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Purpose@#: This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. @*Methods@#: This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. @*Results@#: The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). @*Conclusion@#: The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.
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Purpose@#: This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU).Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher’s exact tests, and logistic regression were performed to analyze the data. @*Results@#: Among the 154 subjects, there were a total of 198 medical device–related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). @*Conclusion@#: These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.
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Purpose@#This study aimed to investigate the risk factors for cardiac implantable electronic device (CIED)-related infections within the first post-procedural year after CIED insertion. @*Methods@#This study included 509 adult patients undergoing CIED implantation procedures between January 1, 2011 and December 31, 2015. The data were analyzed by t-test, chi-square test, Fisher’s exact test, and logistic regression analysis using SPSS/WIN 23.0. @*Results@#Fifteen infections and 494 non-infections were examined. The CIED-related infection rate was 2.9%; patients with 14 pocket infections and one bacteremia were included in the CIED-related infection. The risk factors of CIED-related infections were the estimated glomerular filtration rate (eGFR) of ≤ 45 mL/min/1.73 m2 (Odds ratio [OR] = 4.03, 95% confidence interval [CI],1.15-14.10) and taking a new oral anticoagulant (NOAC) (OR = 4.50, 95% CI 1.09-18.55). @*Conclusion@#These results identified the CIED infection rate and risk factors of CIED-related infection. It is necessary to consider these risk factors before the CIED implantation procedure and to establish the relevant nursing interventions.
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Purpose@#The purpose of this study was to identify the factors influencing nurses’ caring behavior. @*Methods@#The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. @*Results@#Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. @*Conclusion@#Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.
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Purpose@#The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. @*Methods@#A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher’s exact test, and logistic regression with IBM SPSS/WIN 24.0. @*Results@#Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome ( χ2 = 6.01, p = .014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR] = 1.14, 95% Confidence interval [CI] = 1.06-1.23), aphasia (OR = 6.16, CI = 1.62-23.40), anosognosia (OR = 4.84, CI = 1.13-20.79), presence of both aphasia and anosognosia (OR = 7.33, CI = 1.20-44.60), and time required to achieve targeted blood pressure (OR = 1.00, CI = 1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation ( χ2 = 6.32, p = .012), intensive care unit length of stay (Z = -2.08, p = .038), National Institute of Health Stroke scale score at discharge (Z = -3.14, p = .002), and modified Rankin Scale score at discharge (Z = -2.93, p = .003). @*Conclusion@#This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.
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Purpose@#The purpose of this study was to identify the factors influencing nurses’ caring behavior. @*Methods@#The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson’s correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. @*Results@#Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses’ caring behaviors (r = .36, p < .001). Multiple regression analysis showed that perception of support (β = .36, p < .001), total career length (β = .33, p < .001), and familiarity with PFCC (β = .15, p = .018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. @*Conclusion@#Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.
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Purpose@#The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. @*Methods@#A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher’s exact test, and logistic regression with IBM SPSS/WIN 24.0. @*Results@#Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome ( χ2 = 6.01, p = .014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR] = 1.14, 95% Confidence interval [CI] = 1.06-1.23), aphasia (OR = 6.16, CI = 1.62-23.40), anosognosia (OR = 4.84, CI = 1.13-20.79), presence of both aphasia and anosognosia (OR = 7.33, CI = 1.20-44.60), and time required to achieve targeted blood pressure (OR = 1.00, CI = 1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation ( χ2 = 6.32, p = .012), intensive care unit length of stay (Z = -2.08, p = .038), National Institute of Health Stroke scale score at discharge (Z = -3.14, p = .002), and modified Rankin Scale score at discharge (Z = -2.93, p = .003). @*Conclusion@#This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.
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Purpose@#The purpose of this study was to investigate the risk factors of intracranial hemorrhage in children with skull fractures from head trauma. @*Methods@#The retrospective study included 205 patients diagnosed with a skull fracture in a pediatric emergency room. Data were analyzed using χ 2 -test, Fisher’s exact test, t-test, and logistic regression analysis with the SPSS/WIN24.0 program. @*Results@#Intracranial hemorrhage was diagnosed in 71 patients. There were statistically significant differences between the hemorrhagic group and non-hemorrhagic group in age group, places of accident, type of accident, location of the fracture, and symptoms. Intracranial hemorrhage by age group was higher in school-age and adolescence than in infancy. The places of accidents of hemorrhage were higher in street and school than in the home. The types of an accident of bleeding were higher in the case of knock and traffic accident than in fall. Symptoms of nausea, headache, and loss of consciousness were associated with higher intracranial hemorrhage.Multivariable logistic regression analysis showed that knock (OR= 3.29, 95% CI= 1.50-7.22), traffic accident (OR= 4.78, 95% CI= 1.31-17.43), nausea (OR= 4.18, 95% CI= 1.42-12.31), and loss of consciousness (OR= 3.29, 95% CI= 1.41-9.50) were risk factors for intracranial hemorrhage. @*Conclusion@#In this study, the risk factors of intracranial hemorrhage were identified in pediatric patients with skull fractures caused by head trauma. It is recommended that the results of this study be used to manage and educate patients, caregivers, and medical staff after head trauma hemorrhage.
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BACKGROUND@#The purpose of this report is to introduce the occupational cancer surveillance system, implemented in June 2018, and to share the results of our cooperative program.@*METHODS@#The cooperative program begins when the patient is diagnosed with acute myeloid leukemia (AML). Newly diagnosed AML patients are admitted to the internal medicine hematology department, then attending hematology physician requests a consultation from the occupational and environmental medicine (OEM) department. The OEM doctor next visits the hospitalized patient and interviews them to take their occupational history, and preliminarily evaluates the likelihood that the condition is associated with occupation. If the patient wants to apply for compensation through the Korea Workers' Compensation & Welfare Service, the patient was informed to visits the outpatient clinic of the OEM department and requests a ‘work-relatedness evaluation report’ for use in applying for compensation.@*RESULTS@#Among the 103 patients, who received an OEM departmental work history evaluation, 18 patients were considered to have a work-related incidence and 12 patients were registered in the Industrial Accident Compensation Insurance system.@*CONCLUSIONS@#The present report provides data on a sustainable model for identifying occupational disease in a general hospital setting, while also informing patients about their occupational rights.
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Hyperlipidemia, which is closely associated with a fatty diet and aging, is commonly observed in the western and aged society. Therefore, a novel therapeutic approach for this disease is critical, and an immunological view has been suggested as a novel strategy, because hyperlipidemia is closely associated with inflammation and immune dysfunction. In this study, the effects of an aqueous extract of Rubus occidentalis (RO) in obese mice were investigated using immunological indexes. The mice were fed a high-fat diet (HFD) to induce hyperlipidemia, which was confirmed by biochemical analysis and examination of the mouse physiology. Two different doses of RO and rosuvastatin, a cholesterol synthesis inhibitor used as a control, were orally administered. Disturbances in immune cellularity as well as lymphocyte proliferation and cytokine production were significantly normalized by oral administration of RO, which also decreased the elevated serum tumor necrosis factor (TNF)-α level and total cholesterol. The specific immune-related actions of RO comprised considerable improvement in cytotoxic T cell killing functions and regulation of antibody production to within the normal range. The immunological evidence confirms the significant cholesterol-lowering effect of RO, suggesting its potential as a novel therapeutic agent for hyperlipidemia and associated immune decline.
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Animals , Mice , Administration, Oral , Aging , Antibody Formation , Cholesterol , Diet , Diet, High-Fat , Homicide , Hyperlipidemias , Inflammation , Lymphocytes , Mice, Obese , Physiology , Reference Values , Rosuvastatin Calcium , Rubus , Tumor Necrosis Factor-alphaABSTRACT
PURPOSE: The study was to analyze clinical outcomes and risk factors of for complications associated with the hip fracture surgery in the elderly before and after interdisciplinary treatment. METHODS: A retrospective method was used to investigate the general and therapeutic characteristics, frequency of complications and clinical outcomes. The subjects of the study were 553 patients who underwent hip fracture surgery from January, 2009 to December, 2014. RESULTS: The interdisciplinary group was older and less likely to walk independently even before the fracture than a usual care group. The incidence of complications was higher in the interdisciplinary group than the usual care group. The prevalence of complications in both groups was 66.5%. Multivariate logistic regression analysis showsed that the risk factors for complications of hip fracture surgery were as follows: advanced age, stroke, Parkinson disease, time interval from emergency room to operation, pre & post ambulatory status, American Society of Anesthesiologists (ASA) classification quality of postop intensive care unit (ICU) care and foley indwelling. CONCLUSION: This study has implications in that it recognized the necessity for interdisciplinary treatment and provided the basic base data for nursing intervention of the elderly patients who underwent hip fracture surgery.
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Aged , Humans , Classification , Emergency Service, Hospital , Hip , Incidence , Intensive Care Units , Logistic Models , Methods , Nursing , Orthopedics , Parkinson Disease , Prevalence , Retrospective Studies , Risk Factors , StrokeABSTRACT
PURPOSE: The purpose of this study was to examine the effects of prior information about ICU environment on the anxiety and environmental stress of cardiac surgery ICU patients. METHODS: A non-equivalent control group non-synchronized quasi-experimental research design was used. Participants were 60 (control 30, experimental 30) patients who had been admitted to ICU. Prior information about the ICU environment was provided to the experimental group. The anxiety level of subjects was measured by State-Trait Anxiety Inventory (STAI) and the stress level of subjects was measured by the Intensive Care Unit Environmental Stressor Scale (ICUESS). Data were analyzed using a Chi-square test or a Fisher's exact test, independent samples t-test, and paired samples t-test. RESULTS: There was no difference in Anxiety (t=-0.58, p=.563), but there was a significant difference in environmental stress (t=10.46, p<.001). CONCLUSION: Providing prior information would be an effective nursing intervention to reduce environmental stress.
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Humans , Anxiety , Intensive Care Units , Nursing , Research Design , Thoracic SurgeryABSTRACT
BACKGROUND: Direct observation of healthcare workers is commonly used in hospitals to investigate hand hygiene compliance. However, the hand hygiene compliance rate may increase due to the Hawthorne effect, which is the modification of behavior simply because subjects become aware that they are being observed. The objective of this study was to investigate the occurrence of the Hawthorne effect when directly observing hand hygiene compliance in intensive care unit (ICU) healthcare personnel. METHODS: A total of 87 staff members from the coronary care unit and cardiac surgery ICU of a general hospital in Seoul were included in this study: 24 residents and interns, 55 nurses, and 8 nursing assistants. Both covert and overt observations, where subjects were either unaware or aware of any direct observation, were performed on separate occasions. RESULTS: A total of 1,052 covert and 1,336 overt observations were documented over 30 and 34 occasions, respectively. Overall hand hygiene compliance was significantly higher with overt observation than with covert observation (1,041/1,336, 77.9% vs. 659/1,052, 62.6%, P<0.001). The Hawthorne effect was present in all professions and behaviors, with the exception of nursing assistants, and prior to touching a patient. CONCLUSION: Direct observation of hand hygiene compliance was associated with the Hawthorne effect when observations were made overtly and this was likely to contribute to an overestimation of compliance rate.
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Humans , Compliance , Coronary Care Units , Delivery of Health Care , Effect Modifier, Epidemiologic , Hand Hygiene , Health Personnel , Hospitals, General , Intensive Care Units , Nursing , Seoul , Thoracic SurgeryABSTRACT
PURPOSE: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. METHODS: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. RESULTS: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22-2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. CONCLUSION: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.
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Aged , Female , Humans , Male , Middle Aged , APACHE , Blood Pressure/physiology , Hospital Mortality , Intensive Care Units , Lactic Acid/analysis , Logistic Models , Odds Ratio , Patients' Rooms , ROC Curve , Reproducibility of Results , Retrospective Studies , Risk Assessment/methods , Sepsis/pathology , Shock, Septic/pathologyABSTRACT
OBJECTIVES: Based on multicenter research among tertiary hospitals in Korea, it was our intention to effectively contribute to the prevention of needlestick injuries by understanding the current state of the incidence rate of needlestick injuries and the related epidemiology with respect to medical institution and worker's characteristics. METHODS: Ten hospitals were selected, with the research performed from July to September 2007. Data on cases of needlestick injuries were collected by hospital infection-controlling centers using a specifically developed website and a partially modified self-writing questionnaire based on the Exposure Prevention Information Network (EPINet). RESULTS: During the study period, a total of 327 needlestick injury cases were reported, with an incidence of 10.56 cases per 100 patient beds per year. The existence of source of infection could not be confirmed in one third of the needlestick injuries. There were 4.07 incidences per 100 employees per year. The job with the highest incidence was medical doctor interns (18.66 cases), followed by clinical laboratory workers (7.12 cases) and registered nurses (6.66 cases). CONCLUSIONS: There was no difference in number of incidences according to the number of beds. The highest number of cases occurred in the registered nurse-group, but the incidence rate per healthcare worker was the highest in the medical doctor intern-group. Therefore, it is important to conduct research to identify the risk of the incidence with respect to different risk-groups. As a result of this research, it is suggest that a protective policy is required relating to needlestick injuries, regardless of the number of beds and potential cause of infection.
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Humans , Delivery of Health Care , Incidence , Information Services , Intention , Korea , Needlestick Injuries , Surveys and Questionnaires , Tertiary Care CentersABSTRACT
BACKGROUND: This study evaluated the clinical characteristics and risk factors associated with community and hospital onset MRSA isolated from patients admitted to a tertiary care teaching hospital. METHODS: The study was carried out on MRSA isolated from clinical specimens of patients admitted into the wards and the intensive care unit in a 2,200-bed tertiary care teaching hospital from January 1st through December 31st, 2007. In order to identify the risk factors associated with MRSA acquisition, the medical records were reviewed. All statistics were computed using SPSS version 14.0. RESULTS: Of the 835 MRSA isolates, 179 (21.4%) were CO-MRSA and 656 (78.6%) were HO-MRSA. Of the 179 CO-MRSA isolates, 6 (3.4%) were CA-MRSA. Multiple logistic regression analysis showed that a history of using medical device or antibiotics within 1 year before the isolation of MRSA were significant risk factors for HO-MRSA, and a history of hospitalization within 1 year before the isolation of MRSA was a significant risk factor for CO-MRSA. Analysis on the antibiotics administered within 1 year before the isolation of MRSA showed that levofloxacin, macrolides, 1st generation cephalosporins, 3rd generation cephalosporins, 4th generation cephalosporins, vancomycin, metronidazole, and carbapenem were all significant risk factors for HO-MRSA and that TMP/SMX was a significant risk factor for CO-MRSA. Of the 6 (3.4%) CA-MRSA isolates, 1 (16.7%) was the pathogen responsible for soft tissue infection. No patients died from the CA-MRSA infection. CONCLUSION: MRSA isolated from clinical specimens of patients admitted into the wards and the ICU in a tertiary care teaching hospital was usually HO-MRSA, CO-MRSA and HO-MRSA usually had at least one of the risk factors associated with MRSA acquisition, and CO-MRSA was mainly HACO-MRSA.
Subject(s)
Humans , Anti-Bacterial Agents , Cephalosporins , Hospitalization , Hospitals, Teaching , Intensive Care Units , Logistic Models , Macrolides , Medical Records , Methicillin Resistance , Methicillin-Resistant Staphylococcus aureus , Metronidazole , Ofloxacin , Risk Factors , Soft Tissue Infections , Tertiary Healthcare , VancomycinABSTRACT
BACKGROUND: Clean intermittent catheterization is one of the management of the neurogenic bladder caused by such disease as spinal injury. The purpose of this study is to assess the amount of time in a microwave oven required to eliminate seven pathogens isolated from urine of the patients, and to evaluate the effect of repeated use of a microwave oven on the patency and pliability of silicon catheter. METHODS: Seven microorganisms isolated from urine of patients were used as inoculating pathogens. These included Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Enterococcus faecalis, Enterococcus faecium, Staphylococcus aureus, Candida albicans. The silicon catheter was divided into six pieces (4 cm) and sterilized by ethylene oxide gas, Each piece of catheter was incubated for 60 minutes in a suspension of microorganisms, and placed in a plastic container. The piece was microwaved for 0 (control catheters) to 15 minutes a dose of 1,000 watts. Two methods were used. First method was a water-free method that was microwaved after removing water from the catheter. Second method was a water-added method that was microwaved after adding 5 mL of sterile water around the catheter. Then, that was placed in 15 mL sterile phosphate buffer in a conical tube. The fluid was cultured. Using a new silicon catheter, the microwave procedure was repeated until the catheter was no longer patent or pliable. RESULTS: Using a water-free method, E, coli, C. albicans were eliminated at 5 minutes, P. aeruginosa was at 8 minutes, K. pneumoniae, E. faecalis was at 12 minutes, but S. aureus was remained until 15 minutes, Using a water-added method, all strains were eliminated at 8 minutes. The characteristics of the silicon catheter after repeated procedures were not changed in patency or pliability until 100 times. CONCLUSION: The disinfection of silicon catheters using a microwave oven after adding water around the catheter was able to sterilize the frequent pathogens including C. albicans within 8 minutes. It was clinically useful to sterilize repeatedly the catheter using microwave oven without distorting the characteristics of the silicon catheter.
Subject(s)
Humans , Candida albicans , Catheters , Disinfection , Enterococcus faecalis , Enterococcus faecium , Escherichia coli , Ethylene Oxide , Intermittent Urethral Catheterization , Klebsiella pneumoniae , Microwaves , Plastics , Pliability , Pneumonia , Pseudomonas aeruginosa , Silicones , Spinal Injuries , Staphylococcus aureus , Sterilization , Urinary Bladder, Neurogenic , WaterABSTRACT
BACKGROUND: Many studies have shown a strong inverse relationship between the bone mineral density (BMD) and osteoporotic fractures, with a doubling in the incidence of fractures for each standard deviation reduction in the BMD. Newer peripheral densitometry devices have recently been developed, with the advantages of a low cost and increased portability. In addition, studies focusing on the osteoporosis of rural populations are rare. The authors assessed the factors related with the BMD in rural areas, using peripheral bone densitometry. METHODS: 23 men (68.4+/-9.2[mean age+/-SD] years) and 32 women (63.9+/-8.3 years), living in rural areas, voluntarily participated in this community-based study. The BMD of the distal radius (BMDr) and calcaneus (BMDc) were measured using peripheral dual-energy X-ray absorptiometry. The BMI, waist to hip ratio, body composition, blood pressure, lipids, fasting glucose and insulin were measured. The sociodemographic characteristics and physical activities were investigated using questionnaires. RESULTS: 21.7% of the men and 34.4% of the women were diagnosed with osteoporosis according to the WHO definition. The BMDr and BMDc were 0.46+/-0.08 and 0.46+/-0.11 and 0.34+/-0.07 and 0.33+/-0.08g/cm2 in the men and women, respectively. In the men, age, BMI, physical activity and smoking were correlated with the BMDr, and age, lean body mass, physical activity, TV watching and smoking with the BMDc. In the women, age, weight and lean body mass were correlated with the BMDr, and age, weight, BMI, waist circumference, fat mass, lean body mass and year since menopause with the BMDc. From a multiple regression analysis, age and smoking in men, and year since menopause and lean body mass in women, respectively, had independent effects on the BMD. CONCLUSION: In the rural community studied, osteoporosis was as highly prevalent as in urban communities. Of the determinants for the BMD, smoking for men, and lean body mass for women, were modifiable factors. Education for quitting smoking in men, and maintenance of optimal weight in women, are required to prevent osteoporosis in rural areas.