Hospital Information Management Research Articles

An Efficient Healthcare Data Mining Approach Using Apriori Algorithm: A Case Study of Eye Disorders in Young Adults

In the public health sector and the field of medicine, the popularity of data mining and its usage in knowledge discovery and databases (KDD) are rising. The growing popularity of data mining has discovered innovative healthcare links to support decision making. For this reason, there is a great possibility to better diagnose patient’s diseases and maintain the quality of healthcare services in hospitals. So, there is an urgent need to make disease diagnosis possible by discovering the hidden patterns from the patients’ history information in developing countries. This work is a step towards how to use the extracted knowledge to enhance the quality of healthcare facilities. In this paper, we have proposed a web-centered hospital information management system (HIMS) that identifies frequent patterns from the data with eye disorder patients using the association rule-based Apriori data mining technique. The proposed framework has the capability to overcome all the key issues and problems in the current hospital information management system regarding data analysis and reporting services. For this purpose, data were collected from more than 1000 university students (China citizens) both online and manually (printed questionnaire). After applying the Apriori algorithm on the collected data, we revealed that almost 140 individuals out of 1035 had myopia (near-sighted disorder), at current age of 22 years, and that there were no male patients found with myopia. We concluded that their clinical relevance and utility can generate favorable results from prospective clinical studies by mapping out the habits or lifestyles that potentially lead to fatal diseases. In the future, we plan to extend this work to fully automate HIMS to help practitioners to diagnose the reasons of various diseases by extracting patient lifestyle patterns.

C4.5 Algorithm Optimization and Support Vector Machine by Applying Particle Swarm Optimization for Chronic Kidney Disease Diagnosis

Kidneys are one of the organs of the body that have a very important function in life. The main function of the kidneys is to excrete metabolic waste products. Chronic kidney disease is a result of the gradual loss of kidney function. Chronic kidney disease occurs when the kidneys are unable to maintain an internal environment consistent with life and the restoration of useless functions. Data mining is one of the fastest growing technologies in biomedical science and research. In the field of medicine, data mining can improve hospital information management and telemedicine development. In the first stage of data mining process, data processing is done with pre-processing by handling missing values ​​and data transformation. Then, the feature selection stage is carried out using the Particle Swarm Optimization algorithm to find the best attributes. Next, it is done by classifying the dataset. The algorithm used for classification is the C4.5 Algorithm and the Support Vector Machine. Both classifications are known as algorithms that have a fairly good level of accuracy. This study uses the chronic kidney disease dataset from the UCI Machine Learning Repository. The purpose of this study was to determine the level of accuracy of the comparison between the C4.5 Algorithm and the Support Vector Machine after applying the Particle Swarm Optimization algorithm. This research increases the accuracy by 100% for the C4.5 Algorithm and 98.75% for the Support Vector Machine by using 24 attributes and 1 class attribute.

Evaluation of the relation between HBA1C and MPV, PDW levels of patients with Type 2 diabetes admitted in internal medicine polyclinics.

Diabetes is a chronic, broad-spectrum metabolic disorder that requires continuous medical care, in which the organism cannot adequately benefit from carbohydrates, fats, and proteins due to insulin deficiency or defects in the effect of insulin. Vascular complications are considered to be the main cause of mortality in diabetic patients. Platelet activation plays a role in the development of vascular complications. The aim of this study was to evaluate the relationship between HbA1c, which is the parameters that we can evaluate in primary healthcare institutions, and increased Mean Platelet Volume (MPV) and Platelet Distribution Width (PDW) levels, which are thought to be a platelet activation markers in patients with Type 2 diabetes mellitus. In our study, the data for 600 patients who applied to Internal Medicine outpatient clinic of our hospital between January 01, 2022, and June 31, 2022, were obtained by examining their epicrisis through the hospital information management system. Six hundred patients, including 300 control group with HbA1c level below 6.5 and 100 patients each 7-8.5 8.5-10 and above 10, were included in the study. HbA1c, MPV, and PDW levels of the patients were recorded. Among 600 patients who applied to internal medicine polyclinics of our hospital between January 01, 2022, and June 31, 2022, 412 participants were female, while 188 participants were male. It was determined that the participants were 46.91±12.68 years old on average, the youngest participant was 18 years old and the oldest participant was 66 years old. It was determined that the mean HbA1c value of the participants participating in the study was 7.6±2.4, the lowest HbA1c value was 4.3, and the highest HbA1c value was 19.3. It was determined that the mean MPV value of the participants was 10.1±1.1, the lowest MPV value was 7.7, and the highest MPV value was 13.3. It was determined that the mean PDW value of the participants was 16.0±0.4, the lowest PDW value was 14.8, and the highest PDW value was 17.2. In this study, it was determined that MDV and PDW levels showed a statistically significant difference according to the HbA1c value ranges of the patient group. Accordingly, the MPV and PDW levels of the participants whose HbA1c value range is >10 are higher. It was observed that MPV and PDW levels increased as the HbA1c value range increased.

Pulmoner Emboli ile D-dimer Düzeyinin Korelasyonu ve Yaşa Göre Eşik Değerlerinin Belirlenmesi

Aim: This study was conducted to determine the D-dimer threshold levels according to age in patients diagnosed with pulmonary embolism (PE) by pulmonary computed tomography (CT) angiography. Material and Methods: Patients who had pulmonary CT angiography performed and whose D-dimer test was obtained with the suspicion of pulmonary embolism (PE) in the emergency department of a tertiary university hospital between January 01, 2015, and December 30, 2019, were included in the study. The demographic characteristics of the patients, imaging reports, and 1-month mortality were evaluated retrospectively by examining the hospital information management system and patient files. Patients with missing records and patients who had diagnostic examinations other than the preliminary diagnosis of PE were excluded from the study. Results: Among the 6240 patients included in the study, 58.1% were female. The mean age of the patients was 43±17 years. Of the 1,507 patients who had a pulmonary CT angiogram, 9.8% were diagnosed with PE. When we looked at the 1-month mortality of 6240 patients, whose D-dimer assay was analyzed with the preliminary diagnosis of PE, we found that 0.3% of patients died. The monthly mortality rate was 0.7% in patients with high D-dimer levels while the mortality rate in patients with normal D-dimer levels was 0.1%. A positive and statistically significant correlation was found between the location of the pulmonary embolism in pulmonary CT angiography and the D-dimer level (spearman’s rho= 0.251, p<0.001). The cut-off D-dimer value in predicting the presence of PE in all age groups was calculated as 1.34 mg/L. The cut-off values of D-dimer to predict the presence of PE according to age ranges was calculated as 1.18 mg/L (<50 years), 1.19 mg/L (50-60 years), 1.58 mg/L (60-70 years) 1.79 mg/L (70-80 years), 2.83 mg/L (>80 years) respectively. Conclusion: As age increases, the D-dimer cut-off value for the diagnosis of PE also increases. There is a positive and significant relationship between D-dimer level and pulmonary embolism severity.

Readmission to the Emergency Room and Clinical Characteristics of Patients with Covid-19: A Single-Center Trial

Objective: This study aims to determine the demographic and clinical characteristics of patients admitted to the emergency department of a training and research hospital within 72 hours of the diagnosis of COVID-19.Materials and Methods: The study was designed as descriptive and single-centered. The data of patients who presented to the emergency room with the diagnosis of COVID-19 were obtained retrospectively from the Hospital Information Management System.Results: 56.497 patients diagnosed with COVID-19 presented to our emergency room, and 0.4% returned to the emergency room with similar complaints within 72 hours. Among those who returned, 51.4% were female, and the mean age was 41.67. This study found that 30.8% of readmitted people had at least one comorbidity. It was found that 30.8% of the readmission had at least one comorbidity; nausea and cough were the most common reasons for admission in patients with comorbidities.Conclusion: There is a need to design further studies to establish the criteria for the safe return of COVID-19 patients to home, to reduce the re-admission rates, and increase the quality of care.

The risk of incident gastric cancer for populations with different precancerous gastric lesions: a prospective follow-up study

Objective: To provide evidence for optimizing the screening strategy for gastric cancer (GC), we evaluated the risk of incident GC for individuals with different precancerous gastric lesions in a prospective cohort study. Methods: Based on the National Upper Gastrointestinal Cancer Early Detection Program launched in Linqu, Shandong, a high-risk area of gastric cancer in China, we included a total of 14 087 subjects diagnosed with different gastric lesions stages by endoscopic screening from 2012 to 2018. Study subjects were prospectively followed up until December 31, 2019. The incidence of GC during the follow-up was ascertained by repeated endoscopic examinations, cancer, death registry reports, and active follow-up of study subjects and was confirmed by reviewing medical records extracted from the hospital information management system. The Poisson regression model was applied to calculate the relative risk (RR) and 95%CI for GC occurrence among subjects with different gastric lesions. Results: Among 14 087 subjects with different gastric lesions as determined by their first endoscopic examination in 2012-2018, 7 608 (54.00%) had a global diagnosis of superficial gastritis (SG), 2 848 (20.22%) had chronic atrophic gastritis (CAG), 3 103 (22.03%) had intestinal metaplasia (IM), and 520 (3.69%) had low-grade intestinal neoplasia (LGIN). During the follow-up, 109 subjects were diagnosed with GC, including 63 with high-grade intestinal neoplasia (HGIN) and 46 with invasive GC. Compared to subjects having normal gastric mucosa or SG, those with CAG (RR=3.85, 95%CI: 2.04-7.28), IM (RR=5.18, 95%CI: 2.79-9.60), and LGIN (RR=19.08, 95%CI: 9.97-36.53) had significantly increased risk of progression to GC. Individuals with these gastric lesions had an elevated risk of developing HGIN and invasive GC. For subjects with LGIN, the RR was 22.96 (95%CI: 9.71-54.27) for developing HGIN and 14.64 (95%CI: 5.37-39.93) for developing invasive GC. Subgroup analyses found that all age group subjects with LGIN diagnosed during the initial endoscopic examination had a significantly increased risk of developing the GC. Conclusions: Our large-scale prospective study on a high-risk area of GC showed that most residents aged 40-69 years had gastric lesions of different stages. Subjects with more advanced gastric lesions had a significantly increased risk of progression to GC.

Distribution of bacterial, viral and parasitic gastroenteritis agents in children under 18 years of age in Erzurum, Turkey, 2010-2020.

Diarrheal diseases have existed since antiquity, resulting in high morbidity and mortality rates, particularly among children in developing countries. To eradicate these diseases, it is crucial to identify the pathogens that cause them and immediately initiate appropriate treatment. This retrospective study aims to investigate the incidence of childhood gastroenteritis and the epidemiological features of its causative agents. During an 11-year period (2010-2020), as many as 51159 stool samples were obtained from children aged 0-17 years. These samples were examined for the presence of parasitic, bacterial, and/or viral gastroenteritis agents and evaluated retrospectively. The records obtained from the "ENLIL Hospital Information Management System Modules" were used to collect patient-related information. The most frequently observed pathogens were rotavirus (22.4%), adenovirus (2.2), Giardia lamblia (1.6%), and Campylobacter spp. (3.0%), considering the number of samples examined for each organism. The total incidence of viruses was about 25%, parasites 5% and the rate of pathogenic bacteria was 2%. In one-way ANOVA analysis, pathogen positivity was found to be significantly higher in children aged 3-5 years compared to those aged 15-17 and 0-2 [F (5, 51153, 17,588, p<0.001)]. The highest demand for the investigation of GE factors from stool samples was made in August, September and July. According to the number of samples examined, the highest pathogen positivity was in February, October, May, December and March, respectively. The most common pathogens involved in coinfections, occurring in 0.04% of the studied cases, were rotavirus and Giardia lamblia. Parasitic, viral, and bacterial gastroenteritis maintain their current status with a high prevalence in children under 18 years of age, especially in children aged 0-4 years in Erzurum, Turkey.

Analysis of Traditional Chinese Medicine Syndromes and Treatment Laws of Diabetic Kidney Disease and the Action Mechanism of High-Frequency Chinese Herbs in the Treatment of Diabetic Kidney Disease Based on Real-World Study

Abstract Objective Our objective was to analyze the traditional Chinese medicine (TCM) syndrome and treatment laws of diabetic kidney disease (DKD) and the action mechanism of high-frequency Chinese herbs in the treatment of DKD based on real-world study. Methods The data of patients with DKD who had been treated in the First Hospital Affiliated to Henan University of Chinese Medicine from January 1, 2014 to December 31, 2021 were retrospectively analyzed through the hospital information management system. The contents of the cases were statistically analyzed using IBM SPSS Statistics 25 software, and the laws of DKD treatment were summarized. Network pharmacology and molecular docking were used to analyze the action mechanism of high-frequency Chinese herbs in the treatment of DKD. Results The data of a total of 1,201 patients with DKD were included, involving 72 kinds of TCM syndromes. Nine disease nature elements and six disease location elements were extracted, involving 405 Chinese herbs. The top five high-frequency Chinese herbs were Baizhu (Atractylodis Macrocephalae Rhizoma), Fuling (Poria), Huangqi (Astragali Radix), Chuanxiong (Chuanxiong Rhizoma), and Danshen (Salviae Miltiorrhizae Radix et Rhizoma). Thirty kinds of Chinese herbs with the frequency of ≥100 were mainly deficiency-tonifying herbs and blood-activating and stasis-eliminating herbs. The medicinal properties were mainly warm and mild, and the medicinal flavors were sweet and bitter mostly. For the meridian tropism, the main meridian tropism of these herbs is spleen meridian and lung meridian. The clustering method aggregated the 30 commonly used Chinese herbs into six categories. A total of 58 effective active ingredients of high-frequency Chinese herbs and 164 related targets were screened based on the traditional Chinese medicine systems pharmacology database and analysis platform (TCMSP); 1,434 targets of DKD and 90 potential targets of high-frequency Chinese herbs for DKD were obtained. “Active ingredient-potential target” network topology analysis indicated that quercetin, luteolin, 7-O-methylisoxitol, hederagenin, and 4-methylene miltirone were the five core chemical components of high-frequency Chinese herbs in the treatment of DKD. Protein–protein interaction network topology analysis indicated that protein kinase B1, interleukin-6, tumor necrosis factor, vascular endothelial growth factor A, tumor protein P53 were the core protein targets. Twenty signaling pathways were obtained by Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Molecular docking showed that luteolin, 4-methylene miltirone, and osthole had strong binding to AKT1. Conclusion The differentiation and treatment of DKD with TCM follows the principles of “taking kidney as the root, considering both the liver and spleen, tonifying qi and nourishing yin, promoting blood circulation and resolving blood stasis.” High-frequency Chinese herbs for the treatment of DKD have multicomponent, multitarget, and multipath characteristics.

Association of COVID-19 Real-Time Reverse Transcription-Polymerase Chain Reaction (RT-PCR) Cycle Threshold Value With Surrogate Markers of Disease Severity.

Introduction The cycle threshold (Ct) value in real-time reverse transcription-polymerase chain reaction (RT-PCR) serves as a criterion to diagnose coronavirus disease 2019 (COVID-19) and is inversely proportional to viral load. Levels of inflammatory markers such as aspartate aminotransferase (AST), ferritin, D-dimer, high sensitivity C-reactive protein (hs-CRP), and lactate dehydrogenase (LDH) are used as quantitative measures of COVID-19 severity. We examined the association between these markers and Ct values. Methodology This retrospective data analysis included 400 patients with positive RT-PCR results for COVID-19 who were admitted to a tertiary care hospital. Clinical and biochemical data were accessed from the hospital information management system. Associations of clinical parameters and markers of disease severity (e.g., polymorph, AST, hs-CRP, D-dimer, LDH, and ferritin levels) with Ct values were assessed. Observations LDH, ferritin, D-dimer, and hs-CRP were found to be significantly higher in moderate and severe groups than in the mild COVID-19 group. AST, ferritin, and hs-CRP levels were also significantly higher in severe COVID-19 subjects, compared to moderate COVID-19 subjects.Ct values for the E (envelop) gene and ORF (open reading frame) 1b gene were found to be significantly higher in those with severe COVID-19. Polymorph counts in subjects with Ct values of 25 or higher were significantly increased, compared to those with Ct values under 30. LDH, D-dimer, and hs-CRP levels in subjects with Ct values over 30 were significantly lower than for those with Ct values under 30. Ferritin was the best independent predictor of non-survival in study subjects, with an area under the curve (AUC) of 85.5% (95% confidence interval = 73.2-95.9). The Ct value for the E gene had an AUC of 75.1%, and the ORF1b gene had an AUC of 64.5%. However, no significant correlation was detected between any parameter and Ct value. Conclusion Polymorph, LDH, ferritin, D-dimer, and hs-CRP levels were significantly elevated in subjects with low E gene Ct values. Also, these subjects were at risk of severe disease and fatality. Ct values for the E gene thus could serve as an early indicator for patients at risk of severe disease and death.

Neutrophil and platelet lymphocyte ratio in diabetes mellitus

Background: This study, it was aimed to investigate the relationship between Neutrophil Lymphocyte Ratio (NLR) and Platelet Lymphocyte Ratio (PLR) in Type II Diabetes Mellitus (Type II DM) patients. Methods: The data of the study were obtained from 108 patients, 61 women and 47 men, who were diagnosed with Type II DM, who applied to the Diabetes Polyclinics of Training and Research Hospital between 01.01.2020 and 30.06.2020 and a healthy control group without Type II DM. The data of the patients were obtained retrospectively via the Hospital Information Management System (HIMS). Results: The mean age of the Type II DM patient meeting the study criteria were 57.9 ± 12.69 years. The mean age of the control group was determined as 55.8 ± 8.81. There was no significant difference between the patient and control groups in terms of age and gender. The NLR of type II DM patients was 2.96 ± 1.15 and that of the control group was 1.91 ± 0.81. The PLR of type II DM patients was found as 179.29 ± 61.81 and the PLR of the control group was found as 121.21 ± 51.33. When NLR and PLR values of type II DM patients and the control group were compared found that it was statistically significant (p &lt; 0.05). Conclusion: Although more analysis is needed to prove that NLR and PLR are associated with type II DM disease, our study’s high NLR and PLR values in Type II DM patients should suggest that these parameters are essential in the diagnosis and follow-up. Also, NLR and PLR inflammatory diseases, acute coronary syndrome, rheumatoid arthritis, etc., is higher, suggesting that this is related to unsanitary conditions rather than a specific disease.

Results of an advanced nursing triage protocol in emergency departments.

The increasing number of patients admitted to emergency departments (EDs) and overcrowding of EDs lead to a global problem. Advanced nursing triage is an important solution in facilitating patient and time management, also increasing the efficiency of the ED. This study was conducted to predict the possible effects of applying advanced nursing triage modeling with predetermined protocols during the current nursing triage in the ED. This was a descriptive and cross-sectional study. An advanced "triage assessment protocol," which was developed previously, was hypothetically applied for 5 days by triage nurses in the adult ED of a university hospital. The hypothetical application was tested by triage nurses in all shifts. The nurses recorded the examination or treatment options which they thought to apply for the patient on the study form. The data recorded on the advanced triage evaluation protocol form by the triage nurses were compared with the patient outcomes and physician examination/treatment requests in the Hospital Information Management System by the researchers. In the study, it was determined that the rate of examination/treatment that could be requested according to the advanced nursing triage protocol was 46%. There were a good level of agreement on X-ray and a moderate level of agreement on urinary test and urinary beta- Human chorionic gonadotropin (hCG) test between physicians and triage nurses regarding examination/treatment requests. In addition, it was found that there was a 61.2% of agreement on decisions made for patients aged between 18 and 35. The rate of agreement between doctors and nurses regarding a gluco-stick request for patients admitted outside the prime time (92.2%) was found to be significantly higher (87.9%) than for patients admitted during prime time (P = 0.046). "Advanced triage" practices recommended for busy EDs were tested "hypothetically" at the national level due to the lack of legal regulations and were found to be compatible with the actual results of physicians' practices at an acceptable level, especially for selected medical conditions. The method used in this study can be useful in planning the transition to "advanced triage" practices. These results can show the readiness of nurses for the transition to this practice.

Evaluation of Applications For The Diagnosis, Treatment And Nursing Care of Patients Followed in the Children's Emergency Department with the Prediagnosis of Acute Abdomen

Giriş ve Amaç: Çalışmamızın amacı, çocuk acil servisinde akut karın ön tanısıyla izlenen hastaların tanı, tedavi ve hemşirelik bakımlarına yönelik uygulamaların araştırılması amaçlanmıştır.&#x0D; Gereç ve Yöntemler: Retrospektif tipteki araştırma, Manisa Celal Bayar Üniversitesi Hastanesi’nde gerçekleştirildi. Çalışmaya Çocuk Acil Servisi’nde akut karın ile ön tanısı ile izlenen, 18 yaş altındaki hastalar dahil edildi. Araştırma verileri hastaların tedavi süreçleri hakkında bilgileri hasta izlem dosyaları ve hastane bilgi yönetim sistemi üzerinden araştırmacılar tarafından hazırlanan Veri Toplama Formu ile toplanarak değerlendirildi.&#x0D; Bulgular: Çalışmamıza toplam 351 çocuk (Kız: 156/Erkek: 195) dahil edildi. Çocukların ortalama yaşı 8,53 ± 5,10 yıldı. Hastaların %32.2’si cerrahi tanı alırken, %18.2’si ile en çok yapılan cerrahi girişim apendektomi idi. Hastaların %25.9’una birden fazla kez vital takibi yapılırken ateş bulgusu olan çocukların vital takip sıklığı anlamlı derecede yüksek olduğu bulundu (p=0,001). Hastaların %70.4’üne intravenöz yol ile hidrasyon tedavisi uygulandığı, %92.6’sından ultrasonografi veya bilgisayarlı tomografi istendiği saptanmıştır. Radyolojik tetkik istenmesinin hastaların acil servisteki gözlem süreleri üzerindeki etkisi anlamlı bulunmamıştır (p=0,60) ve ultrasonografi istenilen hastaların cerrahi tanı alma oranları anlamlı derecede yüksek bulunmuştur (p=0,02).&#x0D; Sonuç: Acil gözlemde akut karın ağrısı nedeniyle izlenen hastalarda cerrahi dışı nedenler daha fazla gözlenmektedir. Cerrahi girişim gerektiren hastalarda ultrasonografi tanıyı desteklemektedir. Gözlem süresince hastaların semptomlarına yönelik farmakolojik olmayan yöntemler az tercih edilmektedir.

Changes in the Number of Newly Diagnosed Lung Cancer Patients Before and During the COVID-19 Pandemic: A Single-Center Experience.

OBJECTIVE:The coronavirus disease-2019 pandemic has affected the entire health system and patients other than coronavirus-infected patients. Hospital admissions of cancer patients decreased during the closure periods due to the pandemic. This study was conducted to determine whether there was an effect on the hospital admissions of newly diagnosed lung cancer patients in Turkey during the coronavirus disease-2019 pandemic.MATERIAL AND METHODS:In this retrospective study, newly diagnosed lung cancer patients were recorded from the Hospital Information Management System between January 1, 2017, and December 31, 2020, at our tertiary hospital. The number of newly diagnosed lung cancer patients diagnosed in 2020 was compared with each year from 2017 to 2019.Results:Between 2017 and 2020, 15 150 newly diagnosed lung cancer cases were analyzed. According to Global Cancer Observatory data, in 2018, 34 703 newly diagnosed lung cancer cases, and in 2020, 41 264 newly diagnosed lung cancer cases were observed in Turkey. Although a decrease was not observed in the number of patients according to Global Cancer Observatory data, both the total number of patients admitted to our hospital and the number of newly diagnosed lung cancer patients decreased in 2020. The number of newly diagnosed lung cancer patients by year was 4030 patients in 2017, 4004 patients in 2018, 4391 patients in 2019, and 2725 in 2020, respectively. In 2020, newly diagnosed lung cancer patients decreased by 38%, 32%, and 32% compared to 2019, 2018, and 2017, respectively. Also, a significant decrease was seen in the number of newly diagnosed lung cancer patients in the months with closure due to the pandemic compared to the months without closure.Conclusion:There was a significant decrease in hospital admissions of newly diagnosed lung cancer cases in the coronavirus disease-2019 pandemic in our referral hospital. Precautions should be considered to diagnose and treat lung cancer patients in specialized centers during a pandemic due to epidemic diseases such as coronavirus disease-2019.

P16.32: COVID-19 Clinical Outcomes, Coinfection and Secondary Infections in Solid Organ Transplant Recipients

Introduction: The COVID-19 pandemic is still affecting the World. According to the Centers for Disease Control and Prevention, solid organ transplant (SOT) recipients are among those at high risk of serious illness from SARS-CoV-2. Because of the virus’s novelty, there is still a lack of information on topics such as how it behaves in immunocompromised hosts, how it affects immunosuppression, how it affects rejection, and whether it increases the incidence of opportunistic infections. In this study, we aimed to evaluate the clinical course of SOT recipients with COVID-19 over a one year follow-up period and to evaluate co- infections or secondary infections. Method: Data from SOT patients diagnosed with COVID-19 has been retrieved retrospectively from the hospital information management system since March 2020. Demographic characteristics, examinations during hospitalization and admissions to outpatient clinics after illness were screened in detail. Results: There were 53 SOT patients recorded. The median age was 49, the median time post-transplant was 11 years, thirty-four (71.7 %) were men. The kidney was the most frequently transplanted organ (75.5 %). Severe/critical COVID-19 was diagnosed within 11 (20.8%) patients. The most common symptoms were fever (49.1%) and cough (39.6%). Thirty-nine (73.6 %) of the patients were hospitalized. Among those 14 (26.4%) required mechanical ventilation, 8 (15%) required renal replacement therapy, and five (9.4%) died 7 days after diagnosis, 10 (18.8%) patients died 30 days after diagnosis. Co-infections occurred in 15 patients; there were six urinary tract infections, four bacteremia, two Cytomegalovirus (CMV), and one both with CMV and a urinary tract infection. During the follow-up, CMV and Aspergillosis were both detected in three patients, only CMV in one, only Aspergillosis in one, a healthcare-associated infection in one, and pancreatitis in one. All patients who developed CMV and/or aspergillosis had been given high dose steroid during their COVID-19 treatment. Two (3.7%) patients had acute rejection during this period. Conclusion: The impact of immunosuppression on COVID-19 disease severity remains unclear. We believe that high-dose steroid therapy aids SOT patients who develop opportunistic infections such as CMV and aspergillosis. According to some studies, high-dose steroid therapy used to treat COVID-19 can cause opportunistic infections. In our study, we believe that the mortality rates were high due to our patients’ long post-transplantation period and, as a result, their chronic immunosuppression status. Wide-range studies are required to assess the long-term outcomes including allograft rejection, co-infections and secondary infections in SOT patients.

Maintenance of Network Security in Hospital Information Construction Based on the Internet of Things

With the continuous deepening of Chinese medical and health system reform, hospital informatization construction is advancing by leaps and bounds, especially in the context of “Internet of Things + Medical,” hospital informatization construction has made significant progress. However, computer network security management and maintenance work still face many contradictions and problems, and we need to pay attention to them. Based on the analysis of the current situation of computer network security management and maintenance in hospital information construction, this paper focuses on the problems of computer network security management and maintenance and proposes targeted optimization countermeasures. Based on the current problems faced by the medical industry in our country and the state’s support for the medical Internet of Things, this paper studies the application of the Internet of Things in hospital information management at home and abroad. This article uses hospital information network security maintenance evaluation methods and evaluation indicators to conduct an empirical analysis of the information security maintenance level of these 12 hospitals, from the risk assessment of hospital information network security, the establishment of strategies, the level of information security software and hardware equipment, and the information security personnel. Experiments show that 58.33% of the hospitals surveyed have only done part of the work on risk analysis and risk assessment of their own network information security, and 41.67% of the hospitals have not done this work at all. This shows that hospitals should incorporate computer network security management and maintenance into the information construction system, focusing on the outstanding problems and possible risks faced by the arm’s computer network security management and maintenance, and vigorously promote the reform and innovation of computer network security management and maintenance.

A Hospital Information Management System With Habit-Change Features and Medial Analytical Support for Decision Making

A hospital information management system (Doctive) with habit-change features and medial analytical support for decision making is developed in this study to reduce the risks of heart diseases. Doctive is targeted for hospital authorities to monitor patients’ habits and to prescribe medication and advice accordingly. Furthermore, this system provides emergency assistance for patients based on their current location. The proposed system would be beneficial for monitoring and organizing patients’ information to ease data entry, data management, data access, data retrieval and finally decision making. Doctive is tested and evaluated by 41 people who are either medical experts or professionals in the field of data analytics and visualization. The results indicate a high acceptance rate towards using Doctive system in hospitals and very good usability of the system. Doctive can be useful for healthcare providers and developers to track users’ habits for reducing the risk of heart disease. In the future.

PB2007: FACTORS ASSOCIATED WITH EARLY RELAPSE IN MYELOMA PATIENTS AFTER AUTOLOGOUS HEMATOPOIETIC STEM CELL TRANSPLANTATION

Background: Multiple myeloma (MM) is a clonal disease characterized by a neoplastic proliferation of plasma cells that make up approximately 10% of hematologic malignancies. Autologous hematopoietic stem cell transplantation (ASCT) after an induction regimen using combination of immunomodulatory drugs, proteasome inhibitors and dexamethasone is considered the standard treatment of newly diagnosed multiple myeloma in eligible patients. Aims: To demonstrate the pre-transplant factors associated with early relapse in MM patients undergoing ASCT. Methods: 27 adult MM patients who underwent ASCT at The Stem Cell Transplant Center of Dokuz Eylul University Hospital between October 2011 and August 2021 and who relapsed within 18 months of transplantation were included in this study. The data were compiled from the Dokuz Eylul Hematology archive and the Hospital Information Management System at Dokuz Eylul University Hospital and analyzed with SPSS v.24 (Statistical Package for Social Sciences). Mann-Whitney U test is used to compare kappa/lambda ratios, Kaplan Meier test is used to analyze survival and log-rank test is used to test significant difference between survival of two groups. Results: The median age at diagnosis is 57 (42-68) and 52% of patients were male (n=14). Patients received a median one line of treatment before ASCT (1-3). According to the ISS staging system, 9 patients were stage I, 9 patients were stage II and 9 patients were stage III. In 43% of patients (n=12), extramedullary (EM) disease involvement was present at the diagnosis. 33% had hypercalcemia (n=9), 19% had kidney involvement (n=5), 57% had anemia (n=16), and 75% had bone (n=21) at the time of diagnosis. Two patients achieved complete remission (CR) after 2 courses of induction therapy. But they lost this response pre-ASCT and they relapsed in 5th and 6th month after ASCT respectively. The median time to relapse post-ASCT was 6 (2-17) months. In 63% of these patients, clinical relapse was observed, treatment was started due to aggressive biochemical relapse in the rest. 25% (n=7) had EM disease involvement in relapse. In this patient group, the median survival after ASCT is 32 months (5-120). In 3 out of 10 patients with biochemical relapse, EM disease was not observed despite being present at the time of diagnosis. In 9 of the 17 patients with clinical relapse and EM disease at diagnosis, 7 patients relapsed with EM disease. Median Kappa/Lambda ratios at the time of diagnosis were 13.84 and 13.1 at the time of relapse. There was no statistically significant difference in kappa/lambda rates at the time of diagnosis and relapse of patients with biochemical and clinical relapse. Median progression-free survival (PFS) was 5 months in those with clinical relapse and 8 months in patients with biochemical relapse. Median overall survival (OS) was 19.2 months in those with clinical relapse and it was not reached in those with biochemical relapse (p=0.001) (Fig. 1). Image:Summary/Conclusion: It is known that in multiple myeloma, ASCT prolongs PFS. Early loss of response in patients who achieved CR after 2 courses of treatment may be a prognostic clue. OS and PFS are shorter in those with clinical relapses while biochemical relapses are more indolent. The fact that 43% of our patients have EM disease involvement in diagnosis indicates that this feature may be associated with early relapse. Outcomes of single and tandem ASCT in these patients should be examined in further studies.

Research on the Application Status and Development Trend of Hospital Information Management System

Research on the Application Status and Development Trend of Hospital Information Management System

SNIK Quiz: A Multiple Choice Game About Information Management in Hospitals.

SNIK is a knowledge base about the management of health information systems generated by extracting Linked Data from textbooks and other sources. SNIK describes functions, roles executing these functions, and entity types, the information used or updated by these functions. We present SNIK Quiz, a browser game in which students answer multiple-choice questions about information management in hospitals based on SNIK. The questions are semi-automatically generated using templates in order to train basic facts, more complex patterns, and connections between textbooks encoded in SNIK.

Exploration on Application of Computer Database System in Hospital Information Management

Exploration on Application of Computer Database System in Hospital Information Management