본문 바로가기
KERD
논문KCI 등재

일개 병원의 뇌동맥류 파열의 위험요인

Factors Associated with Ruptured Intracranial Aneurysm in a Hospital

윤소영|최자윤|이은하
한국융합학회 (Korea Convergence Society)|2019.01|한국융합학회논문지 (Journal of the Korea Convergence Society)|제10권 제1호|pp. 339-351|DOI https://doi.org/10.15207/JKCS.2019.10.1.339

0

조회

0

다운로드

2

인용

0

참고문헌

키워드

영향요인Risk factors파열뇌동맥류지주막하출혈RuptureIntracranial aneurysmSubarachnoid hemorrhage뇌동맥류환자Patients with Intracranial aneurysm
주제분류학제간연구

초록

본 연구는 2016년 1월부터 12월까지 뇌동맥류로 진단받고 치료를 받고 있는 환자의 일반적, 입원관련, 임상적, 뇌동맥류 자체 및 생활습관 특성 중 위험요인을 확인하고자 의무기록지 검토를 통해 후향적으로 이루어졌다. 로지스틱 회귀분석 결과 2개 이상의 경고증상(14.14 (CI: 1.25-159.40))이 뇌동맥류 파열에 대한 오즈비가 가장 높았고, 다음으로 3점 이상의 두통(13.95 (CI: 3.68-52.83)), 응급실을 통한 입원(13.62 (CI: 4.85-38.26)), 배우자가 없는 경우(9.72 (CI: 2.22-42.49)), 부정맥이 있는 경우(3.70 (CI: 1.22-11.22)), 1 mmHg 수축기압 증가(1.04 (CI: 1.01-1.08)), 1점 GCS 증가 (0.58 (CI: 0.37-0.90)), 1세 나이 증가(0.95 (CI: 0.91-0.99))순이었다. 뇌동맥류 파열이 발생하기 전에 일상적인 평가를 포함한 예방 활동을 수행해야하며 뇌동맥류 환자발견 시 뇌동맥류파열 위험요인에 대한 신속한 사정이 필요하다.

Abstract

This study was conducted to identify the factors associated with the ruptured intracranial aneurysm (RIA) among demographic, admission to hospital, clinical, aneurysym itself and lifestyle characteristics. Medical records of RIA patients and un-RIA patients which had been admitted to undergo treatment including surgery (From January to December 2016) were included into data analysis. Multiple logistic regression showed that two and more than warning signs (14.14 (CI: 1.25-159.40)) indicated the greatest odds ratio with RIA, was followed by headache more than 3 scores (13.95 (CI: 3.68-52.83)), the admission via emergency room (13.62 (CI: 4.85-38.26)), single marital status (9.72 (CI: 2.22-42.49)), 1 mmHg increased systolic blood pressure (1.04 (CI: 1.01-1.08)), 1 score increased GCS (0.58 (CI: 0.37-0.90)), arrythmia finding in electrocardiogram (3.70 (CI: 1.22-11.22)) and increased age (0.95 (CI: 0.91-0.99)). The risk groups having factors associated with RIA were identified. Preventive activities including routine assessment should be done before developing the rupture and urgent care should be needed after developing the rupture for risk groups.

참고문헌 (26)

  1. The Korean Neurosurgical Society, "Neurosurgery" (2012), The Korean Neurosurgical Society
  2. The council for the Critical Care Nursing Curriculum, "Neuroscience critical care nursing" (2010), Koonja Publishing Company
  3. Bo-Ra Seo, "Incidence rate of Aneurysmal SAH in Gwangju City and Jeollanamdo Province in 2007", 대한신경외과학회지, 47(2), pp.124~127 (2010), 대한신경외과학회
  4. K. H. Kim, "Guideline for management of unruptured intracranial aneurysm", Neurointervention, 2(1), pp.43~49 (2007)
  5. Makoto Sonobe, "Small Unruptured Intracranial Aneurysm Verification Study", Stroke, 41(9), pp.1969~1977 (2010), Ovid Technologies (Wolters Kluwer Health)[DOI]
  6. Outcomes research of preventive procedures in unruptured intracranial aneurysm, "H. J. Lee", National Evidence-based Healthcare Collaborating Agency (NECA), ~ (2011)
  7. Jin Soo Lee, "Familial Intracranial Aneurysms", 대한신경외과학회지, 44(3), pp.136~140 (2008), 대한신경외과학회
  8. M. H. Han, "Endovascular treatment of cerebral aneurysms:detachable coils and general principles", Neurointervention, 1(1), pp.1~6 (2006)
  9. J. S. Ahn, "Management of unruptured intracranial aneurysms-natural course and surgical outcomes", Journal of Korean Neurosurgical Society, 30(6), pp.813~818 (2001)
  10. Marieke J.H. Wermer, "Risk of Rupture of Unruptured Intracranial Aneurysms in Relation to Patient and Aneurysm Characteristics", Stroke, 38(4), pp.1404~1410 (2007), Ovid Technologies (Wolters Kluwer Health)[DOI]
  11. M. Shojima, "Size is the most important predictor of aneurysm rupture among multiple cerebral aneurysms: post hoc subgroup analysis of unruptured cerebral aneurysm study Japan", Neurosurgery, 82(6), pp.864~869 (2018)[DOI]
  12. Homajoun Maslehaty, "Predictive anatomical factors for rupture in middle cerebral artery mirror bifurcation aneurysms", Journal of Neurosurgery, 128(6), pp.1799~1807 (2018), Journal of Neurosurgery Publishing Group (JNSPG)[DOI]
  13. J. Mocco, "Aneurysm morphology and prediction of rupture: an international Study of unruptured intracranial aneurysms analysis", Neurosurgery, 82(4), pp.491~496 (2018)[DOI]
  14. 박용성, "인구학적 요인, 의학적 요인, 환경 요인을 고려한 뇌동맥류의 파열 예측관련인자 분석", 보건정보통계학회지, 35(2), pp.113~126 (2010), 한국보건정보통계학회
  15. Anil Can, "Association of intracranial aneurysm rupture with smoking duration, intensity, and cessation", Neurology, 89(13), pp.1408~1415 (2017), Ovid Technologies (Wolters Kluwer Health)[DOI]
  16. F. Faul, "G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences", Behavior research methods, 39(2), pp.175~191 (2007)
  17. J. B. Saunders, "Development of the alcohol use disorders identification test (AUDIT): WHO collaborative project on early detection of persons with harmful alcohol consumption-II", Addiction, 88(6), pp.791~804 (1993)
  18. Y. S. Lee, "Causes of neurologic deterioration before management in the patients with a ruptured aneurysm", Korean Journal of Cerebrovascular Surgery, 11(1), pp.19~24 (2009)
  19. 오효숙, "급성 관상동맥 증후군 환자의 치료추구지연에 대한 의사결정모형", Korean Journal of Health Promotion, 8(4), pp.235~244 (2008), 대한임상건강증진학회
  20. E. Kawahara, "Role of autonomic nervous dysfunction in electrocardio-graphic abnormalities and cardiac injury in patients with acute subarachnoid hemorrhage", Circulation journal : official journal of the Japanese Circulation Society, 67(9), pp.753~756 (2003)[DOI]
  21. J. H. Jung, "Are electrocardiographic changes in patients with acute subarachnoid hemorrhage associated with Takotsubo cardiomyopathy?", Cardiology, 115(2), pp.98~106 (2010)
  22. J. Liu, "Prediction of rupture risk in anterior communicating artery aneurysms with a feed-forward artificial neural network", European Radiology, 28(8), pp.3268~3275 (2018)
  23. Yoshiteru Tada, "Roles of Hypertension in the Rupture of Intracranial Aneurysms", Stroke, 45(2), pp.579~586 (2014), Ovid Technologies (Wolters Kluwer Health)[DOI]
  24. Kiyoshi Takagi, "How should a subarachnoid hemorrhage grading scale be determined? A combinatorial approach based solely on the Glasgow Coma Scale", Journal of Neurosurgery, 90(4), pp.680~687 (1999), Journal of Neurosurgery Publishing Group (JNSPG)[DOI]
  25. H. Iwamoto, "Prevalence of intracranial saccular aneurysms in a Japanese community based on a consecutive autopsy series during a 30-year observation period. The Hisayama study", Stroke, 30(7), pp.1390~1395 (1999)
  26. D. Woo, "Age at intracranial aneurysm rupture among generations: Familial Intracranial Aneurysm Study", Neurology, 72(8), pp.695~698 (2009), Ovid Technologies (Wolters Kluwer Health)[DOI]

이 간행물의 다른 논문 (16건)

원형배열 안테나의 위상차 패턴을 이용한 방향탐지 기법임중수pp. 1-6신경회로망을 이용한 KOSPI 예측 기반의 ETF 매매황희수pp. 7-12마인드맵 기반의 사물인터넷 융합 관리 시스템의 개발허원, 이대현, 배호철pp. 45-51안드로이드 저작권 보호를 위한 메소드 생성 기반 워터마킹 기법의 설계 및 구현박희완pp. 61-69유아교육학과 학생의 구강보건교육과 구강보건지식이 구강보건인식에 융합적으로 미치는 영향윤성욱pp. 71-78
원문 보기