We analyzed the effects of age and sex on the relationship between muscle mass and serum creatinine levels in an apparently healthy population, including older adults. We retrospectively evaluated 1,502 individuals from the Korea National Health and Nutrition Examination Survey (KNHANES) and 4,586 individuals from the Health Check (HC) groups. We utilized data from the KNHANES and HC groups on serum creatinine levels and skeletal muscle mass index (SMI), determined using dual X-ray absorptiometry or bioelectric impedance analysis. A significant negative correlation between SMI and age was observed in both the KNHANES and HC groups in males but not in females. In males, serum creatinine levels showed a significant negative correlation with age in both the KNHANES (r = −0.522, P < 0.0001) and HC groups (r = −0.451, P < 0.0001). In females, there was no significant correlation between serum creatinine levels and age in the KNHANES (r = −0.016, P = 0.5985) and HC group (r = −0.011, P = 0.5618). Serum creatinine levels decrease more significantly in older males than in older females due to sex-specific muscle mass decline.

Background: Although the roles and responsibilities of hospitalists have grown considerably in recent years, research on the current job status and satisfaction levels of Korean hospitalists is lacking. Objective: We investigate the present state of Korean hospitalists and the factors influencing their job satisfaction 6 years after the pilot program’s launch. Design: This cross-sectional analysis was based on an online survey conducted from January 30 to February 18, 2023. Participants: Korean hospitalists (N = 303) Main Measures: The survey encompassed participant demographics, hospital information, education, clinical practice, research involvement, and job satisfaction. We employed multiple logistic regression analyses to identify determinants of satisfaction as a hospitalist. Key Results: The analysis was based on 79 hospitalists’ responses (response rate 26%). Respondents had a median age of 39 years; approximately half were male internal medicine specialists, possessing over 3 years of hospitalist experience. Most respondents were interested in clinical work (94.4%), with only 21.5% interested in research and evidence-based medicine. Over two-thirds indicated that non-clinical duties occupied less than 20% of their time. Overall, job satisfaction among hospitalists averaged 51.9%. Notably, the availability of a research mentor was significantly associated with job satisfaction (P = .011). While hospitalists with more than 3 years of experience, more hospitalists per facility, and autonomy were associated with increased job satisfaction, these associations were not statistically significant. Furthermore, there was no association between night shift work, work type, or work hours and job satisfaction. Conclusions: Although Korean hospitalists primarily focus on clinical practice, our study underscores the positive impact of mentorship from research mentors on job satisfaction, supported by comprehensive univariate and multivariate analyses. These findings signal a progressive transformation in the role of Korean hospitalists, as they increasingly engage in research alongside patient care. Graphical

Sleep and circadian disturbance are common in hospitalized patients. Problems related to sleep induction, frequent awakening, poor sleep quality, and disturbed circadian rhythm including daytime somnolence and nighttime arousal are frequently observed in the hospital. Disturbance of sleep and circadian rhythm could interfere recovery of the patients, prolong the length of stay, and contribute to patient dissatisfaction. Various factors affect sleep and circadian rhythm disturbance in the hospital. Intrinsic factors are related to patients, including medical and psychiatric conditions, uncontrolled pain, prescribed medications, and physical inactivity. External factors related to the hospital environment such as noisy environment, excessive exposure to artificial light, inappropriate humidity, and temperature are also known interrupters for sleep. Medical care provided by professionals, including nighttime vital sign monitoring, phlebotomy, and medication administration, can also contribute to sleep and circadian rhythm disturbances. This review aims to systematically address sleep and circadian rhythm disturbances in hospitalized patients, discuss factors that affect sleep in the hospital, and suggest non-pharmacological and pharmacological treatment options.

This study aimed to investigate the clinical implications and prognostic value of artificial intelligence (AI)-based results for chest radiographs (CXR) in coronavirus disease 2019 (COVID-19) patients. Patients who were admitted due to COVID-19 from September 2021 to March 2022 were retrospectively included. A commercial AI-based software was used to assess CXR data for consolidation and pleural effusion scores. Clinical data, including laboratory results, were analyzed for possible prognostic factors. Total O₂ supply period, the last SpO₂ result, and deterioration were evaluated as prognostic indicators of treatment outcome. Generalized linear mixed model and regression tests were used to examine the prognostic value of CXR results. Among a total of 228 patients (mean 59.9 ± 18.8 years old), consolidation scores had a significant association with erythrocyte sedimentation rate and C-reactive protein changes, and initial consolidation scores were associated with the last SpO₂ result (estimate −0.018, p = 0.024). All consolidation scores during admission showed significant association with the total O₂ supply period and the last SpO₂ result. Early changing degree of consolidation score showed an association with deterioration (odds ratio 1.017, 95% confidence interval 1.005–1.03). In conclusion, AI-based CXR results for consolidation have potential prognostic value for predicting treatment outcomes in COVID-19 patients.

The prediction of corticosteroid responses in coronavirus disease 2019 (COVID-19) patients is crucial in clinical practice, and exploring the role of artificial intelligence (AI)-assisted analysis of chest radiographs (CXR) is warranted. This retrospective case–control study involving mild-to-moderate COVID-19 patients treated with corticosteroids was conducted from 4 September 2021, to 30 August 2022. The primary endpoint of the study was corticosteroid responsiveness, defined as the advancement of two or more of the eight-categories-ordinal scale. Serial abnormality scores for consolidation and pleural effusion on CXR were obtained using a commercial AI-based software based on days from the onset of symptoms. Amongst the 258 participants included in the analysis, 147 (57%) were male. Multivariable logistic regression analysis revealed that high pleural effusion score at 6–9 days from onset of symptoms (adjusted odds ratio of (aOR): 1.022, 95% confidence interval (CI): 1.003–1.042, p = 0.020) and consolidation scores up to 9 days from onset of symptoms (0–2 days: aOR: 1.025, 95% CI: 1.006–1.045, p = 0.010; 3–5 days: aOR: 1.03 95% CI: 1.011–1.051, p = 0.002; 6–9 days: aOR; 1.052, 95% CI: 1.015–1.089, p = 0.005) were associated with an unfavorable corticosteroid response. AI-generated scores could help intervene in the use of corticosteroids in COVID-19 patients who would not benefit from them.

Background: Burnout among healthcare professionals is a critical factor which affects patient safety, treatment outcomes, and the quality of care. This is especially important for hospitalists who manage inpatient care, yet no studies have been conducted on this issue in Korea. This study aimed to investigate burnout and psychiatric symptoms among hospitalists in Korea, as well as to identify the risk and protective factors associated with these issues. Materials and methods: A cross-sectional online survey was conducted targeting all hospitalists in Korea (n=303), and 24.1% (n=79) completed the survey. The Maslach Burnout Inventory–Human Services Survey was used to measure burnout; the Depression, Anxiety, and Stress Scales was used to assess psychiatric symptoms; and the Insomnia Severity Index was used to evaluate sleep disturbances. Risk and protective factors against burnout were assessed using a 5-point Likert scale. Results: More than half of the respondents reported high graded burnout for two domains: depersonalization (50.6%) and reduced personal accomplishment (57%). Conflicts with caregivers, excessive workload, and long working hours were common risk factors for both burnout domains. The satisfaction with nonclinical work was identified as protective factor in depersonalization, and the availability of a research mentor and cap on daily inpatient load per hospitalist were protective factors in reduced personal accomplishment. In the correlation analysis, the maximum number of inpatients and hospitalists per hospital was a significant factor in reducing burnout. Conclusions: This study revealed a high graded burnout rate of more than 50% in depersonalization and reduced personal accomplishments domain among Korean hospitalists, and found the risk and protective factors against burnout. The development of targeted interventions to mitigate burnout based on this study could enhance the mental well-being of healthcare professionals and improve the overall quality of medical care.