Latent classes based on fall risk factors in community-dwelling older adults: The 2017 National Survey of Older Persons.

AIMS: This work aimed to classify the elderly according to fall risk factors and to identify the characteristics of the latent classes. BACKGROUND: Falls mainly occur due to combinations of various risk factors, and each older adult has a different combination of risk factors. DESIGN: This was a secondary data analysis using data from the 2017 National Survey of Older Persons conducted by the Korean Ministry of Health and Welfare. METHODS: Latent class analysis and multiple logistic regression were performed using data from 1556 older adults who experienced at least one fall during 1 year (1 January 2016 to 31 December 2016). Indicator variables included eight fall risk factors. RESULTS: A 3-class solution was selected according to acceptable goodness of fit. The 'healthy falls risk class' included over half of the cohort, and the comprised older adults did not show typical health problems. The 'complex falls risk class' included older people with physical and mental problems, and the 'musculoskeletal falls risk class' included older people with osteoarthritis and back pain. CONCLUSION: The results identified combinations of fall risk factors and characteristics among community-dwelling older adults that may contribute to the planning of effective fall prevention programmes.

Anxiety, depression, and uncertainty appraisal and factors affecting uncertainty risk and opportunity appraisal of health care workers in Korea during the COVID-19 outbreak: Uncertainty risk and opportunity appraisal.

Background: Due to the prolonged period of COVID-19, the uncertainty related to COVID-19 is bound to increase for healthcare workers (HCWs) in tertiary medical institutions as much as for the HCWs in dedicated hospitals. Purpose: To assess anxiety, depression, and uncertainty appraisal, and to determine the factors affecting uncertainty risk and opportunity appraisal experienced by HCWs at the forefront of COVID-19 treatment. Method: This was a descriptive, cross-sectional study. The participants were HCWs at a tertiary medical center in Seoul. HCWs included medical (doctors, nurses) and non-medical (nutritionists, pathologists, radiologists, office workers, etc.) personnel. Self-reported structured questionnaires (patient health questionnaire, generalized anxiety disorder scale, and uncertainty appraisal) were obtained. Finally, responses from 1337 people were used to evaluate factors affecting uncertainty risk and opportunity appraisal using a quantile regression analysis. Results: The average ages of medical and non-medical HCWs were 31.69 ± 7.87 and 38.66 ± 11.42 years, and the proportion of females was high. The rates of moderate to severe depression (23.23%) and anxiety (6.83%) were higher in medical HCWs. The uncertainty risk score was higher than the uncertainty opportunity score for all the HCWs. Factors that increased uncertainty opportunity were a decrease in depression in medical HCWs and a decrease in anxiety in non-medical HCWs. Increase in age was directly proportional to uncertainty opportunity in both groups. Conclusion: There is a need to devise a strategy to reduce uncertainty among HCWs who inevitably face various infectious diseases that appear in the near future. In particular, since there are various types of non-medical as well as medical HCWs in medical institutions who can prepare an intervention plan that comprehensively considers the characteristics of each occupation and the distribution of risks and opportunities of uncertainty will be able to improve the quality of life of HCWs and further promote the health of the people.

Different Impact of Metabolic Syndrome on the Risk of Incidence of the Peripheral Artery Disease and the Venous Thromboembolism: A Nationwide Longitudinal Cohort Study in South Korea.

Background: Limited data is available between metabolic syndrome (MetS) and the development of peripheral arterial disease (PAD) or venous thromboembolism (VTE) in the Asian population. We investigated the incidence of PAD and VTE according to the prevalence of MetS and evaluated the impact of individual components in MetS on the development of PAD and VTE using Korean national data. Methods: Data obtained from national health screening examinations of the Korean National Health Insurance Service from January 1, to December 31, 2009. In total, 9,927,538 participants, 7,830,602 participants were included in this study and the incidence rate of PAD and VTE was investigated retrospectively during a 7-year follow-up. Using the National Cholesterol Education Program Adult Treatment Panel III criteria, patients were placed into one of three groups depending on MetS component numbers: 0 (normal), 1-2 (Pre-MetS), or 3-5 (MetS). Results: The incidence rates of PAD and VTE in MetS were 2.25% and 0.71%, respectively. After multivariable adjustment, the risk of PAD was significantly associated with MetS (hazard ratio (HR) 1.45, 95% confidence interval (CI) 1.42-1.49), the risk of VTE was not associated with MetS (HR 1.01, 95% CI 0.96-1.05). When subgroup analyses were conducted according to MetS components, elevated fasting glucose (HR 1.26, 95% CI 1.23-1.27), abdominal obesity (HR 1.15, 95% CI 1.12-1.17), and elevated blood pressure (HR 1.13, 95% CI 1.12-1.15) were the most related to PAD. Abdominal obesity (HR 1.104, 95% CI 1.064-1.146) was associated with an increased risk of VTE. Conclusions: MetS was significantly associated with an increased incidence rate of PAD among the general Korean population. On the other hand, MetS was not associated with the VTE incidence rate. Of the MetS components, only abdominal obesity was a significant predictor of VTE.

The Gambling Factors Related with the Level of Adolescent Problem Gambler.

The purpose of this study was to investigate the gambling factors related with the gambling problem level of adolescents to provide basic information for the prevention of adolescent gambling problems. The data was drawn from the 2015 Survey on Youth Gambling Problems of the Korea Center on Gambling Problems for Korean students in grades 7-11 (ages 13-17 years) and included 14,011 study subjects (average age 14.9 years, 52.5% male). The lifetime gambling behavior experience was 42.1%, and 24.2% had a gambling behavior experience within the past three months. The past three-month prevalence of problem gambling was 1.1%. The gambling factors related with the level of adolescent problem gambling include the presence of nearby gambling facilities, having personal relationships with people that gamble, a higher number of experienced gambling behaviors, male adolescents, and a greater amount of time spent gambling. To the best of our knowledge, this study is the first report to identify gambling factors related with the level of adolescent problem gambling in Korean adolescents using national data. These findings suggest that gambling prevention efforts must consider not only access to individual adolescents as early intervention, but also environmental strategies such as accessibility regulations and alternative activities.

[Evaluation of Validity of the Korean Triage and Acuity Scale].

PURPOSE: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). METHODS: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. CONCLUSION: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

A multicenter cohort study of primary hypertension in Korea: study design and interim analysis of the Korean registry of target organ damage in hypertension (KorHR).

BACKGROUND: The Korean Registry of Target Organ Damage in Hypertension aims to evaluate the clinical characteristics and prevalence of subclinical target organ damage in Korean hypertensive patients. METHOD: This is a prospective, observational, multicenter cohort study in which 23 university hospitals participated. Since May 2013, we have enrolled 1,318 consecutive hypertensive patients without known cardiovascular disease who met the following inclusion criteria: 1) age older than 30 years and 2) the first visit to the participating hospitals was within the last 5 years. RESULTS: The mean age was 52 ± 12 years; 62.1% were male, and 41.3% were incident hypertensives. Patients with diabetes mellitus accounted for 7.8% of the population and 43.8% had hyperlipidemia or were on statins at baseline. The mean office blood pressures were 152 ± 20/96 ± 14 mmHg for incident hypertensive patients and 129 ± 13/78 ± 10 mmHg for patients on treatment. Patients with electrocardiographic and echocardiographic left ventricular hypertrophy accounted for 18.9 and 25.6%, respectively. The mean brachial-ankle pulse wave velocity (PWV) was 1564 ± 293 m/s and 19.5% had PWV values of more than 1750 cm/s. Patients with microalbuminuria and chronic kidney disease accounted for 21 and 4%, respectively. The first prescribed class of antihypertensive medications was angiotensin converting enzyme inhibitors in 2.9%, angiotensin receptor blockers (ARBs) in 57.5%, diuretics in 7.6%, calcium channel blockers (CCBs) in 61.0%, beta blockers in 17.3%, and fixed dose combination pill in 27.8%. CONCLUSION: Our interim analysis shows that subclinical target organ damage in hypertension is considerably present for incident or treated hypertensive patients. CCBs and ARBs were the most commonly prescribed classes of antihypertensive medications and fixed dose combination pills were actively used in Korea. TRIAL REGISTRATION: NCT01861080. Registered 16 May 2013.