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박신율(Sin Youl Park),우정민(Jungmin Woo) 대한생물치료정신의학회 2012 생물치료정신의학 Vol.18 No.2
Objectives:It is known that delirium is common among elder patients and is associated poor clinical outcomes. As elderly patients are increasing in emergency department(ED), the prevalence of delirium should be on the rise. However delirium has been under-recognized by medical team. Our study was designated to evaluate the frequency, the clinical effect and risk factors of delirium of hospitalized elder patients in ED. Methods:We retrospectively reviewed elderly patients admitted to general ward after over 24 hours hospitalization in ED between January 2008 and December 2008. examined the frequency and assessed the clinical effect and risk factors. Results:Among 414 patients, 42 patients(10.1%) developed delirium in ED over 12 month period studied. The development of delirium in ED was associated with significant poor outcomes ; increased hospital mortality and prolonged hospital stays. Independent risk factors of delirium were stroke, metabolic derangements, dementia, hemodynamic instability, depression. Conclusion:ED environment can be important risk factors of delirium, thus ED physician should try to recognize and correct the possible risk factors of delirium earlier and in particular, should try to reduce exposure time to the ED environment in elderly patients.
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서준석,정제명,이정호,박신율,류현욱,이경우,김윤정,박노한,이정식,서강석,박정배,이희중 대한응급의학회 2004 대한응급의학회지 Vol.15 No.6
P u r p o s e: Rapid ascent from low to high altitude (above 2500 m) often causes acute mountain sickness (AMS), a symptom-complex characterized by headache and other systemic symptoms (gastrointestinal upset, weakness, dizziness, and difficulty sleeping). In this study, we observed the vital signs and AMS symptoms. 13 participants in a mountain climb in order to determine correlation between AMS and risk factors such as obesity, smoking, and a previous history of AMS. M e t h o d s: We studied 13 participants who climbed Mt. Cholatse (6440 m), and measured their vital signs and symptoms during the trekking. Standard Lake Louise questionnaires were filled out at five times during the trek: at the sea level, 2700 m, 3440 m, 4040 m, and 4700 m. With AMS scores and severity grades, we evaluate the severity of symptoms and the physical status. R e s u l t s: The overall AMS score was 3.7 ±0.5, and headache was the most frequent symptom. As the altitude increased, oxygen saturation decreased whereas other vital signs (blood pressure, respiratory rate, and pulse rate) increased. The average AMS scores and severity grades increased more rapidly for obese men than for non-obese men (p<0.001). Smoking and previous history of AMS were also associated with the development of AMS (p< 0 . 0 0 1 ) . C o n c l u s i o n: Persons who are obese or have a history of a smoking or AMS, are more likely to develop AMS symptoms. Further understanding of the natural and evolution of AMS and of the risk factors associated with AMS will educate the general population and physicians and help in its prevention and treatment.
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의식이 명료한 다발성 외상환자에게 전신 전산화단층촬영이 반드시 필요한가?
문유호 ( You Ho Mun ),김윤정 ( Yun Jeong Kim ),신수정 ( Soo Jeong Shin,),박동찬 ( Dong Chan Park ),박신율 ( Sin Ryul Park ),류현욱 ( Hyun Wook Ryu ),서강석 ( Kang Suk Seo ),박정배 ( Jung Bae Park ),정제명 ( Jae Myung Chung ),배지 대한외상학회 2010 大韓外傷學會誌 Vol.23 No.2
Purpose: Whole-body CT is a very attractive diagnostic tool to clinicians, especially, in trauma. It is generally accepted that trauma patients who are not alert require whole-body CT. However, in alert trauma patients, the usefulness is questionable. Methods: This study was a retrospective review of the medical records of 146 patients with blunt multiple trauma who underwent whole body CT scanning for a trauma workup from March 1, 2008 to February 28, 2009. We classified the patients into two groups by patients` mental status (alert group: 110 patients, not-alert group: 36 patients). In the alert group, we compared the patients` evidence of injury (present illness, physical examination, neurological examination) with the CT findings. Results: One hundred forty six(146) patients underwent whole-body CT. The mean age was 44.6±18.9 years. One hundred four (104, 71.2%) were men, and the injury severity score was 14.0±10.38. In the not-alert group, the ratios of abnormal CT findings were relatively high: head 23/36(63.9%), neck 3/6(50.0%), chest 16/36(44.4%) and abdomen 9/36(25%). In the alert group, patients with no evidence of injury were rare (head 1, chest 6 and abdomen 2). Nine(9) patients did not need any intervention or surgery. Conclusion: Whole-body CT has various disadvantages, such as radiation, contrast induced nephropathy and high medical costs. In multiple trauma patients, if they are alert and have no evidence of injury, they rarely have abnormal CT findings, and mostly do not need invasive treatment. Therefore, we should be cautious in performing whole-body CT in alert multiple trauma patients. (J Korean Soc Traumatol 2010;23:89-95)
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