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Pediatrics
Characteristics, management and clinical outcomes of patients with sepsis: a multicenter cohort study in Korea
Kyeongman Jeon, Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Eun Young Choi, Seok Chan Kim, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Sang Hyun Kwak, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Jae Hwa Cho, Beongki Kim, Chae‐Man Lim
Acute Crit Care. 2019;34(3):179-191.   Published online July 1, 2019
DOI: https://doi.org/10.4266/acc.2019.00514
  • 8,269 View
  • 316 Download
  • 20 Web of Science
  • 22 Crossref
AbstractAbstract PDF
Background
Mortality rates associated with sepsis have increased progressively in Korea, but domestic epidemiologic data remain limited. The objective of this study was to investigate the characteristics, management and clinical outcomes of sepsis patients in Korea.
Methods
This study is a multicenter retrospective cohort study. A total of 64,021 adult patients who visited an emergency department (ED) within one of the 19 participating hospitals during a 1-month period were screened for eligibility. Among these, patients diagnosed with sepsis based on the third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) were included in the study.
Results
Using the Sepsis-3 criteria, 977 sepsis patients were identified, among which 36.5% presented with septic shock. The respiratory system (61.8%) was the most common site of infection. The pathogen involved was identified in 444 patients (45.5%) and multi-drug resistance (MDR) pathogens were isolated in 171 patients. Empiric antibiotic therapy was appropriate in 68.6% of patients, but the appropriateness was significantly reduced in infections associated with MDR pathogens as compared with non-MDR pathogens (58.8% vs. 76.0%, P<0.001). Hospital mortality was 43.2% and 18.5% in sepsis patients with and without shock, respectively. Of the 703 patients who survived to discharge, 61.5% were discharged to home and 38.6% were transferred to other hospitals or facilities.
Conclusions
This study found the prevalence of sepsis in adult patients visiting an ED in Korea was 1.5% (15.2/1,000 patients). Patients with sepsis, especially septic shock, had a high mortality and were often referred to step-down centers after acute and critical care.

Citations

Citations to this article as recorded by  
  • Early Prediction of Mortality for Septic Patients Visiting Emergency Room Based on Explainable Machine Learning: A Real-World Multicenter Study
    Sang Won Park, Na Young Yeo, Seonguk Kang, Taejun Ha, Tae-Hoon Kim, DooHee Lee, Dowon Kim, Seheon Choi, Minkyu Kim, DongHoon Lee, DoHyeon Kim, Woo Jin Kim, Seung-Joon Lee, Yeon-Jeong Heo, Da Hye Moon, Seon-Sook Han, Yoon Kim, Hyun-Soo Choi, Dong Kyu Oh, S
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Deficits in blood culture collection in the emergency department if sepsis is suspected: results of a retrospective cohort study
    Charlotte Berninghausen, Frank Schwab, Alexander Gropmann, Bernd A. Leidel, Rajan Somasundaram, Lydia Hottenbacher, Petra Gastmeier, Sonja Hansen
    Infection.2024;[Epub]     CrossRef
  • Pre-Sepsis Length of Hospital Stay and Mortality: A Nationwide Multicenter Cohort Study
    Joong-Yub Kim, Hong Yeul Lee, Jinwoo Lee, Dong Kyu Oh, Su Yeon Lee, Mi Hyeon Park, Chae-Man Lim, Sang-Min Lee
    Journal of Korean Medical Science.2024;[Epub]     CrossRef
  • Platelet indices in critically ill septic patients as a predictor of mortality
    Rehab Salah Taha, Mohamed Elsayed Afandy, Abdelaziz Hamid Elbadawi, Mohamed Samir Abd El Ghafar
    Egyptian Journal of Anaesthesia.2023; 39(1): 56.     CrossRef
  • Antibiogram of Multidrug-Resistant Bacteria Based on Sepsis Onset Location in Korea: A Multicenter Cohort Study
    Hyung-Jun Kim, Dong Kyu Oh, Sung Yoon Lim, Young-Jae Cho, Sunghoon Park, Gee Young Suh, Chae-Man Lim, Yeon Joo Lee
    Journal of Korean Medical Science.2023;[Epub]     CrossRef
  • HYPOTENSION AT THE TIME OF SEPSIS RECOGNITION IS NOT ASSOCIATED WITH INCREASED MORTALITY IN SEPSIS PATIENTS WITH NORMAL LACTATE LEVELS
    Ji Hwan Kim, Yong Kyun Kim, Dong Kyu Oh, Kyeongman Jeon, Ryoung-Eun Ko, Gee Young Suh, Sung Yun Lim, Yeon Joo Lee, Young-Jae Cho, Mi-Hyeon Park, Sang-Bum Hong, Chae-Man Lim, Sunghoon Park
    Shock.2023; 59(3): 360.     CrossRef
  • Mortality among adult patients with sepsis and septic shock in Korea: a systematic review and meta-analysis
    Myeong Namgung, Chiwon Ahn, Yeonkyung Park, Il-Youp Kwak, Jungguk Lee, Moonho Won
    Clinical and Experimental Emergency Medicine.2023; 10(2): 157.     CrossRef
  • Effects of prior antiplatelet and/or nonsteroidal anti-inflammatory drug use on mortality in patients undergoing abdominal surgery for abdominal sepsis
    Se Hun Kim, Ki Hoon Kim
    Surgery.2023; 174(3): 611.     CrossRef
  • Clinical effects of bacteremia in sepsis patients with community-acquired pneumonia
    Tae Wan Kim, Se-Uk Lee, Boram Park, Kyeongman Jeon, Sunghoon Park, Gee Young Suh, Dong Kyu Oh, Soo Yeon Lee, Mi Hyeon Park, Haein Lee, Chae-man Lim, Ryoung-Eun Ko, Sang-Bum Hong, Suk-Kyung Hong, Yeon Joo Lee, Young-Jae Cho, Sung Yoon Lim, Jeongwon Heo, Ja
    BMC Infectious Diseases.2023;[Epub]     CrossRef
  • Current status of treatment of acute respiratory failure in Korea
    Yong Jun Choi, Jae Hwa Cho
    Journal of the Korean Medical Association.2022; 65(3): 124.     CrossRef
  • Clinical Characteristics and Outcomes of Neutropenic Sepsis: A Multicenter Cohort Study
    Soo Jin Na, Dong Kyu Oh, Sunghoon Park, Yeon Joo Lee, Sang-Bum Hong, Mi-Hyun Park, Ryoung-Eun Ko, Chae-Man Lim, Kyeongman Jeon
    Shock.2022; 57(5): 659.     CrossRef
  • Mortality of patients with hospital-onset sepsis in hospitals with all-day and non-all-day rapid response teams: a prospective nationwide multicenter cohort study
    Dong-gon Hyun, Su Yeon Lee, Jee Hwan Ahn, Jin Won Huh, Sang-Bum Hong, Younsuck Koh, Chae-Man Lim, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Jeongwon Heo, Jae-myeong Lee, Kyung Cha
    Critical Care.2022;[Epub]     CrossRef
  • Clinical outcomes and prognostic factors of patients with sepsis caused by intra-abdominal infection in the intensive care unit: a post-hoc analysis of a prospective cohort study in Korea
    Chan Hee Park, Jeong Woo Lee, Hak Jae Lee, Dong Kyu Oh, Mi Hyeon Park, Chae-Man Lim, Suk-Kyung Hong, Chae-Man Lim, Sang-Bum Hong, Dong Kyu Oh, Gee Young Suh, Kyeongman Jeon, Ryoung-Eun Ko, Young-Jae Cho, Yeon Joo Lee, Sung Yoon Lim, Sunghoon Park, Chae-Ma
    BMC Infectious Diseases.2022;[Epub]     CrossRef
  • Sepsis in the XXI Century: Etiology, Risk Factors, Epidemiological Features, Complications, Prevention
    L. I. Gomanova, A. Y. Brazhnikov
    Epidemiology and Vaccinal Prevention.2021; 20(3): 107.     CrossRef
  • Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea
    Ryoung-Eun Ko, Kyung Hoon Min, Sang-Bum Hong, Ae-Rin Baek, Hyun-Kyung Lee, Woo Hyun Cho, Changhwan Kim, Youjin Chang, Sung-Soon Lee, Jee Youn Oh, Heung Bum Lee, Soohyun Bae, Jae Young Moon, Kwang Ha Yoo, Kyeongman Jeon
    Tuberculosis and Respiratory Diseases.2021; 84(4): 317.     CrossRef
  • Clinical Usefulness of Red Cell Distribution Width/Albumin Ratio to Discriminate 28-Day Mortality in Critically Ill Patients with Pneumonia Receiving Invasive Mechanical Ventilation, Compared with Lacate/Albumin Ratio: A Retrospective Cohort Study
    Jong Hwan Jeong, Manbong Heo, Seung Jun Lee, Yi Yeong Jeong, Jong Deog Lee, Jung-Wan Yoo
    Diagnostics.2021; 11(12): 2344.     CrossRef
  • Review of 20 Years of Continuous Quality Improvement of a Rapid Response System, at Four Institutions, to Identify Key Process Responsible for Its Success
    Mary Anne Vandegrift, Robert Granata, Vicken Y. Totten, John Kellett, Frank Sebat
    Critical Care Explorations.2021; 3(8): e0448.     CrossRef
  • An Update on Sepsis Biomarkers
    Mi-Hee Kim, Jung-Hyun Choi
    Infection & Chemotherapy.2020; 52(1): 1.     CrossRef
  • Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate*
    Sunghoon Park, Kyeongman Jeon, Dong Kyu Oh, Eun Young Choi, Gil Myeong Seong, Jeongwon Heo, Youjin Chang, Won Gun Kwack, Byung Ju Kang, Won-Il Choi, Kyung Chan Kim, So Young Park, Yoon Mi Shin, Heung Bum Lee, So Hee Park, Seok Chan Kim, Sang Hyun Kwak, Ja
    Critical Care Medicine.2020; 48(10): 1462.     CrossRef
  • Prevention of sepsis in an aging society
    Youngjoon Kang
    Acute and Critical Care.2019; 34(3): 221.     CrossRef
  • Optimal antimicrobial therapy and antimicrobial stewardship in sepsis and septic shock
    Hyeri Seok, Dae Won Park
    Journal of the Korean Medical Association.2019; 62(12): 638.     CrossRef
  • Sepsis
    Yunghee Lee, Young-Jae Cho
    The Korean Journal of Medicine.2019; 94(6): 495.     CrossRef
Trauma
The Best Prediction Model for Trauma Outcomes of the Current Korean Population: a Comparative Study of Three Injury Severity Scoring Systems
Kyoungwon Jung, John Cook-Jong Lee, Rae Woong Park, Dukyong Yoon, Sungjae Jung, Younghwan Kim, Jonghwan Moon, Yo Huh, Junsik Kwon
Korean J Crit Care Med. 2016;31(3):221-228.   Published online August 30, 2016
DOI: https://doi.org/10.4266/kjccm.2016.00486
  • 9,470 View
  • 203 Download
  • 7 Crossref
AbstractAbstract PDF
Background
Injury severity scoring systems that quantify and predict trauma outcomes have not been established in Korea. This study was designed to determine the best system for use in the Korean trauma population.
Methods
We collected and analyzed the data from trauma patients admitted to our institution from January 2010 to December 2014. Injury Severity Score (ISS), Revised Trauma Score (RTS), and Trauma and Injury Severity Score (TRISS) were calculated based on the data from the enrolled patients. Area under the receiver operating characteristic (ROC) curve (AUC) for the prediction ability of each scoring system was obtained, and a pairwise comparison of ROC curves was performed. Additionally, the cut-off values were estimated to predict mortality, and the corresponding accuracy, positive predictive value, and negative predictive value were obtained.
Results
A total of 7,120 trauma patients (6,668 blunt and 452 penetrating injuries) were enrolled in this study. The AUCs of ISS, RTS, and TRISS were 0.866, 0.894, and 0.942, respectively, and the prediction ability of the TRISS was significantly better than the others (p < 0.001, respectively). The cut-off value of the TRISS was 0.9082, with a sensitivity of 81.9% and specificity of 92.0%; mortality was predicted with an accuracy of 91.2%; its positive predictive value was the highest at 46.8%.
Conclusions
The results of our study were based on the data from one institution and suggest that the TRISS is the best prediction model of trauma outcomes in the current Korean population. Further study is needed with more data from multiple centers in Korea.

Citations

Citations to this article as recorded by  
  • Outcomes in trauma patients undergoing veno-venous extracorporeal membrane oxygenation for acute respiratory distress syndrome
    Seon Hee Kim, Up Huh, Seunghwan Song, Min Su Kim, Il Jae Wang, Young Jin Tak
    Perfusion.2023; 38(5): 1037.     CrossRef
  • Prehospital Trauma Scoring Systems for Evaluation of Trauma Severity and Prediction of Outcomes
    Radojka Jokšić-Mazinjanin, Nikolina Marić, Aleksandar Đuričin, Zoran Gojković, Velibor Vasović, Goran Rakić, Milena Jokšić-Zelić, Siniša Saravolac
    Medicina.2023; 59(5): 952.     CrossRef
  • Correlation between trauma and injury severity score and prognosis in patients with trauma
    Chusnul Chatimah, Indah D. Pratiwi, Chairul H. Al Husna
    Journal of Taibah University Medical Sciences.2021; 16(6): 807.     CrossRef
  • Trauma Volume and Performance of a regional Trauma Center in Korea: Initial 5-year analysis
    Byungchul Yu, Giljae Lee, Min A Lee, Kangkook Choi, Sungyoul Hyun, Yangbin Jeon, Yong-Cheol Yoon, Jungnam Lee
    Journal of Trauma and Injury.2020; 33(1): 31.     CrossRef
  • Inclusion of lactate level measured upon emergency room arrival in trauma outcome prediction models improves mortality prediction: a retrospective, single-center study
    Jonghwan Moon, Kyungjin Hwang, Dukyong Yoon, Kyoungwon Jung
    Acute and Critical Care.2020; 35(2): 102.     CrossRef
  • Trauma and Injury Severity Score modification for predicting survival of trauma in one regional emergency medical center in Korea: Construction of Trauma and Injury Severity Score coefficient model
    In Hye Kang, Kang Hyun Lee, Hyun Youk, Jeong Il Lee, Hee Young Lee, Keum Seok Bae
    Hong Kong Journal of Emergency Medicine.2019; 26(4): 225.     CrossRef
  • The thorax trauma severity score and the trauma and injury severity score
    Seong Ho Moon, Jong Woo Kim, Joung Hun Byun, Sung Hwan Kim, Jun Young Choi, In Seok Jang, Chung Eun Lee, Jun Ho Yang, Dong Hun Kang, Ki Nyun Kim, Hyun Oh Park
    Medicine.2017; 96(42): e8317.     CrossRef
Infection
Sepsis in Patients Receiving Immunosuppressive Drugs in Korea: Analysis of the National Insurance Database from 2009 to 2013
Seung-Young Oh, Songhee Cho, Hannah Lee, Eun Jin Chang, Se Hee Min, Ho Geol Ryu
Korean J Crit Care Med. 2015;30(4):249-257.   Published online November 30, 2015
DOI: https://doi.org/10.4266/kjccm.2015.30.4.249
  • 7,649 View
  • 178 Download
  • 6 Crossref
AbstractAbstract PDF
Background
The aim of this study is to evaluate the influence of immunosuppressants on in-hospital mortality from sepsis.
Methods
Using data of the Health Insurance Review & Assessment Service, we collected data from patients who were admitted to the hospital due to sepsis from 2009 to 2013. Based on drugs commonly used for immunosuppression caused by various diseases, patients were divided into three groups; immunosuppressant group, steroid-only group, and control group. Patients with no history of immunosuppressants or steroids were assigned to the control group. To identify risk factors of in-hospital mortality in sepsis, we compared differences in patient characteristics, comorbidities, intensive care unit (ICU) care requirements, and immunodeficiency profiles. Subgroup analysis according to age was also performed.
Results
Of the 185,671 included patients, 13,935 (7.5%) were in the steroid-only group and 2,771 patients (1.5%) were in the immunosuppressant group. The overall in-hospital mortality was 38.9% and showed an increasing trend with age. The steroid-only group showed the lowest in-hospital mortality among the three groups except the patients younger than 30 years. The steroid-only group and immunosuppressant group received ICU treatment more frequently (p < 0.001), stayed longer in the hospital (p < 0.001), and showed higher medical expenditure (p < 0.001) compared to the normal group. Univariate and multivariate analyses revealed that age, male gender, comorbidities (especially malignancy), and ICU treatment had a significant effect on in-hospital mortality.
Conclusions
Despite longer hospital length of stay and more frequent need for ICU care, the in-hospital mortality was lower in patients taking immunosuppressive drugs than in patients not taking immunosuppressive drugs.

Citations

Citations to this article as recorded by  
  • Predictive performance of NEWS and qSOFA in immunocompromised sepsis patients at the emergency department
    Lisanne Boekhoud, Helena M. E. A. Schaap, Rick L. Huizinga, Tycho J. Olgers, Jan C. ter Maaten, Douwe F. Postma, Hjalmar R. Bouma
    Infection.2024;[Epub]     CrossRef
  • Effects of Early Initiation of High-Dose Dexamethasone Therapy on Pro-Inflammatory Cytokines and Mortality in LPS-Challenged Mice
    Ji-young Son, Won Gun Kwack, Eun Kyoung Chung, Sooyoung Shin, Yeo Jin Choi
    Healthcare.2022; 10(7): 1247.     CrossRef
  • Alleviation of LPS-Induced Inflammation and Septic Shock by Lactiplantibacillus plantarum K8 Lysates
    Gayoung Kim, Kyeong-Hun Choi, Hangeun Kim, Dae-Kyun Chung
    International Journal of Molecular Sciences.2021; 22(11): 5921.     CrossRef
  • Critical Care Research Using “Big Data”: A Reality in the Near Future
    Kwangha Lee
    Acute and Critical Care.2018; 33(4): 269.     CrossRef
  • Should Very Old Patients Be Admitted to the Intensive Care Units?
    Jun Kwon Cha, In-Ae Song
    The Korean Journal of Critical Care Medicine.2017; 32(4): 376.     CrossRef
  • Sepsis in Immunocompromised Patients: Current Status in Korea
    Kwangha Lee
    The Korean Journal of Critical Care Medicine.2015; 30(4): 239.     CrossRef
Reviews
Hematology
Severe Fever with Thrombocytopenia Syndrome
Seung Jin Yoo, Sang Taek Heo, Keun Hwa Lee
Korean J Crit Care Med. 2014;29(2):59-63.   Published online May 31, 2014
DOI: https://doi.org/10.4266/kjccm.2014.29.2.59
  • 5,392 View
  • 89 Download
  • 3 Crossref
AbstractAbstract PDF
Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, caused by a novel species of Phlebovirus of Bunyaviridae family, in China, South Korea, and Japan. SFTS is primarily known as a tick-borne disease, and human-to-human transmission is also possible in contact with infectious blood. Common clinical manifestations include fever, thrombocytopenia, and leukopenia as initial symptoms, and multiple organ dysfunction and failure manifest with disease progression. Whereas disease mortality is reported to be 12% to 30% in China, a recent report of cumulative SFTS cases indicated 47% in Korea. Risk factors associated with SFTS were age, presence of neurologic disturbance, serum enzyme levels, and elevated concentrations of certain cytokines. Diagnosis of SFTS is based on viral isolation, viral identification by polymerase chain reaction, and serologic identification of specific immunoglobulin G. Therapeutic guideline has not been formulated, but conservative management is the mainstream of treatment to prevent disease progression and fatal complications.

Citations

Citations to this article as recorded by  
  • The first discovery of severe fever with thrombocytopenia syndrome virus in Taiwan
    Tsai-Lu Lin, Shan-Chia Ou, Ken Maeda, Hiroshi Shimoda, Jacky Peng-Wen Chan, Wu-Chun Tu, Wei-Li Hsu, Chi-Chung Chou
    Emerging Microbes & Infections.2020; 9(1): 148.     CrossRef
  • Epidemiology of severe fever and thrombocytopenia syndrome virus infection and the need for therapeutics for the prevention
    Norbert John C. Robles, Hae Jung Han, Su-Jin Park, Young Ki Choi
    Clinical and Experimental Vaccine Research.2018; 7(1): 43.     CrossRef
  • Two Treatment Cases of Severe Fever and Thrombocytopenia Syndrome with Oral Ribavirin and Plasma Exchange
    In Park, Hye In Kim, Ki Tae Kwon
    Infection & Chemotherapy.2017; 49(1): 72.     CrossRef
The Subspecialty Certification for Critical Care Medicine in Korea
Dong Chan Kim
Korean J Crit Care Med. 2009;24(3):117-123.
DOI: https://doi.org/10.4266/kjccm.2009.24.3.117
  • 2,383 View
  • 30 Download
  • 1 Crossref
AbstractAbstract PDF
The Korean Society of Critical Care Medicine (KSCCM) has introduced the Subspecialty System for Critical Care Medicine in Korea under the auspices of the Korean Academy of Medical Sciences (KAMS) in March 2008. Nine medical societies that included the Korean Association of Internal Medicine, the Korean Academy of Tuberculosis and Respiratory Diseases, the Korean Society of Anesthesiology, the Korean Neurological Association, the Korean Neurosurgical Society, the Korean Surgical Society, the Korean Society of Emergency Medicine, the Korean Society for Thoracic and Cardiovascular Surgery and the Korean Pediatric Society participated to the new critical care subspecialty. The Board of Critical Care should be certified again every 5 year after achieving the required qualification by the KSCCM. This paper summarizes the Subspecialty Certification System for Critical Care Medicine in Korea.

Citations

Citations to this article as recorded by  
  • Impact of staffing model conversion from a mandatory critical care consultation model to a closed unit model in the medical intensive care unit
    Sung Jun Ko, Jaeyoung Cho, Sun Mi Choi, Young Sik Park, Chang-Hoon Lee, Chul-Gyu Yoo, Jinwoo Lee, Sang-Min Lee, Robert Jeenchen Chen
    PLOS ONE.2021; 16(10): e0259092.     CrossRef
Original Articles
Analysis of Cases Requested to the Ethics Committee of an University Hospital for the Discontinuation of Therapy
Jeong Min Kang, Younsuck Koh
Korean J Crit Care Med. 2005;20(1):68-75.
  • 1,560 View
  • 25 Download
AbstractAbstract PDF
BACKGROUND
A hospital ethics committee (HEC) handles ethics problems in a hospital and mediates conflicts between patients and caregivers. The role of HEC on treatment withdrawal has increased after Boramae-hospital's case on 1997 in Korea. This study is an analysis of cases referred to the HEC of Asan Medical Center for the discontinuation of patient therapy. METHODS: The conference records of the HEC from January 1998 to December 2003 and the relevant patient charts were reviewed retrospectively. RESULTS: Twenty-seven cases related to treatment withdrawal were referred to the HEC during the study period. Based on the number of admitted ICU patients during the study period, the case request rate was 0.05%. The bimodal distribution of the cases in terms of age was neonate, 13 (48%); infant, 6 (22%); adult, 8 (30%). The major causes of treatment withdrawal were futile management, financial difficulty and patient suffering. The HEC recommended the continuation of treatment in 7 cases (25.9%); treatment withdrawal in 11 (40.7%); treatment withholding in 8 (29.6%); transfer to another hospital in one case (3.8%). Of the seven recommendations for treatment continuation, only three were accepted by their families. These three patients were eventually discharged alive. Treatment was withdrawn within one week in all eleven cases recommended for that by the HEC. Treatment was withheld in seven of those eight such recommended cases. CONCLUSIONS: The case referral rate was low in the studied hospital. In all cases, the patients' families requested the case to the HEC. Although the committee's recommendations to withhold or withdraw the treatment were followed by the families, the recommendation to continue therapy was often refused.
The Distribution of Medical Personnel and Medical Equipments in the Intensive Care Units in Korea
Shin Ok Koh, Pyung Hwan Park, Myoung Hoon Kong, Yong Lak Kim
Korean J Crit Care Med. 2001;16(2):138-143.
  • 1,727 View
  • 60 Download
AbstractAbstract PDF
BACKGROUND
Not much of the fund is invested in the intensive care unit (ICU) in Korean hospitals since the cost of ICU care is set too low compared to the other medical fields as well as to the other part of the world. This study is designed to support the base of an ICU standard guideline in Korea.
METHODS
The questionnaire were sent to 73 ICUs and 24 neonatal ICUs (NICU) of 30 hospitals. Twenty-two of them were teaching hospitals and 8 of them were general hospitals.
RESULTS
The ratios of ICU bed number to total bed number were 5.0% and 6.0% in teaching hospital and general hospital respectively. The ratios of NICU bed to total bed were 3.4% and 2.0% in teaching hospital and general hospital respectively. Intensivists were kept in 24.6% of ICU and 36.4% of NICU. Residents were kept in 43.1% of ICU and 45.5% of NICU. The utilization of ICU service was 90% for teaching hospital and 86% for general hospital. The utilization of NICU was 89% for teaching hospital and 3% of general hospital. Nurse to patient ratios varied widely. Most ICUs in teaching hospital showed the nurse to patients ratio of 1 : 4 which was about 32% of total ICU. Most NICUs in teaching hospital showed the nurse to patients ratio of 1 : 5 which was around 20% of total NICU. Most of the ICUs were equipped with central piping system for oxygen and compressed air supply, vacuum system and all the necessary medical gadgets such as mechanical ventilators, ECG monitors, defibrillators, pulse oximeters and infusion pumps.
CONCLUSIONS
The distribution of medical personnel as well as medical equipments were varied widely. The variation existed between teaching hospital and general hospital as well as within the teaching hospitals. We need to establish a standard, which grades the level of ICU according to the number of keeping physician, nurse-patients ratio, and the types of medical equipments they have.

ACC : Acute and Critical Care