Comparison of Epidemiological Characteristics and Outcomes for the In-hospital Cardiac Arrest between Poisoned Patients in Korea: A Population Study Based on Korean Health Insurance Review and Assessment Service

PURPOSE: Poisoning is an important cause of death in Korea. We aimed to investigate the epidemiological characteristics and outcomes for in-hospital cardiac arrest (IHCA) in poisoned patients in Korea. METHODS: This is a population-based study, analyzing 576 IHCA patients who were poisoned and registered in the Korean Health Insurance Review and Assessment Service in 2013. The cardiopulmonary resuscitation outcomes, including survival discharge and 30-day survival rate, were analyzed. The main diagnoses were categorized in accordance with the Korean Standard Classification of Diseases version 6. RESULTS: The overall survival discharge and 30-day survival rate were 31.6% and 15.3%, respectively. The most common etiologies of poisoning were pesticides (54.3%), drugs and medications (21.9%), carbon monoxide (8.9%), and unspecified substances (5.4%); the 30-day survival rate for each etiology was 16.6%, 15.2%, 9.8%, and 19.4%, respectively. A geographical analysis showed a high 30-day survival rate in Gwangju (32.0%), Daejeon (25.0%) and Ulsan (25.0%). CONCLUSION: Pesticides poisoning is the most common cause for IHCA patients. The survival rate after IHCA by poisoning was similar in pesticides poisoning than in other toxic etiologies. Therefore, it is crucial to reduce pesticide poisoning and to establish a poisoning information inquiry system.

Comparison of Epidemiological Characteristics and Outcomes for the in-hospital Cardiac Arrest between Nursing Care Hospitals Versus Non-nursing Care Hospitals of Korea: A Population Study Based on Korean Health Insurance Review and Assessment Service

PURPOSE: The aim of this study was to investigate the epidemiological characteristics and outcomes for in-hospital cardiac arrest (IHCA) patients who were 65 years and older between nursing care hospitals versus non-nursing care hospitals in Korea. METHODS: This is a population study enumerating 24,203 IHCA patients registered in Korean Health Insurance Review and Assessment Service in 2013. The Cardiopulmonary resuscitation (CPR) outcomes including survival discharge and 30 day survival rate were analyzed. The main diagnoses of IHCA patients were categorized according to the Korean Standard classification of Disease version 6 (KCD-6). All data of patients who were CPR recipients in nursing care hospitals were compared with those of CPR recipients in non-nursing care hospitals. RESULTS: The overall survival discharge and 30 day survival rate were 29.5% and 28.1%, respectively. However, the survival discharge rate of IHCA patients was significantly low in nursing care hospitals compared to non-nursing care hospitals (20.0% vs. 30.0%, p<0.001). The 30 day survival rate was similarly low in nursing care hospitals (20.1% vs. 28.4%, p<0.001). The most common diagnosis of IHCA patients was respiratory disease in nursing care hospitals and cardiovascular disease in non-nursing care hospitals. The most common respiratory disease leading to IHCA in nursing care hospitals was acute respiratory infections. CONCLUSION: The survival rate after IHCA was lower in nursing care hospitals, and the major diagnosis leading to CPR was acute respiratory infections rather than chronic underlying diseases. Therefore, it is crucial to set higher standards in performing CPR and controlling infections in nursing care hospitals nationwide.

The Usefulness of Leukosan SkinLink for Simple Facial Laceration Repair in the Emergency Department

BACKGROUND: Repair of facial laceration in the emergency department can pose a number of difficulties. Children can be uncooperative, but adults can also be if they have sustained head trauma or are intoxicated. Leukosan SkinLink consists of topical adhesive and adhesive tape that can be applied easily to long or tense wounds. In this study, the authors compared conventional suturing with Leukosan SkinLink for facial laceration patients in the emergency department. METHODS: The prospective study was carried out from March 2013 to September 2013 with linear facial laceration patients visiting the emergency department. Exclusion criteria were open fractures, joint injuries, skin defects, hairy skin, and mucosa. The author used Leukosan SkinLink for skin closure in the experimental group and used conventional suturing in the control group. The scar evaluation using the Patient and Observer Scar Assessment Scale (POSAS) along with satisfaction scores, procedure times, and complications were compared. RESULTS: A total of 77 patients (30 in the control group and 47 in the experimental group) participated and underwent follow-up for 6 months postoperatively. The scar assessment using the POSAS and the satisfaction score in both groups were similar. The average procedure time in the experimental group was shorter. In the control group, there were four cases of wound dehiscence, two of infection, and one of skin necrosis, whereas four cases of wound dehiscence and one allergic reaction occurred in the experimental group. CONCLUSIONS: With a simple application technique, Leukosan SkinLink is a new effective method for facial laceration repair especially useful for children and uncooperative adults.