Journal of Yeungnam Medical Science

Original articles

Impact of an emergency department resident strike during the coronavirus disease 2019 (COVID-19) pandemic in Daegu, South Korea: a retrospective cross-sectional study: Yo Han Cho, Jae Wan Cho, Hyun Wook Ryoo, Sungbae Moon, Jung Ho Kim, Sang-Hun Lee, Tae Chang Jang, Dong Eun Lee; J Yeungnam Med Sci. 2022;39(1):31-38. Published online August 10, 2021; DOI: https://doi.org/10.12701/yujm.2021.01130

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Background
To prepare for future work stoppages in the medical industry, this study aimed to identify the effects of healthcare worker strikes on the mortality rate of patients visiting the emergency department (ED) at six training hospitals in Daegu, Korea.
Methods
We used a retrospective, cross-sectional, multicenter design to analyze the medical records of patients who visited six training hospitals in Daegu (August 21–September 8, 2020). For comparison, control period 1 was set as the same period in the previous year (August 21–September 8, 2019) and control period 2 was set as July 1–19, 2020. Patient characteristics including age, sex, and time of ED visit were investigated along with mode of arrival, length of ED stay, and in-hospital mortality. The experimental and control groups were compared using t-tests, and Mann-Whitney U-test, chi-square test, and Fisher exact tests, as appropriate. Univariate logistic regression was performed to identify significant factors, followed by multivariate logistic regression analysis.
Results
During the study period, 31,357 patients visited the ED, of which 7,749 belonged to the experimental group. Control periods 1 and 2 included 13,100 and 10,243 patients, respectively. No significant in-hospital mortality differences were found between study periods; however, the results showed statistically significant differences in the length of ED stay.
Conclusion
The ED resident strike did not influence the mortality rate of patients who visited the EDs of six training hospitals in Daegu. Furthermore, the number of patients admitted and the length of ED stay decreased during the strike period.

Citations

Citations to this article as recorded by

Impact of junior doctor strikes on patient flow in the emergency department: a cross-sectional analysis
Svenja Ravioli, Raeesa Jina, Omar Risk, Fleur Cantle
European Journal of Emergency Medicine.2024; 31(1): 53. CrossRef
What Do Trainees Want? The Rise of House Staff Unions
Debra Malina, Lisa Rosenbaum
New England Journal of Medicine.2024; 390(3): 279. CrossRef
Experience of operating a medical humanities course at one medical school during the COVID-19: a retrospective study
Yu Ra Kim, Hye-won Shin, Young Hwan Lee, Seong-Yong Kim
Journal of Yeungnam Medical Science.2023; 40(2): 179. CrossRef
A deliberative framework to assess the justifiability of strike action in healthcare
Ryan Essex
Nursing Ethics.2023;[Epub] CrossRef
Study on the Learning Environment of Medical Students in the COVID-19
Yu Ra Kim, Hye Jin Park, Saeyoon Kim
Keimyung Medical Journal.2023; 42(2): 80. CrossRef

Determining the correlation between outdoor heatstroke incidence and climate elements in Daegu metropolitan city: Jung Ho Kim, Hyun Wook Ryoo, Sungbae Moon, Tae Chang Jang, Sang Chan Jin, You Ho Mun, Byung Soo Do, Sam Beom Lee, Jong-yeon Kim; Yeungnam Univ J Med. 2019;36(3):241-248. Published online July 2, 2019; DOI: https://doi.org/10.12701/yujm.2019.00248

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Abstract PDF

Background
Heatstroke is one of the most serious heat-related illnesses. However, establishing public policies to prevent heatstroke remains a challenge. This study aimed to investigate the most relevant climate elements and their warning criteria to prevent outdoor heatstroke (OHS).
Methods
We investigated heatstroke patients from five major hospitals in Daegu metropolitan city, Korea, from June 1 to August 31, 2011 to 2016. We also collected the corresponding regional climate data from Korea Meteorological Administration. We analyzed the relationship between the climate elements and OHS occurrence by logistic regression.
Results
Of 70 patients who had heatstroke, 45 (64.3%) experienced it while outdoors. Considering all climate elements, only mean heat index (MHI) was related with OHS occurrence (p=0.019). Therefore, the higher the MHI, the higher the risk for OHS (adjusted odds ratio, 1.824; 95% confidence interval, 1.102–3.017). The most suitable cutoff point for MHI by Youden’s index was 30.0°C (sensitivity, 77.4%; specificity, 73.7%).
Conclusion
Among the climate elements, MHI was significantly associated with OHS occurrence. The optimal MHI cutoff point for OHS prevention was 30.0°C.

Citations

Citations to this article as recorded by

Ambient heat exposure and kidney function in patients with chronic kidney disease: a post-hoc analysis of the DAPA-CKD trial
Zhiyan Zhang, Hiddo J L Heerspink, Glenn M Chertow, Ricardo Correa-Rotter, Antonio Gasparrini, Niels Jongs, Anna Maria Langkilde, John J V McMurray, Malcolm N Mistry, Peter Rossing, Robert D Toto, Priya Vart, Dorothea Nitsch, David C Wheeler, Ben Caplin
The Lancet Planetary Health.2024; 8(4): e225. CrossRef

Original Article

Comparison of symptomatic and asymptomatic pulmonary embolism in proximal deep vein thrombosis: Dong Hun Kim, Young Woo Seo, Gyun Moo Kim, Seung Hyun Ko, Jae Seok Jang, Tae Chang Jang; Yeungnam Univ J Med. 2017;34(2):231-237. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.231

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Abstract PDF: BACKGROUND
Deep vein thrombosis (DVT) and pulmonary embolism (PE) are conditions with significant morbidity and mortality. Proximal DVT has a significant association with PE and possible fatal outcomes. Traditionally, PE is subdivided into symptomatic PE and asymptomatic PE, which have different treatments, preventions and prognoses. The growing utilization of computed tomography pulmonary angiography has led to increased detection of PE in DVT patients. This study examined the clinical characteristics and compared symptomatic PE and asymptomatic PE following proximal DVT. METHODS: The medical records of 258 DVT inpatients from July, 2012 to June, 2015 were reviewed retrospectively. After excluding the patients who did not performed PE evaluation and were not diagnosed with PE, 95 patients diagnosed with PE following proximal DVT were enrolled in this study. They were divided into the symptomatic PE group and asymptomatic PE group. RESULTS: The body weight, body mass index, thrombus size, thrombus length and location were similar in the two groups. The symptomatic PE following proximal DVT group showed an older age, higher incidence of emergency department access (85.0% vs. 38.7%, p < 0.001) and preceding infection (25.0% vs. 1.3%, p < 0.001) as well as a higher incidence of immobilization (45.0% vs 13.3%, p=0.016). In the multivariate logistic regression study, preceding infection and emergency department access showed significant association with symptomatic PE. CONCLUSION: In proximal DVT inpatients, symptomatic PE was associated with emergency department access and preceding infection. The possibility of a symptomatic PE event should be considered in proximal DVT patients, especially those who were admitted through the emergency department and had preceding infection.

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