Objective To evaluate mortality from sepsis and septic shock in Korea during the past 10 years, we conducted a systematic review and meta-analysis.Methods We searched six databases for studies on mortality from sepsis and septic shock in adult patients. Primary outcomes were 28- or 30-day mortality and in-hospital mortality from sepsis and septic shock. To assess the risk of bias, we used the Newcastle-Ottawa Scale and Risk of Bias 2 tools. The protocol is registered in PROSPERO (No. CRD42022365739).Results A total of 61 studies were included. The mortality rates from sepsis and septic shock at 28 or 30 days were 22.7% (95% confidence interval [CI], 20.0%–25.6%; I2=89%) and 27.6% (95% CI, 22.3%–33.5%; I2=98%), respectively, according to the Sepsis-3 criteria. Furthermore, in accordance with the Sepsis-3 criteria, the in-hospital mortality rates were 28.1% (95% CI, 25.2%–31.1%; I2=87%) and 34.3% (95% CI, 27.2%–42.2%; I2=97%), respectively.Conclusion The mortality rates from sepsis and septic shock in Korea are high. In the case of septic shock, the in-hospital mortality rate is approximately 30%.

This study aimed to assess the impact of the pandemic on hospitalization and mortality rates among patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We conducted a systematic search across three medical databases for studies comparing the AECOPD mortality and hospitalization rates during the COVID-19 pandemic with those before the pandemic, up until December 2023. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Meta-analysis of Observational Studies in Epidemiology guidelines, we performed a meta-analysis with a random-effects model to pool odds ratios (ORs), 95% confidence intervals (CIs), and heterogeneity (I²). From 4689 records, 21 studies met our inclusion criteria. Our analysis revealed a significant increase in in-hospital mortality during the pandemic (pooled OR = 1.27, 95% CI = 1.17–1.39, I² = 50%). Subgroup analysis highlighted a more pronounced mortality risk in single-center studies and smaller populations. Conversely, hospitalization rates for AECOPD significantly declined during the pandemic (pooled OR = 0.39, 95% CI = 0.18–0.85, I² = 99%). The study demonstrates that during the COVID-19 pandemic, there was a substantial decrease in hospital admissions for AECOPD and an increase in in-hospital deaths. This shows that better healthcare plans and pandemic preparedness are needed to help people with chronic conditions.

Background: Cognitive impairment is a major comorbidity of chronic obstructive pulmonary disease (COPD), but the underlying mechanisms are not fully understood. In this study, we used resting-state functional magnetic resonance imaging to investigate brain functional connectivity (FC) abnormalities in patients with COPD and explored the correlation between abnormal FC and COPD-related clinical parameters. Methods: Forty-one patients with COPD, without a definite diagnosis of cognitive impairment or depression, and 30 age- and sex-matched controls were recruited. A total of 184 resting-state functional connectivity (RSFC) maps were generated for all seed points. Welch’s t-test was used to assess differences in RSFC between the COPD and control groups, and the correlation coefficients between RSFC and clinical parameters were calculated. Results: Patients with COPD had lower scores on the Mini-Mental State Exam (MMSE) and Korean version of the Montreal Cognitive Assessment and higher scores on the Beck Depression Inventory than the control group. Additionally, patients with COPD showed decreased RSFC in the left middle-posterior cingulate cortex, left posterior-dorsal cingulate cortex, and right superior occipital gyrus and increased RSFC in the left superior temporal sulcus, left posterior transverse collateral sulcus, right occipital pole, and right precentral gyrus. The regions showing differences in FC correlated with MMSE score, COPD symptom assessment scales, such as the COPD Assessment Test and modified Medical Research Council Dyspnea Scale, and pulmonary function parameters, including forced expiratory volume in one second and forced vital capacity. Conclusion: Patients with COPD showed significant differences in FC within specific brain regions that correlated with symptoms, cognition, and lung function.

Kim Y, et al. Allergy Asthma Immunol Res. 2021 Sep;13(5):808-816. https://doi.org/10.4168/aair.2021.13.5.808

This nationwide, population-based observational study investigated the association between the floor level of out-of-hospital cardiac arrest (OHCA) incidence and survival outcomes in South Korea, notable for its significant high-rise apartment living. Data were collected retrospectively from OHCA patients through the South Korean Out-of-Hospital Cardiac Arrest Surveillance database. The study incorporated cases that included the OHCA’s building floor information. The primary outcome assessed was survival to discharge, analyzed using multivariate logistic regression, and the secondary outcome was favorable neurological outcome. Among 36,977 patients, a total of 29,729 patients were included, and 1680 patients were survivors. A weak yet significant correlation between floor level and hospital arrival time was observed. Interestingly, elevated survival rates were noted among patients from higher floors despite extended emergency medical service response times. Multivariate analysis identified age, witnessed OHCA, shockable rhythm, and prehospital return of spontaneous circulation (ROSC) as primary determinants of survival to discharge. The floor level’s impact on survival was less substantial than anticipated, suggesting residential emergency response enhancements should prioritize witness interventions, shockable rhythm management, and prehospital ROSC rates. The study underscores the importance of bespoke emergency response strategies in high-rise buildings, particularly in urban areas, and the potential of digital technologies to optimize response times and survival outcomes.