Background: Few studies used nationwide data to assess the age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of thromboangiitis obliterans (TAO; Buerger's disease).Methods: Data for 24,392 patients who had newly diagnoses related to TAO (I73.1) from 2006 through 2017 were extracted from the National Health Insurance Service in Korea. The age-standardized prevalence rate, incidence rate, 10-year survival rate, and death risk of TAO were analyzed. Results: The mean (standard deviation) age of TAO patients overall was 62.0 (15.7) years; 61.3 (15.4) in males and 63.2 (16.1) in females (P<0.001). The proportion of patients older than 50 years old was about 80% overall. The proportion patients who died of TAO was 28.1%. Overall, the age-standardized prevalence rate of TAO decreased from 11.1 persons per 100,000 persons in 2006 to 8.43 persons in 2017, and overall, the incidence rate of TAO decreased from 6.07 persons in 2006 to 3.38 persons in 2017. Theage-standardized prevalence rate and incidence rate in males were higher than that in females. The 10-year survival rate of TAO was about 65% (60.7% in males and 72.5% in females). The adjusted hazard ratio increased significantly with older age, male sex, hypertension, diabetes mellitus, myocardial infarction, heart failure, ischemic stroke, hemorrhagic stroke, chronic kidney disease, and malignant neoplasm. Conclusions:The 10-year survival rate of TAO was about 65%. Even though the age-standardized prevalence rate and incidence rate of TAO is decreased during the study period, the adjusted hazard ratio showed significantly increases with age and with male sex after adjustment for comorbidities.
Background Most patients with low back pain prefer to ignore symptoms and avoid medical management because of incorrect perceptions about this condition. However, over 90% of patients with chronic low back pain are hardly unable to perform daily activities, with 50% reporting that their daily activities have been severely impeded. Purpose In this study, an individualized educational program was developed and implemented in a sample of Korean patients with chronic low back pain, and the effectiveness of this program was evaluated. Methods This study was conducted as a randomized controlled trial with outpatients (n = 43) in an orthopedic clinic. The Analysis, Design, Development, Implementation, and Evaluation model was applied to develop the educational program. The experimental group was provided with an educational booklet and contacted via biweekly personalized telephone and face-to-face counseling sessions. The control group was provided the educational booklet only. SAS Version 9.4 was used to analyze collected data using the χ2 test, t test, Fisher’s exact test, Wilcoxon test, linear regression analysis, and Spearman partial correlation analysis. Results After 8 weeks, the experimental group demonstrated a significantly greater reduction in maximum, average, and current low back pain experienced within the immediately preceding 24 hours than the control group (p = .001, p = .002, and p = .014, respectively). In addition, daily living disability showed a greater reduction, and average back muscle strength showed a more significant improvement in the experimental group than in the control group (p = .001 and p = .035). The difference in medication adherence between the groups was not statistically significant (p = .089). The experimental group rated an average of 4.3 out of 5.0 points on the program satisfaction scale, indicating an 86% rate of satisfaction. Conclusions/Implications for Practice In this study, the individualized educational program was shown to be effective in helping alleviate symptoms in patients with chronic low back pain, decrease daily living disability, and improve average back muscle strength. It was further demonstrated that following up with expert medical staffs can motivate patients to incorporate the recommendations of the program into their daily routine, leading to higher patient satisfaction.
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