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Background/Aims@#A quick and accurate diagnosis of Helicobacter pylori (H. pylori) infections is vital for effectively managing many upper gastrointestinal tract diseases. Many diagnostic methods have been developed for rapid and accurate diagnosis, including invasive and non-invasive methods, but each tool has some limitations. Among the invasive diagnostic methods, the rapid urease test (RUT) is a relatively time-saving and accurate method, but a variation in the reaction time range causes inconvenience and inefficiency in the clinical field. This study developed a liquid-type medium, Helicotest ® , to enable faster detection. This study examined the reaction time of a new liquid-type RUT kit with other commercial kits. @*Methods@#Two H. pylori strains were cultured (H. pylori ATCC 700392 and 43504), and the urease activity of H. pylori was measured using a urease activity assay kit (MAK120, Sigma Aldrich). Four RUT kits were used to compare the time of H. pylori detection, including Helicotest ® (Won Medical, Bucheon, Korea), Hp kit (Chong Kun Dang, Seoul, Korea), CLO kit (Halyard, Alpharetta, GA, USA), and ASAN Helicobacter Test ® (ASAN, Seoul, Korea). @*Results@#The detection of H. pylori was possible in bacterial amounts less than 10 μL. The color change was detected from five minutes with bacterial densities of 5 μL and 10 μL for both strains, whereas 30 minutes and one hour were required for 0.5 μL and a 1 μL bacterial density of ATCC 43504 and 700392 strains, respectively. @*Conclusions@#Compared to other RUT kits, Helicotest ® showed the fastest reaction. Therefore, faster diagnosis in clinical practice is expected.
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Purpose@#The purpose of this study is to examine the effects of the rural elderly suicide literacy level upon suicide stigma and coping advice with suicidal crises (recommending professional help for a suicidal person). In particular, this study investigates the role of cultural norms (perceived social expectations for the experience of negative emotions) on suicide stigma and coping ability. @*Methods@#A survey was conducted addressing elderly people (N=119) living in rural areas. Regression analysis using SPSS PROCESS macro was used to examine the relationships among the key variables. @*Results@#Participants with higher suicide literacy showed lower suicide stigma, and this perception had a significant effect on enhancing their coping advice with suicidal crises. Also, perceived social expectations significantly influenced the relationship between suicide stigma and coping advice. With lower levels of social expectations, the mediating effect of suicide stigma on the relationship between suicide literacy and recommending professional help did not exist whereas the indirect effect was significant when it pertained to high levels of social expectations. @*Conclusion@#This result signifies that suicide stigma serves as a barrier deterring Koreans from reaching out for professional help regarding their mental health. Moreover, these findings underscore the importance of cultural psychological factors such as perceived social expectations in terms of developing suicide prevention strategies.
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Purpose@#This study conducted two online surveys to rectify unclear factors of the existing scale and to modify suicide stigma scale with enhanced emotional aspects. The purpose of the first survey was to examine emotional responses toward suicide attempters and to revise items from existing scales. The purpose of the second survey was to verify the validity and reliability of the Korean Suicide Stigma Scale (KSSS). @*Methods@#The subject of this study is General Public. In the first online survey, 57 participants responded open-ended question regarding emotional aspect of attitudes toward suicidal person. 552 participants for the second survey responded to quantitative items for measuring suicide stigma. Descriptive and frequency analysis were used to examine the participant's demographic characteristics. Exploratory Factor Analysis and Confirmatory Factor Analysis were used to assess construct and convergent validity. @*Results@#The results yielded 7-factors with 28 items: Incompetence, Immorality, Selfishness, Sympathy, Social Exclusion, Dishonor, and Disgust. The Glorification factor, which was included in the previous scale, was deleted. ‘Dishonor’ and ‘Disgust’ factors were newly added. @*Conclusion@#The KSSS is similar to the scales developed in the Western countries, however it also reflects Korea’s unique Confucian cultural values. The KSSS can be used to systematically measure suicide stigma, and will help us develop effective suicide prevention strategies to reduce stigma in Korean society.
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Background@#The purpose of this study was to assess the correlation between sedatives and mortality in critically ill patients who required mechanical ventilation (MV) for ≥ 48 hours from 2008 to 2016. @*Methods@#We conducted a nationwide retrospective cohort study using population-based healthcare reimbursement claims database. Data from adult patients (aged ≥ 18) who underwent MV for ≥ 48 hours between 2008 and 2016 were identified and extracted from the National Health Insurance Service database. The benzodiazepine group consisted of patients who were administered benzodiazepines for sedation during MV. All other patients were assigned to the non-benzodiazepine group. @*Results@#A total of 158,712 patients requiring MV for ≥ 48 hours were admitted in 55 centers in Korea from 2008 to 2016. The benzodiazepine group had significantly higher in-hospital and one-year mortality compared to the non-benzodiazepine group (37.0% vs. 34.3%, 55.0% vs. 54.4%, respectively). Benzodiazepine use decreased from 2008 to 2016, after adjusting for age, sex, and mean Elixhauser comorbidity index in the Poisson regression analysis (incidence rate ratio, 0.968; 95% confident interval, 0.954–0.983; P < 0.001). Benzodiazepine use, older age, lower case volume (≤ 500 cases/year), chronic kidney disease, and higher Elixhauser comorbidity index were common significant risk factors for in-hospital and oneyear mortality. @*Conclusion@#In critically ill patients undergoing MV for ≥ 48 hour, the use of benzodiazepines for sedation, older age, and chronic kidney disease were associated with higher in-hospital mortality and one-year mortality. Further studies are needed to evaluate the impact of benzodiazepines on the mortality in elderly patients with chronic kidney disease requiring MV for ≥ 48 hours.
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Background@#The purpose of this study was to assess the correlation between sedatives and mortality in critically ill patients who required mechanical ventilation (MV) for ≥ 48 hours from 2008 to 2016. @*Methods@#We conducted a nationwide retrospective cohort study using population-based healthcare reimbursement claims database. Data from adult patients (aged ≥ 18) who underwent MV for ≥ 48 hours between 2008 and 2016 were identified and extracted from the National Health Insurance Service database. The benzodiazepine group consisted of patients who were administered benzodiazepines for sedation during MV. All other patients were assigned to the non-benzodiazepine group. @*Results@#A total of 158,712 patients requiring MV for ≥ 48 hours were admitted in 55 centers in Korea from 2008 to 2016. The benzodiazepine group had significantly higher in-hospital and one-year mortality compared to the non-benzodiazepine group (37.0% vs. 34.3%, 55.0% vs. 54.4%, respectively). Benzodiazepine use decreased from 2008 to 2016, after adjusting for age, sex, and mean Elixhauser comorbidity index in the Poisson regression analysis (incidence rate ratio, 0.968; 95% confident interval, 0.954–0.983; P < 0.001). Benzodiazepine use, older age, lower case volume (≤ 500 cases/year), chronic kidney disease, and higher Elixhauser comorbidity index were common significant risk factors for in-hospital and oneyear mortality. @*Conclusion@#In critically ill patients undergoing MV for ≥ 48 hour, the use of benzodiazepines for sedation, older age, and chronic kidney disease were associated with higher in-hospital mortality and one-year mortality. Further studies are needed to evaluate the impact of benzodiazepines on the mortality in elderly patients with chronic kidney disease requiring MV for ≥ 48 hours.
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Purpose@#To find biomarkers for disease, there have been constant attempts to investigate the genes that differ from those in the disease groups. However, the values that lie outside the overall pattern of a distribution, the outliers, are frequently excluded in traditional analytical methods as they are considered to be ‘some sort of problem.’ Such outliers may have a biologic role in the disease group. Thus, this study explored new biomarker using outlier analysis, and verified the suitability of therapeutic potential of two genes (TM4SF4 and LRRK2). @*Materials and Methods@#Modified Tukey’s fences outlier analysis was carried out to identify new biomarkers using the public gene expression datasets. And we verified the presence of the selected biomarkers in other clinical samples via customized gene expression panels and tissue microarrays. Moreover, a siRNA-based knockdown test was performed to evaluate the impact of the biomarkers on oncogenic phenotypes. @*Results@#TM4SF4 in lung cancer and LRRK2 in breast cancer were chosen as candidates among the genes derived from the analysis. TM4SF4 and LRRK2 were overexpressed in the small number of samples with lung cancer (4.20%) and breast cancer (2.42%), respectively. Knockdown of TM4SF4 and LRRK2 suppressed the growth of lung and breast cancer cell lines. The LRRK2 overexpressing cell lines were more sensitive to LRRK2-IN-1 than the LRRK2 under-expressing cell lines @*Conclusion@#Our modified outlier-based analysis method has proved to rescue biomarkers previously missed or unnoticed by traditional analysis showing TM4SF4 and LRRK2 are novel target candidates for lung and breast cancer, respectively.
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Purpose@#This study explored how and why young and middle-aged adults disclose depressive feelings to others. In particular, we investigated the role of social norms to see whether using mobile instant messaging (MIM) could lower the perceived barriers of emotional disclosure. Furthermore, the motivations of emotional disclosure via MIM were compared between young and middle-aged adults. @*Methods@#A total of 255 Koreans (128 middle-aged people, 127 young adults) participated in an online survey. Pearson’s correlation coefficients, paired t-tests, SPSS PROCESS macro, and exploratory factor analysis were used to examine the relationships among the key variables. @*Results@#The perceived social norms were found to be a significant deterrent in disclosing depressive feelings to others. However, there was a significant interaction effect between generations and perceived social norms. Although young adults with low social norm awareness were more likely to disclose depressive feelings via MIM, emotional disclosure among middle-aged adults increased with higher levels of perceived social norms. Also, different motivations were observed. @*Conclusion@#The results confirmed the significant effect of social norms as well as generational differences when using MIM as a channel of emotional disclosure.
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BACKGROUND: The impact of institutional case volume to graft failure rate after adult kidney transplantation is relatively unclear compared to other solid organ transplantations. METHODS: A retrospective cohort study of 13,872 adult kidney transplantations in Korea was performed. Institutions were divided into low- ( 60 cases/year) volume centers depending on the annual case volume. One-year graft failure rate was defined as the proportion of patients who required dialysis or re-transplantation at one year after transplantation. Postoperative in-hospital mortality and long-term graft survival were also measured. RESULTS: After adjustment, one year graft failure was higher in low-volume centers significantly (adjusted odds ratio [aOR], 1.50; 95% confidence interval [CI], 1.26–1.78; P < 0.001) and medium-volume centers (aOR, 1.87; 95% CI, 1.57–2.23; P < 0.001) compared to high-volume centers. Low-volume centers had significantly higher mortality (aOR, 1.75; 95% CI, 1.15–2.66; P = 0.01) than that of high-volume centers after adjustment. Long-term graft survival of up to 9 years was superior in high-volume centers compared to low- and medium-volume centers (P < 0.001). CONCLUSION: Higher-case volume centers were associated with lower one-year graft failure rate, lower in-hospital mortality, and higher long-term graft survival after kidney transplantation.
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Adult , Humans , Cohort Studies , Dialysis , Graft Survival , Hospital Mortality , Kidney Transplantation , Kidney , Korea , Mortality , Odds Ratio , Organ Transplantation , Retrospective Studies , TransplantsABSTRACT
PURPOSE: The purpose of this study is to examine the mediating effects of emotional venting via instant messaging (IM) and positive emotion in the relationship between negative emotion and depression.METHODS: Online survey was conducted in Korea between 2 April and 7 April 2019. To obtain samples with representativeness, data were gathered by the professional research firm. A total of 250 Koreans were participated in this study. The collected data were analyzed using descriptive statistics, Pearson's correlation coefficients, and SPSS PROCESS macro to test the mediating effects.RESULTS: This study analyzed the direct/indirect effects of negative emotion on emotional venting via IM, in the relationship between positive emotion and depression. Negative emotion had indirect effects on depression through emotional venting via IM and positive emotion. Both emotional venting via IM and positive emotion had dual mediating effects in the influence of negative emotion on depression.CONCLUSION: These results suggest that it is important to manage negative emotion to prevent depression. Also, this study confirmed that emotional venting via IM is a powerful factor influencing emotional recovery.
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BACKGROUND: The purpose of this study was to evaluate whether institutional case volume affects clinical outcomes in patients receiving mechanical ventilation for 48 hours or more. METHODS: We conducted a nationwide retrospective cohort study using the database of Korean National Healthcare Insurance Service. Between January 2007 and December 2016, 158,712 adult patients were included at 55 centers in Korea. Centers were categorized according to the average annual number of patients: > 500, 500 to 300, and 500 patients/year) showed lower in-hospital mortality and long-term mortality, compared to centers with lower case volume (< 300 patients/year) in patients who required mechanical ventilation for 48 hours or more.
Subject(s)
Adult , Humans , Cohort Studies , Critical Illness , Delivery of Health Care , Hospital Mortality , Insurance , Korea , Mortality , Odds Ratio , Respiration, Artificial , Retrospective StudiesABSTRACT
The objective of this preliminary study is to investigate the effects of various head turn in hemiplegic stroke patients with pharyngeal dysphagia. Twenty hemiplegic stroke patients with dysphagia participated in this study. A patient with dysphagia from an upper esophageal sphincter disorder was excluded. All participants underwent a videofluoroscopic swallow study (VFSS) with a 3 mL liquid diet, and their heads were randomly turned to a neutral position, toward the weaker side, toward the stronger side, or to a chin tuck posture. To assess patient swallowing function with VFSS, the videofluoroscopic dysphagia scale (VDS) and penetration-aspiration scale (PAS) were conducted by a physiatrist blinded to the participant's characteristics. No significant improvements in the VDS and PAS were observed in patients with heads rotated toward the weaker or stronger side when compared with heads in the neutral position. However, there was a significant improvement in the VDS for heads in the chin tuck position when compared with those in the neutral position (p < 0.05). These preliminary results revealed that the head turn practice without VFSS, as a compensatory strategy, could not improve dysphagia in hemiplegic stroke patients. Therefore, compensatory postures might be re-considered with in hemiplegic stroke patients with pharyngeal dysphagia.
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Humans , Chin , Deglutition , Deglutition Disorders , Diet , Esophageal Sphincter, Upper , Head , Posture , StrokeABSTRACT
BACKGROUND: A number of questionnaires designed for analyzing family members' inconvenience and demands in intensive care unit (ICU) care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24) questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. METHODS: The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items) and satisfaction with decision making (10 items). RESULTS: In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman's r = 0.84, p < 0.001). Cronbach's αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation) total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03) and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84). CONCLUSIONS: The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members' satisfaction about ICU care.
Subject(s)
Humans , Atmosphere , Critical Care , Decision Making , Emergencies , Intensive Care Units , North America , Tertiary Care Centers , Visual Analog ScaleABSTRACT
Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.
Subject(s)
Humans , Airway Obstruction , Bronchi , Bronchoscopy , Intensive Care Units , Intubation , Patient Rights , Prone PositionABSTRACT
BACKGROUND: A number of questionnaires designed for analyzing family members' inconvenience and demands in intensive care unit (ICU) care have been developed and validated in North America. The family satisfaction in the intensive care Unit-24 (FS-ICU-24) questionnaire is one of the most widely used of these instruments. This study aimed to translate the FS-ICU-24 questionnaire into Korean and validate the Korean version of the questionnaire. METHODS: The study was conducted in the medical, surgical, and emergency ICUs at three tertiary hospitals. Relatives of all patients hospitalized for at least 48 hours were enrolled for this study participants. The validation process included the measurement of construct validity, internal consistency, and interrater reliability. The questionnaire consists of 24 items divided between two subscales: satisfaction with care (14 items) and satisfaction with decision making (10 items). RESULTS: In total, 200 family members of 176 patients from three hospitals completed the FS-ICU-24 questionnaire. Construct validity for the questionnaire was superior to that observed for a visual analog scale (Spearman's r = 0.84, p < 0.001). Cronbach's αs were 0.83 and 0.80 for the satisfaction with care and satisfaction with decision making subscales, respectively. The mean (± standard deviation) total FS-ICU-24 score was 75.44 ± 17.70, and participants were most satisfied with consideration of their needs (82.13 ± 21.03) and least satisfied with the atmosphere in the ICU waiting room (35.38 ± 34.84). CONCLUSIONS: The Korean version of the FS-ICU-24 questionnaire demonstrated good validity and could be a useful instrument with which to measure family members' satisfaction about ICU care.
Subject(s)
Humans , Atmosphere , Critical Care , Decision Making , Emergencies , Intensive Care Units , North America , Tertiary Care Centers , Visual Analog ScaleABSTRACT
Reinforced endotracheal tubes (ETTs) are designed to resist kinking or compression. However, these have a potential risk of being obstructed or severed by a patient's bite. We report a case in which a reinforced ETT was severed by tube-bite while the patient was in the prone position during an intensive care unit stay. Bronchoscopic evaluation showed that the severed distal part of the tube had lodged in the patient's right main bronchus, and it had to be surgically removed. The patency of reinforced ETTs should be carefully monitored in patients intubated in the prone position.
Subject(s)
Humans , Airway Obstruction , Bronchi , Bronchoscopy , Intensive Care Units , Intubation , Patient Rights , Prone PositionABSTRACT
Seizure is the second most common neurologic complication after liver transplantation and may be caused by metabolic abnormalities, electrolyte imbalance, infection, and immunosuppressant toxicity. A 61-year-old male patient underwent liver transplantation due to hepatitis B virus-related liver cirrhosis with portal systemic encephalopathy. The immediate postoperative course of the patient was uncomplicated. However, on postoperative day (POD) 6, weakness developed in both lower extremities. No abnormal findings were detected on a brain computed tomography (CT) scan on POD 8, but a generalized tonic clonic seizure developed which was difficult to control even with multiple antiepileptic drugs. A follow-up brain CT scan on POD 15 showed a 2.7 cm sized acute intracranial hemorrhage (ICH) in the left parietal lobe. The patient's mental status improved after 2 months and he was able to communicate through eye blinking or head shaking. Our case reports an acute ICH that manifested into a refractory seizure in a patient who underwent a liver transplant.
Subject(s)
Humans , Male , Middle Aged , Anticonvulsants , Blinking , Brain , Brain Diseases , Follow-Up Studies , Head , Hepatic Encephalopathy , Hepatitis B , Intracranial Hemorrhages , Liver Cirrhosis , Liver Transplantation , Liver , Lower Extremity , Parietal Lobe , Seizures , Tissue Donors , Tomography, X-Ray ComputedABSTRACT
BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Subject(s)
Humans , Male , Comorbidity , Health Expenditures , Hospital Mortality , Immunosuppression Therapy , Immunosuppressive Agents , Insurance , Insurance, Health , Intensive Care Units , Korea , Length of Stay , Mortality , Multivariate Analysis , Risk Factors , Sepsis , SteroidsABSTRACT
BACKGROUND: The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis. METHODS: Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed. RESULTS: Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality. CONCLUSIONS: Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.
Subject(s)
Humans , Male , Comorbidity , Health Expenditures , Hospital Mortality , Immunosuppression Therapy , Immunosuppressive Agents , Insurance , Insurance, Health , Intensive Care Units , Korea , Length of Stay , Mortality , Multivariate Analysis , Risk Factors , Sepsis , SteroidsABSTRACT
In most cases, persistent left superior vena cava (PLSVC) is asymptomatic and discovered accidentally. This case involves a 43-year-old male who underwent an emergency cadaveric liver transplantation. Postoperatively, the left internal jugular vein was cannulated using a sono-guided Seldinger technique in the intensive care unit. But the chest X-ray showed that the catheter followed the left paramediastinal course instead of crossing midline to the right to enter the superior vena cava. In consideration of the patient's status, an intra-arterial or extra-vascular placement could be excluded. For a diagnosis, we performed a bed-side transthoracic echocardiography with an agitated saline micro-bubble test. When agitated saline was injected through the catheter, the coronary sinus was initially opacified, and then the right atrium followed. In conclusion, we were able to make a diagnosis of PLSVC by a bedside test without radiation exposure.
Subject(s)
Adult , Humans , Male , Cadaver , Catheters , Contrast Media , Coronary Sinus , Diagnosis , Dihydroergotamine , Echocardiography , Emergencies , Heart Atria , Heart Defects, Congenital , Intensive Care Units , Jugular Veins , Liver Transplantation , Liver , Thorax , Vena Cava, SuperiorABSTRACT
BACKGROUND: The Acute Physiology and Chronic Health Evaluation (APACHE) IV model has not yet been validated in Korea. The aim of this study was to compare the ability of the APACHE IV with those of APACHE II, Simplified Acute Physiology Score (SAPS) 3, and Korean SAPS 3 in predicting hospital mortality in a surgical intensive care unit (SICU) population. METHODS: We retrospectively reviewed electronic medical records for patients admitted to the SICU from March 2011 to February 2012 in a university hospital. Measurements of discrimination and calibration were performed using the area under the receiver operating characteristic curve (AUC) and the Hosmer-Lemeshow test, respectively. We calculated the standardized mortality ratio (SMR, actual mortality predicted mortality) for the four models. RESULTS: The study included 1,314 patients. The hospital mortality rate was 3.3%. The discriminative powers of all models were similar and very reliable. The AUCs were 0.80 for APACHE IV, 0.85 for APACHE II, 0.86 for SAPS 3, and 0.86 for Korean SAPS 3. Hosmer and Lemeshow C and H statistics showed poor calibration for all of the models (P < 0.05). The SMRs of APACHE IV, APACHE II, SAPS 3, and Korean SAPS 3 were 0.21, 0.11 0.23, 0.34, and 0.25, respectively. CONCLUSIONS: The APACHE IV revealed good discrimination but poor calibration. The overall discrimination and calibration of APACHE IV were similar to those of APACHE II, SAPS 3, and Korean SAPS 3 in this study. A high level of customization is required to improve calibration in this study setting.