Who Comes to the Emergency Room with an Infection from a Long-term Care Hospital? A Retrospective Study Based on a Medical Record Review

PURPOSE: Health careeassociated infections increase disease prevalence and mortality and are the main reason for the hospitalization of the elderly. However, the management of underlying infections in patients hospitalized in long-term care hospitals (LTCHs) is insufficient, and the transfer of these poorly managed patients to the emergency room (ER) of an acute care hospital can lead to rapid spread of infection. This study investigated the risk factors associated with an ER visit due to infections that developed in LTCHs. METHODS: The electronic medical records of patients who were transferred to the ER of a university hospital in South Korea were used. Infection prevalence, causative infectious agent, and antibiotic sensitivity were assessed. The associations between patient characteristics and hospital-associated infections were examined using multiple logistic regression analyses. RESULTS: Among the 483 patients transferred to the ER during the study period, the number of infection cases was 197, and 171 individuals (35.4%) had one or more infections, with pneumonia being the most common (52.8%), followed by urinary tract (21.3%) and bloodstream (17.8%) infections. Patients with bedsores, fever, an indwelling catheter, and a higher nursing need were more likely to be seen in the ER because of infectious disease from an LTCH. CONCLUSION: Both an intensive care system and surveillance support should be established to prevent infections, particularly in high-risk patients at LTCHs.

Characteristics and Mortality Risk Factors in Geriatric Hospital Patients visiting One Region-wide Emergency Department

PURPOSE: This study was to examine the clinical characteristics and mortality risk factors of geriatric hospital patients who visited one region-wide emergency department (ED). It's basically meant to develop criteria for the patient management of geriatric hospitals and to provide related information. METHODS: A retrospective research study was implemented using electronic medical records. The subjects in this study included 484 geriatric hospital patients who were selected from among 15,994 patients that visited one region-wide ED between January 1, 2014, and December 31, 2015. RESULTS: There were significant differences in death, a change for the better and no change for the better, which were results of treatment, according to the length of stay in hospital, hospitalization in a general ward, not having an operation or surgery, the presence or absence of malignant neoplasm, the insertion of foley catheter, intubation, ventilator and the insertion of central venous catheter. CONCLUSION: The results of this study suggest that a patient management system is necessary in geriatric hospitals and that competent healthcare workers who can properly respond to emergencies are required as well.

Prevalence of Vitiligo and Associated Comorbidities in Korea

PURPOSE: Vitiligo prevalence and its associated comorbidities rate have been reported variably among different populations. We aimed to determine the prevalence of vitiligo in Korea along with the baseline rate of comorbidities and compared the risks to the general population using hospital visit information of the total population in Korea. MATERIALS AND METHODS: We assessed demographic characteristics of vitiligo patients in Korean population from 2009 to 2011 in a nationwide data from Health Insurance Review Assessment Service. Patients who had at least one visit to Korea's primary, secondary, or tertiary referral hospitals with International Classification of Diseases, 10th Revision, Clinical Modification diagnosis code for vitiligo were identified. As a supplementary study, comorbidities associated with vitiligo were selected for further review to calculate relative risks compared to the general population. RESULTS: The annual prevalence of vitiligo determined by hospital-visiting rate in Korea was 0.12% to 0.13% over a three year period. In sync with other previous epidemiological studies, there was bimodal distribution among the age groups and no difference between genders. Also, vitiligo in Korean population was associated with various autoimmune/non-autoimmune diseases such as thyroiditis, atopic dermatitis, and psoriasis. CONCLUSION: This study was by far the most comprehensive review on prevalence of vitiligo using a data of total population in Korea. The prevalence is within a range of those reported in previous literatures, and increased risk of comorbidities such as thyroid diseases and psoriasis in vitiligo might aid clinicians in the initial work up of vitiligo patients and concurrent follow ups.