ABSTRACT
Objective@#With trends in population aging an increasing number of older patients are visiting the emergency department (ED). This study aimed to identify the characteristics of ED utilization and risk factors for in-hospital mortality in older patients who visited EDs. @*Methods@#This nationwide observational study used National Emergency Department Information System data collected during a 2-year period from January 2016 to December 2017. The characteristics of older patients aged 70 years or older were compared with those of younger patients aged 20 to 69 years. Risk factors associated with in-hospital mortality were analyzed by multivariable logistic regression. @*Results@#A total of 6,596,423 younger patients and 1,737,799 older patients were included. In the medical and nonmedical older patient groups, significantly higher proportions of patients were transferred from another hospital, utilized emergency medical services, had Korean Triage and Acuity Scale scores of 1 and 2, required hospitalization, and required intensive care unit admission in the older patient group than in the younger patient group. ED and post-hospitalization mortality rates increased with age; in particular, older medical patients aged 90 or older had an in-hospital mortality rate of 9%. Older age, male sex, transfer from another hospital, emergency medical service utilization, a high Korean Triage and Acuity Scale score, systolic blood pressure 20/min, heart rate >100/min, body temperature <36°C, and altered mental status were associated with in-hospital mortality. @*Conclusion@#Development of appropriate decision-making algorithms and treatment protocols for high risk older patients visiting the ED might facilitate appropriate allocation of medical resources to optimize outcomes.
ABSTRACT
Objective@#With trends in population aging an increasing number of older patients are visiting the emergency department (ED). This study aimed to identify the characteristics of ED utilization and risk factors for in-hospital mortality in older patients who visited EDs. @*Methods@#This nationwide observational study used National Emergency Department Information System data collected during a 2-year period from January 2016 to December 2017. The characteristics of older patients aged 70 years or older were compared with those of younger patients aged 20 to 69 years. Risk factors associated with in-hospital mortality were analyzed by multivariable logistic regression. @*Results@#A total of 6,596,423 younger patients and 1,737,799 older patients were included. In the medical and nonmedical older patient groups, significantly higher proportions of patients were transferred from another hospital, utilized emergency medical services, had Korean Triage and Acuity Scale scores of 1 and 2, required hospitalization, and required intensive care unit admission in the older patient group than in the younger patient group. ED and post-hospitalization mortality rates increased with age; in particular, older medical patients aged 90 or older had an in-hospital mortality rate of 9%. Older age, male sex, transfer from another hospital, emergency medical service utilization, a high Korean Triage and Acuity Scale score, systolic blood pressure 20/min, heart rate >100/min, body temperature <36°C, and altered mental status were associated with in-hospital mortality. @*Conclusion@#Development of appropriate decision-making algorithms and treatment protocols for high risk older patients visiting the ED might facilitate appropriate allocation of medical resources to optimize outcomes.
ABSTRACT
PURPOSE: To evaluate device efficacy using the corneal curvature value. METHODS: Prospectively, 35 patients (70 eyes) were enrolled in the present study. Three sets of corneal curvature values were obtained using the autorefractor (RK-F1(R)), manual keratometer (OM-2(R)), partial coherence interferometry keratometer (IOL Master(R)), wavefront analyzer (KR-1W(R)), and videokeratography (Orbscan II(R)). Repeatability of each device was evaluated by coefficient of variation, standard deviation, and intraclass correlation coefficient. RM-ANOVA on ranks was used to compare the differences in corneal curvatures among the devices. The Bland-Altman plot was performed to assess measurement agreement among the devices. RESULTS: The coefficient of variation values from each device ranged from 2.92% (IOL master(R)) to 3.06% (Orbscan II(R)), and the values of intraclass correlation coefficient ranged from 0.965 (KR-1W(R)) to 0.997 (IOL master(R)). Compared with the manual keratometer, there was a maximum corneal curvature difference of 1.23 D in KR-1W(R), while the other devices had differences less than 0.82 D. CONCLUSIONS: When assessing corneal curvature, the repeatability values were similar among the 5 devices, although a difference greater than 1 D was observed when comparing the KR-1W(R) to the manual keratometer.
Subject(s)
Humans , Corneal Topography , Interferometry , Prospective StudiesABSTRACT
PURPOSE: To study target refraction to improve visual quality in patients implanted with ReSTOR(R) SN6AD1 IOL (intraocular lens). METHODS: This study included 128 patients (160 eyes) that had undergone cataract surgery and who had a far visual acuity score higher than 0.8 after 6 months. These patients were divided into 4 groups. The uncorrected visual acuity (UCVA) at far and near were greater than 0.8 and better than J1 in the first group (Group 1), greater than 0.8 and worse than J1 in the second group (Group 2), less than 0.8 and better than J1 in the third group (Group 3) and less than 0.8 and worse than J1 in the last group (Group 4). We also compared the postoperative refractive errors of the four groups. RESULTS: At 6 months postoperatively, the spherical equivalent (SE) was -0.12 +/- 0.51 in Group 1, 0.08 +/- 0.54 in Group 2, -0.60 +/- 0.60 in Group 3 and 0.02 +/- 0.73 in Group 4. The SE value of Group 3 was significantly different compared to those of the other groups. Groups 1 and 3 who had better visual acuity at near distance show a negative value of SE, and Groups 3 and 4 who had worse visual acuity at far distance contained more individuals with an absolute value of SE greater than 0.5 compared to those in Groups 1 and 2. CONCLUSIONS: The refractive power in multifocal IOL insertion is different from that used in monofocal IOL insertion. As the SE indicates a greater myopic shift, the visual acuity is better at near distance, and, when the absolute value of SE is greater than 0.5, the visual acuity at far distance is decreased.