Validation of I71.3 code for ruptured abdominal aortic aneurysm in Korea: misplaced diagnosis in claims data

Purpose@#Studies in western countries have shown a decline in the incidence of ruptured abdominal aortic aneurysm (rAAA) with advancements in endovascular repair and screening. However, according to health insurance data in Korea based on rAAA code (I71.3), overall rAAA has been increasing. This study aimed to validate the I71.3 code for rAAA and attempt to define the true incidence of rAAA in Korea. @*Methods@#A 20-year multicenter retrospective review of rAAA was undertaken from the period of January 1, 2000 to December 31, 2020. All patients were diagnosed with the rAAA code I71.3 in each of the 4 hospitals. The CT images and surgical records of these patients were reviewed to differentiate true rAAA and misdiagnosis. Further data on true rAAA patient outcomes including mortality and treatment success were also collected. @*Results@#A total of 305 rAAA (I71.3) codes were identified in the 4 centers. However, medical record review showed true rAAA in only 131 (43.0%). The remaining 174 cases (57.0%) were misdiagnosed. Impending ruptures were the most common misdiagnoses (37.9%). The total in-hospital mortality including deaths before treatment was 38.9% (n = 51), while mortality of treated patients was 24.4% (n = 15). @*Conclusion@#The analysis of I71.3 code for rAAA showed that only 43.0% were true rAAA and the remaining 57.0% were misdiagnosed. This indicates that the I71.3 code is overestimated in National Health Insurance-based data and that the true incidence of rAAA could be much lower.

Evaluation of a Functional Model of Acquired Capability for Suicide in a Nationwide Sample of Korean Adults

OBJECTIVE: We examined a functional model of acquired capability for suicide, which was elaborated from the “Interpersonal-Psychological Theory of Suicide”. METHODS: A total of 6,027 Korean community subjects were recruited from The Korean Epidemiologic Catchment Area study conducted in 2011. The subjects were assessed systematically using the Korean version of the Composite International Diagnostic Interview version 2.1, the Korean version of the Barratt Impulsiveness Scale, and the Korean version of the Mood Disorder Questionnaire. We used structural equation modeling to identify potential factors contributing to a suicide attempt. RESULTS: Most aspects of the model were supported by the data and “the short-term enhancer for the acquired capability for suicide” had direct effects on suicide attempts. However, the suicidal planning effects of “the short-term enhancer for the acquired capability for suicide” were eliminated by the rule of parsimony. CONCLUSION: The main finding was that “the short-term enhancer for the acquired capability for suicide” is relevant to suicide attempts when it's direct, indirect, and reciprocal effects are tested within a more complete system of relationships than found in existing studies. The implications of these findings are discussed with regard to future conceptual work and empirical research.

Childhood Exposure to Psychological Trauma and the Risk of Suicide Attempts: The Modulating Effect of Psychiatric Disorders

OBJECTIVE: We examined whether childhood exposure to psychological trauma is associated with greater suicidality and whether specific psychiatric disorders modulate this association in a representative sample of Korean adults. METHODS: The Korean version of the Composite International Diagnostic Interview 2.1 was administered to 6,027 subjects aged 18-74 years. Subjects who experienced a traumatic event before the age of 18 years, the childhood-trauma-exposure group, were compared with controls without childhood trauma exposure. RESULTS: Childhood exposure to psychological trauma was associated with lifetime suicidal ideation (OR=3.19, 95% CI=2.42-4.20), suicide plans (OR=4.15, 95% CI=2.68-6.43), and suicide attempts (OR=4.52, 95% CI=2.97-6.88). These associations weakened after further adjustment for any psychiatric disorders, but they were not eliminated. The risk of suicide attempts related to childhood trauma increased with the presence of a concurrent alcohol use, depressive, or eating disorder. CONCLUSION: In terms of clinical implications, patients with these disorders who have a history of childhood trauma should be carefully assessed for their suicide risk and aggressively treated for psychiatric disorders.

The Prevalence and Risk Factors for Erectile Dysfunction in Korean Young Men: a Web-based Survey / 대한남성과학회지

PURPOSE: To obtain basic information for studies of male sexual dysfunction, we investigated the prevalence and the risk factors of erectile dysfunction(ED) in Korean young men via an Internet survey. MATERIALS AND METHODS: In June 2006, 23594 subjects aged from 20 to 59, who had registered with an internet research company, were asked to join our study if they had had stable sexual activities more than once a month for the past 6 months. Questions covered demographic characteristics, sexual life, International Index of Erectile Function(IIEF), and International Prostatic Symptom Score(IPSS). RESULTS: A total of 601 subjects completed the questionnaires. The prevalence of self-reported ED was 6.7%. The proportion of men with self-reported ED was 3.7% in the 20-29 age group, 6.0% in the 30-39 age group, and 9.5% in the 40-49 age group. The overall prevalence of ED assessed by IIEF-EF domain score of < or = 25 was 41.0%. We found a statistically significant correlation between men with self-reported ED and lower IIEF-EF domain scores. Self-reported ED was significantly associated with aging, smoking, lower education, and lower urinary tract symptoms (LUTS). Lower IIEF-EF domain scores were correlated with higher IPSS total, voiding and storage scores. CONCLUSIONS: ED in Korean young men is common and closely associated with LUTS. An Internet survey requires less man power, less time, and less research funds than classical survey methods such as mail or interview surveys. These study results will be useful as basic data for future studies of young Korean men's sexual function

The Prevalence and Risk Factors for Erectile Dysfunction in Korean Young Men: a Web-based Survey / 대한남성과학회지

PURPOSE: To obtain basic information for studies of male sexual dysfunction, we investigated the prevalence and the risk factors of erectile dysfunction(ED) in Korean young men via an Internet survey. MATERIALS AND METHODS: In June 2006, 23594 subjects aged from 20 to 59, who had registered with an internet research company, were asked to join our study if they had had stable sexual activities more than once a month for the past 6 months. Questions covered demographic characteristics, sexual life, International Index of Erectile Function(IIEF), and International Prostatic Symptom Score(IPSS). RESULTS: A total of 601 subjects completed the questionnaires. The prevalence of self-reported ED was 6.7%. The proportion of men with self-reported ED was 3.7% in the 20-29 age group, 6.0% in the 30-39 age group, and 9.5% in the 40-49 age group. The overall prevalence of ED assessed by IIEF-EF domain score of < or = 25 was 41.0%. We found a statistically significant correlation between men with self-reported ED and lower IIEF-EF domain scores. Self-reported ED was significantly associated with aging, smoking, lower education, and lower urinary tract symptoms (LUTS). Lower IIEF-EF domain scores were correlated with higher IPSS total, voiding and storage scores. CONCLUSIONS: ED in Korean young men is common and closely associated with LUTS. An Internet survey requires less man power, less time, and less research funds than classical survey methods such as mail or interview surveys. These study results will be useful as basic data for future studies of young Korean men's sexual function