Moon Seong Baek

Asthma is a prevalent chronic disease worldwide, and individuals with asthma often experience reduced quality of life (QOL) due to symptoms such as dyspnea and impaired physical function. Given the vulnerability of this population, identifying strategies to maintain or improve QOL is essential. Asthma-related physical inactivity and muscle weakness may increase the risk of sarcopenia, which can further deteriorate QOL. This study aimed to examine the association between handgrip strength and health-related QOL in Korean adults with asthma. We used data from the Korea National Health and Nutrition Examination Survey conducted between 2014 and 2019. A total of 867 adults aged ≥19 years who reported a physician diagnosis of asthma and completed handgrip strength and EuroQol 5-Dimension (EQ-5D) assessments were included. Participants were categorized into high- and low-handgrip-strength groups based on sex-specific thresholds (28.9 kg for men and 16.8 kg for women). The EQ-5D index was used to classify patients into low-, middle-, and high-QOL groups. Multinomial logistic regression analyses were conducted to evaluate the association between handgrip strength and QOL, adjusting for age, sex, household income, education, smoking status, high-risk alcohol use, resistance exercise, body mass index, hypertension, diabetes, arthritis, and depression. Participants with higher handgrip strength were more likely to be in the high-QOL group than those with lower handgrip strength (adjusted OR = 2.25; 95% CI: 1.22–4.16). In the subgroup analyses, the association was significant in women (adjusted OR = 2.89; 95% CI: 1.32–6.29), but not in men. A significant association was also observed in participants with as-needed medication use, but not in those with daily medication use. Higher handgrip strength was associated with better QOL in adults with asthma, particularly among women and those with less severe disease. Interventions aimed at improving muscle strength may contribute to enhanced QOL in this population.

Background: Despite recent advances and global improvements in sepsis recognition and supportive care, mortality rates remain high, and adherence to sepsis bundle components in Korea is low. To address this, the Korean Sepsis Alliance, affiliated with the Korean Society of Critical Care Medicine, developed the first sepsis treatment guidelines for Korea based on a comprehensive systematic review and meta-analysis.Methods: A de novo method was used to develop the guidelines. Methodologies included determining key questions, conducting a literature search and selection, assessing the risk of bias, synthesizing evidence, and developing recommendations. The certainty of evidence and the strength of recommendations were determined using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Draft recommendations underwent internal and external review processes and public hearings. The development of these guidelines was supported by a research grant from the Korean Disease Control and Prevention Agency.Results: In these guidelines, we focused on early treatments for adult patients with sepsis and septic shock. Through the guideline development process, 12 key questions and their respective recommendations were formulated. These include lactate measurement, fluid therapies, target blood pressure, antibiotic administration, use of vasopressors and dobutamine, extracorporeal membrane oxygenation, and echocardiography.Conclusions: These guidelines aim to support medical professionals in making appropriate decisions about treating adult sepsis and septic shock. We hope these guidelines will increase awareness of sepsis and reduce its mortality rate.

This study aimed to evaluate the 1-year mortality rate among older patients with COVID-19 discharged from hospital and to identify risk factors associated with this outcome. Using a COVID-19 dataset from the Korean National Health Insurance System, this study’s evaluation period spanned from October 8, 2020, through December 31, 2021. The primary outcome was the 1-year mortality rate following hospital discharge. A logistic regression model was employed for multivariable analysis to estimate the odds ratios for the outcomes, and the Kaplan-Meier method was used to analyze differences in 1-year survival rates. Among the 66,810 COVID-19 patients aged 60 years or older who were hospitalized during the study period, the in-hospital mortality rate was 4.8% (n = 3219). Among the survivors (n = 63,369), the 1-year mortality rate was 4.9% (n = 3093). Non-survivors, compared to survivors, were significantly older (79.2 ± 9.5 vs. 68.9 ± 7.8, P < 0.001) and exhibited a lower rate of COVID-19 vaccination (63.0% vs. 91.7%, P < 0.001). Additionally, non-survivors experienced a higher incidence of organ dysfunction, along with a greater proportion of required mechanical ventilation (14.6% vs. 1.0%, P < 0.001) and extracorporeal membrane oxygenation (4.0% vs. 0.1%, P < 0.001). Multivariable logistic regression analysis identified older age, male sex, cardiovascular disease, immunosuppression, organ dysfunction, illness severity, and corticosteroid use during hospitalization as factors associated with death within 1 year after hospital discharge. However, vaccination was found to have a long-term protective effect against death among COVID-19 survivors. The 1-year mortality rate after hospital discharge for older COVID-19 patients was comparable to the in-hospital mortality rate for these patients in Korea. The long-term mortality rate among hospitalized older COVID-19 patients was influenced by demographic factors and the severity of illness experienced during hospitalization.

Background: The Controlling Nutritional Status (CONUT) score and the prognostic nutritional index (PNI) have emerged as important nutritional indices because they provide an objective assessment based on data. We aimed to investigate how these nutritional indices relate to outcomes in patients with sepsis.Methods: Data were collected retrospectively at five hospitals for patients aged ≥18 years receiving treatment for sepsis between January 1, 2017, and December 31, 2021. Serum albumin and total cholesterol concentrations, and peripheral lymphocytes were used to calculate the CONUT score and PNI. To identify predictors correlated with 30-day mortality, analyses were conducted using univariate and multivariate Cox proportional hazards models.Results: The 30-day mortality rate among 9,763 patients was 15.8% (n=1,546). The median CONUT score was 5 (interquartile range [IQR], 3–7) and the median PNI score was 39.6 (IQR, 33.8–46.4). Higher 30-day mortality rates were associated with individuals with moderate (CONUT score: 5–8; PNI: 35–38) or severe (CONUT: 9–12; PNI: 38). With CONUT scores, the hazard ratio (HR) associated with moderate malnutrition was 1.52 (95% confidence interval [CI], 1.24–1.87, P<0.001); for severe, HR=2.42 (95% CI, 1.95–3.02, P<0.001). With PNI scores, the HR for moderate malnutrition was 1.29 (95% CI, 1.09–1.53, P=0.003); for severe, HR=1.88 (95% CI, 1.67–2.12, P<0.001).Conclusions: The nutritional indices CONUT score and PNI showed significant associations with mortality of sepsis patients within 30 days.

Yun JE, et al. Allergy Asthma Immunol Res. 2024 Sep;16(5):534-545. https://doi.org/10.4168/aair.2024.16.5.534

Kim TW, et al. J Korean Med Sci. 2024 Feb;39:e75. https://doi.org/10.3346/jkms.2024.39.e75