function in older adults living alone. Conclusions We found that cognitive function trajectories among older adults may differ depending on the type of living arrangement. Therefore, further studies and health policies are required for avoiding cognitive impairment by living arrangement among older adults based on the results of this study.

Gastric cancer is one of the most common cancers in Korea and the world. Since 2004, this is the 4th gastric cancer guideline published in Korea which is the revised version of previous evidence-based approach in 2018. Current guideline is a collaborative work of the interdisciplinary working group including experts in the field of gastric surgery, gastroenterology, endoscopy, medical oncology, abdominal radiology, pathology, nuclear medicine, radiation oncology and guideline development methodology. Total of 33 key questions were updated or proposed after a collaborative review by the working group and 40 statements were developed according to the systematic review using the MEDLINE, Embase, Cochrane Library and KoreaMed database. The level of evidence and the grading of recommendations were categorized according to the Grading of Recommendations, Assessment, Development and Evaluation proposition. Evidence level, benefit, harm, and clinical applicability was considered as the significant factors for recommendation. The working group reviewed recommendations and discussed for consensus. In the earlier part, general consideration discusses screening, diagnosis and staging of endoscopy, pathology, radiology, and nuclear medicine. Flowchart is depicted with statements which is supported by meta-analysis and references. Since clinical trial and systematic review was not suitable for postoperative oncologic and nutritional follow-up, working group agreed to conduct a nationwide survey investigating the clinical practice of all tertiary or general hospitals in Korea. The purpose of this survey was to provide baseline information on follow up. Herein we present a multidisciplinary-evidence based gastric cancer guideline.

Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

Background: Multimorbidity and suicide rates are on the rising among older Korean population. Recent studies have shown that multimorbidity is associated with increased suicidal ideation. Thus, this study was to investigate individual factors of suicidal ideation among older Korean adults with multimorbidity. Methods: A cross-sectional study was conducted using a subsample (n=20,533) with multimorbidity aged 65 over of the 2017 Korean community health survey. Binary logistic regression model assessed the association of physical activity, sitting times, self-reported sleep duration, and depression with suicidal ideation in older adults with multimorbidity. Results: Overall, 2,790 (13.6%) of the sample reported suicidal ideation within the past year. Logistic regression analysis showed that women, low monthly family income, low physical activity, long sitting times, inappropriate sleep duration and depression were significantly associated with increased risk of suicidal ideation in older adults with multimorbidity. Conclusions To reduce the rate of suicidal ideation in older adults with multimorbidity, healthcare providers should be aware of the importance on routine assessment for physical activities, sleep pattern, and mental status of older adults in clinical settings. Particularly, female and low-income older adults with multimorbidity should be prioritized for early detection and individualized suicide prevention based on our findings.

Purpose: : This systematic review was conducted to identify which dyadic intervention could be implemented for heart failure patient–family caregiver dyads to improve patient and/or their family caregivers outcomes.Method : Eleven databases were searched from their inception to July, 2021. This review considered any randomized controlled trials that evaluated the effectiveness of intervention including heart failure patient-family caregiver dyads. Two reviewers independently evaluated the methodological quality using the Cochrane Collaboration’s tool for assessing risk of bias and extracted details of the included studies. The studies included in this review were not suitable for meta-analysis and therefore the results were presented as a narrative summary. Results: : Six studies including 900 dyads were included and mainly primary family caregiver of patients was spouse. Majority of dyadic intervention were focused on psychoeducational intervention excepting one study on mobile health intervention. All studies included in this review focused on patients’ outcomes compared to family caregivers’ outcomes and dyadic outcomes. Individual interventions improved quality of life among heart failure patients and their family caregivers in two articles. The overall quality of selected articles was low. Conclusions : This study provides moderate support for the use of a dyadic intervention to improve quality of life among heart failure patients and their family caregivers. More rigorous high-quality studies investigating interventions to meet the needs of patient and family caregivers in heart failure care are needed.

Human sparganosis is a zoonotic disease caused by infection and migration of the plerocercoid of Spirometra spp. Although sparganosis were reported from most parts of the body, the sparganum parasitizing inside cerebral artery is remarkably uncommon. We report a case of cerebral intravascular sparganosis in an elderly patient with acute ischemic stroke who was diagnosed by retrieving sparganum during mechanical thrombectomy. Finally, the parasites were identified as Spirometra erinaceieuropaei using multiplex PCR and cox1 gene sequencing.

PURPOSE: Heart failure (HF) is considered an important medical burden with rehospitalization and mortality. Anemia is a major risk factor associated with the severity of HF. To improve the understanding of the impact of anemia in the population with HF, we explored the prevalence of anemia, its guidelines, relationship between anemia and mortality or rehospitalization, and limitation of reviewed papers of various populations with HF.METHODS: We used Whittemore and Knafl's integrative review methodology (2005), and thirty research papers were analyzed. PubMed, CINAHL, Cochrane, PsychInfo, Embase, Web of Science were searched for papers published between January 1960-June 2018.RESULTS: Anemia in individuals with HF was primarily defined using the World Health Organization guideline. The prevalence of anemia in patients with HF varied from 9% to 56.7%. Moreover, such a condition significantly increases the prevalence of mortality or rehospitalization in patients with HF. The analyzed majority were non-prospective cohort study including secondary data analysis.CONCLUSION: Anemia in individuals with HF is a significant risk factor of mortality and rehospitalization. Prospective cohort studies should be designed to identify the optimal value for screening anemia and the impact of anemia on rehospitalization and mortality among HF patients.
Anemia ; Cohort Studies ; Heart Failure ; Heart ; Hospitalization ; Humans ; Mass Screening ; Mortality ; Prevalence ; Prospective Studies ; Risk Factors ; Statistics as Topic ; World Health Organization