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- 검색키워드
- 저자 : ( Che Wan Lim ) (검색결과 2 건)
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( Che Wan Lim ),( Dong Jin Oh ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: Hypertension is common in hemodialysis (HD) patients and contributes to this population`s high risk for cardiovascular morbidity and mortality. Most hypertension treatment decisions use BPs obtained in the clinic, while peri-dialytic BP recordings in the clinic are highly variable and poorly reproducible, making treatment decisions diffi cult. Recently, it is shown that home BP are better predictors of mortality than individual pre- or post-HD BP measurements in US. We purposed to examine the relationship between inter-dialytic home BP and pre-HD, intra-dialytic, and post- HD BP in stable HD patients. Methods:This was a single center cross sectional study from December 2013 to February 2014. HD patients who had been on treatment for longer than 3 months, were included for the study. Hospitalized patients and those with an acute illness were excluded. Patients who had a change in dry weight or antihypertensive drugs within 2 weeks were also excluded. Home BP monitoring was performed over 1 week using the same automatic oscillometric device . Patients were asked to record their BP three times daily Results:Twenty patients (14 male and 6 female) took part in the study. Mean home BP was 140.4±12.1 and 74.7±12.8 mmHg (systolic and diastolic, respectively). Mean pre-HD BP was 151.4±18.6 and 73.8±10.8 mmHg, and post-HD BP was 126.1±17.3 and 68.9±13.8 mmHg, respectively. In the correlation analysis, Home BP was associated with intra-dialytic BP (r=0.479, p-value 0.033 and r=0.568, p-value 0.009, systolic and diastolic respectively). In contrast, pre-HD BP was associated with home BP only for systolic BP (r=0.449, p-value 0.047), and post-HD BP was associated with home BP only for diastolic BP(r=0.563, p-value 0.019). Conclusions: Home BP was associated with intra-dialytic BP better than pre-HD or post-HD BP. We might have to consider intra-dialytic BP with more attention when managing hypertension in HD patients
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Facility characteristics as independent prognostic factors of nursing home-acquired pneumonia
( Che Wan Lim ),( Younghoon Choi ),( Chang Hyeok An ),( Sang Joon Park ),( Hee Jin Hwang ),( Jae Ho Chung ),( Joo Won Min ) 대한내과학회 2016 The Korean Journal of Internal Medicine Vol.31 No.2
Background/Aims: Recently, the incidence of nursing home-acquired pneumonia (NHAP) has been increasing and is now the leading cause of death among nursing home residents. This study was performed to identify risk factors associated with NHAP mortality, focusing on facility characteristics. Methods: Data on all patients ≥70 years of age admitted with newly diagnosed pneumonia were reviewed. To compare the quality of care in nursing facilities, the following three groups were defined: patients who acquired pneumonia in the community, care homes, and care hospitals. In these patients, 90-day mortality was compared. Results: Survival analyses were performed in 282 patients with pneumonia. In the analyses, 90-day mortality was higher in patients in care homes (12.2%, 40.3%, and 19.6% in community, care homes, and care hospitals, respectively). Among the 118 NHAP patients, residence in a care home, structural lung diseases, treatment with inappropriate antimicrobial agents for accompanying infections, and a high pneumonia severity index score were risk factors associated with higher 90-day mortality. However, infection by potentially drug-resistant pathogens was not important. Conclusions: Unfavorable institutional factors in care homes are important prognostic factors for NHAP.
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