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Article ; Online: Age and comorbidities as predictors of hospital mortality in adult patients who receive extracorporeal membrane oxygenation therapy

Te-Chun Yeh / Hsiao-Huang Chang / Ju-O Wang / Senyeong Kao / Tso-Chou Lin / Shung-Tai Ho

Journal of Medical Sciences, Vol 42, Iss 3, Pp 120-

A population-based study

2022 Volume 126

Abstract: Background: The incidence rate of extracorporeal membrane oxygenation (ECMO) use in Taiwan has increased significantly and is now higher than the worldwide incidence since 2000. Several studies have investigated hospital mortality and the risk factors of ...

Abstract	Background: The incidence rate of extracorporeal membrane oxygenation (ECMO) use in Taiwan has increased significantly and is now higher than the worldwide incidence since 2000. Several studies have investigated hospital mortality and the risk factors of patients receiving ECMO. Comorbidities and age were not evaluated in these studies. Aim: To investigate the impact of age and comorbidities on hospital mortality of ECMO patients. Methods: A retrospective study of ECMO patients was performed using the claims data from the Taiwan National Health Insurance Research Database. Results: A total of 5834 adult patients were included in the study, and 2270 patients (38.9%) were discharged from the hospital between 2004 and 2012. The most common comorbidities were coronary artery disease (35.7%), hypertension (32.0%), and acute myocardial infarction (28.4%). Age, interstitial lung disease, rheumatologic disease, and lymphoma were the major predictors for hospital mortality in ECMO patients. On the contrary, acute myocarditis was found to be a favorable factor. Conclusion: Our results indicated that age and comorbidities were strongly associated with hospital mortality among ECMO patients. These findings can assist ECMO specialists to improve evaluations of mortality risk, especially among elderly patients with specific comorbidities.
Keywords	comorbidity ; extracorporeal membrane oxygenation ; hospital mortality ; survival rate ; Medicine ; R ; Medical emergencies. Critical care. Intensive care. First aid ; RC86-88.9
Subject code	610
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Wolters Kluwer Medknow Publications
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Preoperative Use and Discontinuation of Traditional Chinese Herbal Medicine and Dietary Supplements in Taiwan

Te-Chun Yeh / Shung-Tai Ho / Che-Hao Hsu / Ju-O Wang / Senyeong Kao / Yi-Chang Su / Sunny Jui-Shan Lin / Huei-Han Liou / Tso-Chou Lin

Healthcare, Vol 11, Iss 1605, p

A Cross-Sectional Questionnaire Survey

2023 Volume 1605

Abstract: Traditional Chinese herbal medicine has widespread use in Taiwan. This cross-sectional questionnaire survey investigates the preoperative use and discontinuation of Chinese herbal medicine and dietary supplements among Taiwanese patients. We obtained the ...

Abstract	Traditional Chinese herbal medicine has widespread use in Taiwan. This cross-sectional questionnaire survey investigates the preoperative use and discontinuation of Chinese herbal medicine and dietary supplements among Taiwanese patients. We obtained the types, frequency, and sources of Chinese herbal remedies and supplements used. Among 1428 presurgical patients, 727 (50.9%) and 977 (68.4%) reported the use of traditional Chinese herbal medicine and supplements in the past one month, respectively. Only 17.5% of the 727 patients stated discontinuation of herbal remedies 4.7 ± 5.1 (1–24) days before the surgery, and 36.2% took traditional Chinese herbal medicine with concomitant physician-prescribed Western medicine for their underlying diseases. The most commonly used Chinese herbs are goji berry ( Lycium barbarum ) (62.9%) and Si-Shen-Tang (48.1%) in single and compound forms, respectively. The presurgical use of traditional Chinese herbal medicine was common in patients undergoing gynecologic (68.6%) surgery or diagnosed with asthma (60.8%). Women and those with a high household income had a greater tendency to use herbal remedies. This study demonstrates the high proportion of the presurgical use of Chinese herbal remedies and supplements along with physician-prescribed Western medicine in Taiwan. Surgeons and anesthesiologists should be aware of the potential adverse effects of drug–herb interaction for Chinese patients.
Keywords	traditional Chinese herbal medicine ; dietary supplements ; preoperative ; discontinuation ; Medicine ; R
Language	English
Publishing date	2023-05-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: A Worldwide Bibliometric Analysis of Publications on Coronavirus in the Past 3 Decades

Te-Chun Yeh / Yu-Ching Lee / Ling-Fang Wei / Senyeong Kao / Chia-Jen Liu / Ju-O Wang

Iranian Journal of Public Health, Vol 50, Iss

A Bibliometric Article

2021 Volume 12

Abstract: Background: Coronaviruses caused three pandemics and impact public health globally in the 21st century. However, limited data were for the evaluation of the trend of coronavirus researches. We aimed to analyze quantitatively, qualitatively, and visually ... ...

Abstract	Background: Coronaviruses caused three pandemics and impact public health globally in the 21st century. However, limited data were for the evaluation of the trend of coronavirus researches. We aimed to analyze quantitatively, qualitatively, and visually evaluate global scientific publications on coronavirus by using bibliometric analysis. Methods: Coronavirus-related research from 1990-2019 was retrieved from the Web of Science Core Collection database (WoS). Microsoft Excel and VOS viewer software were used to assess the characteristics of publications. Results: Overall, 9,553 publications on coronavirus were retrieved on 12 Mar 2020. The United States took a leading position in coronavirus-related research and accounted for more than one-thirds (36.7%) of all publications. The most productive journal in this field was Journal of Virology (1,056, 11.1%), and the most productive institution was University of Hong Kong (394, 4.1%). The main hot topics in coronavirus field were virus infection and protein. Active collaborations between countries were observed. Conclusion: Over the past three decades, coronavirus research has gradually increased due to two global outbreaks. Through this global bibliometric evaluation, some relevant evidence could be provided. Corresponding to the impact of novel coronavirus (COVID-19), a large number of articles can be expected to appear in the next few years, and international cooperation should be strengthened to solve the problem.
Keywords	Bibliometric analysis ; Coronavirus ; COVID-19 ; MERS-CoV ; Public aspects of medicine ; RA1-1270
Subject code	001
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Tehran University of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Discrepant End-Tidal Concentrations of Sevoflurane at the Same A-Line Autoregressive Index Level during Induction of General Anesthesia

Che-Hao Hsu / Shung-Tai Ho / Chih-Cherng Lu / Ju-O Wang / Te-Chun Yeh / Tso-Chou Lin

Journal of Clinical Medicine, Vol 10, Iss 4526, p

An Observational Study

2021 Volume 4526

Abstract: Background: The A-Line Autoregressive Index (AAI), which is derived from auditory evoked potentials, has been used for determining anesthetic depth. This study verified the correlation between AAI values and the corresponding end-tidal concentrations of ... ...

Abstract	Background: The A-Line Autoregressive Index (AAI), which is derived from auditory evoked potentials, has been used for determining anesthetic depth. This study verified the correlation between AAI values and the corresponding end-tidal concentrations of sevoflurane during general anesthesia induction. Methods: Thirty young male adults undergoing elective minor orthopedic surgery were sequentially allocated to receive inspiratory 3%, 5%, or 6% sevoflurane for mask induction, followed by mechanical ventilation after tracheal intubation. The inspiratory, end-tidal and estimated jugular bulb concentrations of sevoflurane were recorded at three target AAI values: below 20, below 10, and at the start of burst suppression. Results: The mean time to loss of consciousness in the 6% sevoflurane group was shorter than that in the 5% and 3% groups; however, the groups had comparable AAI values (range: 16–45). The 6% group had a higher end-tidal concentration (4.5% ± 0.2% vs. 3.8% ± 0.2%, p < 0.05) than did the 5% group, despite having the same target anesthetic levels by AAI score ≤10, whereas the estimated jugular bulb concentrations were comparable (1.9% vs. 1.9%) in both groups. Conclusions: Following mechanical ventilation with inspiratory 3%, 5%, or 6% sevoflurane, the end-tidal concentrations were discrepant at the same end points of AAI levels, despite similar estimated jugular bulb concentrations of sevoflurane. Thus, conventional alveolar concentration may overestimate anesthesia depth during rapid wash-in of sevoflurane.
Keywords	A-line Autoregressive Index (AAI) ; end-tidal concentration ; general anesthesia ; induction ; sevoflurane ; Medicine ; R
Subject code	333
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical risk factors of extracorporeal membrane oxygenation support in older adults.

Te-Chun Yeh / Hsiao-Huang Chang / Luo-Ping Ger / Ju-O Wang / Senyeong Kao / Shung-Tai Ho

PLoS ONE, Vol 13, Iss 4, p e

2018 Volume 0195445

Abstract: The ageing population and the expected increase in the number of elderly patients make an evidence-based assessment of Extracorporeal Membrane Oxygenation (ECMO) therapy in old patients progressively more important. Veno-arterial (VA) ECMO results for ... ...

Abstract	The ageing population and the expected increase in the number of elderly patients make an evidence-based assessment of Extracorporeal Membrane Oxygenation (ECMO) therapy in old patients progressively more important. Veno-arterial (VA) ECMO results for patient aged <65 years is well known. However, the risk profile and in-hospital prognosis of advanced age patients with ECMO still need more investigation. The aim of this study was to identify risk factors that predicted the outcomes for elderly patients who received VA-ECMO.In this retrospective study, medical records for patients with ECMO aged 65 years and over were collected between 2009 and 2012 at a tertiary hospital.A total of 99 patients (mean age: 76.4±6.4 years) were included. The most common condition requiring VA-ECMO support was cardiogenic shock. Among survivors on VA-ECMO, 28 (28.3%) patients were successfully weaned from support. Thirteen (13.1%) patients were successfully discharged. We found that cardiogenic shock (OR = 3.158, P = 0.013), acute physiology and chronic health evaluation II (APACHE II) score (OR = 1.147, P<0.001), and simplified acute physiology score II (SAPS II) score (OR = 1.054, P = 0.001) were risk factors associated with survival on VA-ECMO. By using the areas under the receiver operating characteristic (AUC) curve, the APACHE II score and SAPS II score displayed acceptable discriminative power (AUC 0.722; 0.715, respectively).Our findings indicate that the risk of mortality increases with cardiogenic shock, higher APACHE II score, and higher SAPS II score. These risk factors can be utilized as potential predictors to identify the potential candidates for ECMO support.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2018-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Long-term use of opioids in 210 officially registered patients with chronic noncancer pain in Taiwan

Tso-Chou Lin / Luo-Ping Ger / Joseph V. Pergolizzi, Jr. / Robert B. Raffa / Ju-O Wang / Shung-Tai Ho

Journal of the Formosan Medical Association, Vol 116, Iss 4, Pp 257-

A cross-sectional study

2017 Volume 265

Abstract: Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. Methods: An observational ... ...

Abstract	Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. Methods: An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine. Results: For 210 of 328 outpatients (64.0%), the median pain duration was 96 months and opioid treatment duration was 57 months. The median morphine equivalent dose was 150 mg/d, with 30.5% of patients exceeding the daily watchful dose, defined as 200 mg of morphine equivalent dose. Pain reduction after taking opioids was ∼50% in the past week. The top three diagnoses were chronic pancreatitis, spinal cord injury, and neuralgia. The leading side effects were constipation (46.7%), and decreased sexual desire (69.5%) and satisfaction (57.9%). Depression was currently diagnosed in 55.2% of patients. Twenty patients (9.5%) displayed at least one aberrant behavior in the past month. Only 76 (36.2%) patients had ever received nerve block procedures, and 118 (56.2%) tried complementary and alternative medicine. Conclusion: This nationwide survey described the concurrent pain intensity, daily function, and various adverse effects by long-term opioids among 210 monitored outpatients with chronic noncancer pain in Taiwan. More efforts are suggested to reduce opioid prescriptions in the 30% of patients exceeding daily watchful dose.
Keywords	chronic pain ; noncancer ; opioid ; Medicine (General) ; R5-920
Subject code	616 ; 610
Language	English
Publishing date	2017-04-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Factors associated with Taiwan anesthesiologists' intention to leave anesthesia practice

Ju-O Wang / Chung-Yi Li / Senyeong Kao / Te-Chun Yeh / James F. Arens / Shung-Tai Ho

Journal of the Formosan Medical Association, Vol 114, Iss 6, Pp 509-

2015 Volume 516

Abstract: Anesthesiologists in Taiwan had the heaviest workload compared with other Taiwanese specialists. In a previous study, anesthesia-related mortality was >12 times the rate reported in the USA, UK, and Japan. Nine percent of Taiwanese anesthesiologists left ...

Abstract	Anesthesiologists in Taiwan had the heaviest workload compared with other Taiwanese specialists. In a previous study, anesthesia-related mortality was >12 times the rate reported in the USA, UK, and Japan. Nine percent of Taiwanese anesthesiologists left their jobs to work as general practitioners in clinics. This study aims to assess the current working conditions of anesthesiologists in Taiwan and their satisfaction with their occupation, and to identify the factors associated with the intentions of anesthesiologists in Taiwan to leave anesthesia practice. Methods: A self-reported questionnaire was completed by 474 attending anesthesiologists in Taiwan. The Chi-square test was used for categorical variables and the t test for continuous variables. Multivariate logistic regression was conducted to identify the factors significantly associated with the willingness of anesthesiologists to continue in anesthesiology. Results: The sample anesthesiologists worked 59.9 hours/week, however a reasonable length of time to work is 49.6 hours/week. They simultaneously covered four operating rooms daily, but three rooms is considered reasonable. Surprisingly, 54.9% of them expressed their unwillingness to practice clinical anesthesia. Those anesthesiologists dissatisfied with their overall working conditions had a substantially increased odds ratio (6.96) of deterring continuing to practice in anesthesia. Furthermore, an inability to take care of the family and a low salary significantly decreased the willingness to practice in anesthesia (odds ratio: 0.42 and 0.38, respectively). Conclusion: Unfavorable working conditions were considered to lower the satisfaction of anesthesiologists in Taiwan. In particular, an inability to take care of the family and a low salary were major factors in deterring anesthesiologists in Taiwan from continuing in anesthesia.
Keywords	anesthesiologists ; anesthetics ; satisfaction and work factor ; workload ; Medicine (General) ; R5-920
Subject code	150
Language	English
Publishing date	2015-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Trends and characteristics of pethidine use in Taiwan

Hsueh-Hsing Pan / Chung-Yi Li / Tso-Chou Lin / Ju-O Wang / Shung-Tai Ho / Kwua-Yun Wang

Clinics, Vol 67, Iss 7, Pp 749-

a six-year-long survey

2012 Volume 755

Abstract: OBJECTIVES: To investigate the trends and characteristics of pethidine prescriptions and users in Taiwan from 2002 to 2007. METHOD: All pethidine users (n = 3,301,136) in Taiwan from 2002 to 2007 were linked to National Health Insurance claims to ... ...

Abstract	OBJECTIVES: To investigate the trends and characteristics of pethidine prescriptions and users in Taiwan from 2002 to 2007. METHOD: All pethidine users (n = 3,301,136) in Taiwan from 2002 to 2007 were linked to National Health Insurance claims to identify pethidine prescriptions. We examined the trends in pethidine user prevalence and the proportion of pethidine prescriptions according to health care characteristics. A logistic regression model was used to compare patient demographics and health care characteristics associated with pethidine prescriptions between 2002 and 2007. RESULTS: Despite the decline in the number of pethidine users and prescriptions over the six-year period, more than half a million people were prescribed pethidine annually. In fact, an increasing proportion of pethidine prescriptions were observed in clinics, outpatient settings, and patients who had both operations and cancer diagnoses. Pethidine prescriptions were mostly associated with a non-operation status without a cancer diagnosis (>60%). However, approximately 10% of the total pethidine prescriptions were found in patients with a cancer diagnosis but no operation. Compared to those in 2002, pethidine prescriptions in 2007 were more likely to be found in people 80 years or older, rural residents, patients from clinics, outpatient settings and operation patients with cancer diagnoses. CONCLUSIONS: A population-based survey in Taiwan demonstrated decreasing consumption of pethidine from 2002 to 2007; however, an increased proportion of prescriptions in certain health care settings was observed. In addition, 10% of the pethidine prescriptions were for cancer patients without operations. These cases need further evaluation for the determination of appropriate pethidine use.
Keywords	Pethidine ; Prescription ; Consumption ; Defined Daily Dose ; Population-Based ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2012-07-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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