1.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.
2.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.
3.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.
4.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.
5.Risk factors of hypotension during cesarean section with spinal anesthesia in parturients with COVID-19: a retrospective study in comparison with pregnant women without COVID-19
Si Ra BANG ; Gunn Hee KIM ; Sung Jun CHO ; Mi Jung YOON
Anesthesia and Pain Medicine 2024;19(4):326-332
The incidence of hypotension in parturients with coronavirus disease (COVID-19) undergoing regional anesthesia remains controversial. This study aimed to investigate the incidence of hypotension during spinal anesthesia in parturients infected with COVID-19, as well as to identify associated risk factors. Methods: This retrospective study compared COVID-19-positive parturients who underwent cesarean section under spinal anesthesia (COVID-19 group) with a control group between January 2017 and June 2022. We reviewed the medical records and collected the following information: basic patient characteristics, spinal anesthesia, and newborn-related data. Results: Compared with the control group, the COVID-19 group did not show any significant differences in terms of hypotension occurrence and vasopressor usage. A positive correlation was noted in the COVID-19 group between heart rate and duration of hospital stay (P < 0.001, Spearman’s rho = 0.422). In subgroup analysis of the COVID-19 group, group with a baseline heart rate ≥ 100 (group H) had lower Apgar scores at 1 min, longer hospital stays, and more severe COVID-19 symptoms than the with a baseline heart rate < 100 (group L). Moreover, in group H, there was a positive correlation between the heart rate and the lowest systolic blood pressure after spinal anesthesia (P = 0.012, Spearman’s rho = 0.528). Conclusions: Parturients with COVID-19 do not appear to have a higher risk of hypotension during cesarean section under spinal anesthesia than those without COVID-19. Given the close association between preoperative heart rate and extent of hypotension in parturients with COVID-19 undergoing spinal anesthesia, vigilant monitoring of vital signs by anesthesiologists is crucial during the perioperative period.
6.Impact of the COVID-19 Pandemic on Admission and Mortality Among Patients With Severe Emergency Diseases at Emergency Departments in Korea in 2020: Registry Data From the National Emergency Department Information System
Sun Kyoung NA ; Jeung-Hee KIM ; Weon-Young LEE ; Mi Ra OH
Journal of Korean Medical Science 2023;38(30):e243-
We aimed to investigate the impact of the coronavirus disease 2019 (COVID-19) pandemic on admissions of patients with acute myocardial infarction, stroke, and severe trauma, and their excess mortality in emergency departments (EDs) in South Korea using registry data from the National Emergency Department Information System (NEDIS) for patients attending EDs of regional and local emergency medical centers. During the outbreak period of 2020, there were 350,698 ED visits, which was lower than the total in 2019 (392,627 visits).Multiple logistic regression revealed that, compared with 2019, there was significantly higher ED mortality rate during the COVID-19 outbreak in 2020 (adjusted odds ratio, 1.10;95% confidence interval, 1.07–1.13). This finding implies that during the early outbreak period, people might have avoided seeking medical care even for acute and life-threatening conditions, or transfer times at the scene to the hospital arrival were delayed, or treatment for the patients in EDs were delayed.
7.Changes in Health Care Utilization and Medical Expenditures among the Visually Disabled
Hyo Jin SEONG ; Jiwon KIM ; Tae Mi YOUK ; Ha Ra JEON ; Hyunki KIM ; Eun Jee CHUNG
Journal of the Korean Ophthalmological Society 2022;63(2):175-182
Purpose:
To identify changes in medical expenditures and health care utilization before and after visual impairment onset, then analyze differences according to visual impairment severity.
Methods:
Patients aged ≥ 18 years who were registered as visually disabled from 2005 to 2013 were selected using the database from the registry of the disabled and the National Health Insurance Service. The observation period of 3 years before and after the registration was divided into 6-month units (12 points of interest). At each point of interest, medical cost, number of outpatient visits, and length of hospital stay (LOS) were analyzed. The control group was obtained through 1:10 stratification randomization to match sex and age; individuals in the control group were then selected via 1:1 propensity score matching for the premium quantile and residential area.
Results:
In total, 131,434 patients with visual disability and the same number of non-visually impaired controls were included. Compared with non-disabled individuals, the mean medical cost and number of outpatient visits were higher for patients with visual disability (1.9- and 1.4-fold, respectively, p < 0.001); the LOS was also 3.5 days longer (p < 0.001). The mean medical cost and number of outpatient visits were greater in severely visually disabled patients than in mildly disabled patients (1.6- and 0.5-fold, respectively, p < 0.001); the LOS was also 12 days longer in severely disabled patients (p < 0.001). From 18 months before disability registration, medical costs and LOS increased according to the presence and severity of visual disability; the number of outpatient visits increased uniformly, regardless of disability and severity.
Conclusions
More severe cases of visual impairment are associated with greater health care utilization and expenditures. Policy intervention is necessary to ensure that patients receive appropriate treatment and steady health care by reducing the burden of medical expenditures.
8.A Comparative Analysis of Clinical Screening Test and Language Specific Test in Language Delay Children
Na Ra LEE ; So Hee CHUNG ; Mi Kyoung SONG ; Young Hwa KONG ; Chan Uhng JOO ; Sun Jun KIM
Chonnam Medical Journal 2020;56(1):44-49
The aim of this study was to investigate the usefulness of a clinical screening test [the Korean Infant and Child Developmental Test (KICDT)] compared to language specific tests: the sequenced language scale for infant (SELSI) and the Preschool Receptive-Expressive language Scale (PRES) in children with delayed language development. A retrospective chart review was conducted on 615 children who visited the Department of Pediatrics at Chonbuk National University Hospital from January 2013 to December 2016. All patients were evaluated with KICDT as a clinical screening test and SELSI or PRES as a language specific test. Language Developmental Quotients (LDQs) from the KICDT were compared with the Receptive Language Quotient (RLQ) and expressive language quotient (ELQ) from the SELSI or PRES. The sensitivity, specificity and predictive values of LDQ of KICDT were calculated by comparing with SELSI/PRES. Language DQs from the KICDT were significantly correlated with the RLQ (r=0.706), ELQ (r=0.768), and total language quotient (TLQ) (r=0.766) from the SELSI/PRES (p<0.05). In cross tabulation, the patients belonging to the retardation groups in both KICDT and SELSI/PRES were 417 (67.8%). Otherwise, patients belonging to the normal group in KICDT but not in SELSI/PRES were 151 (24.6%). Sensitivity and specificity of LDQ of KICDT relative to SELSI/PRES were 72.3% and 92.2% respectively (p<0.05). Our data suggests that clinical screening tests alone, not cumbersome language specific tests, can determine language developmental delays in children.
9.Mediating Effect of Ego-Resiliency in the Relationship between Growth Mindset and Pregnancy Stress
Su Kyoung KANG ; Hae Mi KIM ; Mi Ra CHUNG
Journal of the Korean Society of Maternal and Child Health 2019;23(2):126-135
PURPOSE: This study investigates the effect of pregnant women's growth mindset on the stress of pregnancy through ego-resilience. METHODS: The subjects included 551 pregnant women in Seoul and Gyeonggi area. Data were collected using a structured questionnaire; statistical, frequency, correlation, and structural equation analyses were performed using SPSS21 and M-plus 7.0. RESULTS: First, pregnant women's growth mindset had a direct effect on pregnancy stress. Second, the mediating pathway that influenced pregnancy stress through the ego-resilience of growth mindset was significant. CONCLUSION: These results suggest that it is important to devise and practice a method to improve the growth mindset of pregnant women, enhance ego-resilience, and reduce the negative effects of stress by reducing pregnancy stress.
Female
;
Gyeonggi-do
;
Humans
;
Methods
;
Negotiating
;
Pregnancy
;
Pregnant Women
;
Seoul
10.Knowledge, Confidence, and Learning Needs Regarding Advance Directives among Hospital Nurses
Nan Soon JANG ; Hae Sook PARK ; Mi Ra KIM ; Joo Yeon LEE ; Yeo Won CHO ; Kyoung Mi KIM ; Youn Jung SON
Journal of Korean Critical Care Nursing 2018;11(1):35-45
PURPOSE: Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses.METHOD: This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire.RESULTS: The mean score of knowledge, confidence and learning needs were 5.00±1.73, 29.81±7.52, and 64.54±8.48 respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005).CONCLUSION: Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.
Advance Directives
;
Cross-Sectional Studies
;
Learning
;
Methods
;
Seoul
;
Terminal Care

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