Degree 【 display / non-display 】

Degree 【 display / non-display 】

• 札幌医科大学大学院   Surgical influence on Th1/Th2 balance and monocyte surface antigen expression and its relation to infectious complications

Professional Memberships 【 display / non-display 】

Professional Memberships 【 display / non-display 】

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  Japan Society for Surgical Infection

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  The Japan Society for Transplantation

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  The Japanese Society of Gastroenterological Surgery

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  The Japanese Society of Gastroenterology

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  日本臨床外科学会

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Research Areas 【 display / non-display 】

Research Areas 【 display / non-display 】

• Other   Other  

Affiliation 【 display / non-display 】

Affiliation 【 display / non-display 】

• Sapporo Medical University School ff Medicine   Department of Intensive Care Medicine   Associate Professor   Professor of University Hospital  

Papers 【 display / non-display 】

Papers 【 display / non-display 】

• Clinical impact of rehabilitation and <scp>ICU</scp> diary on critically ill patients: A systematic review and meta‐analysis

  Tomohiro Ishinuki, Ling Zhang, Keisuke Harada, Hiroomi Tatsumi, Nobuaki Kokubu, Yoshika Kuno, Kanon Kumasaka, Rina Koike, Toshio Ohyanagi, Hirofumi Ohnishi, Eichi Narimatsu, Yoshiki Masuda, Toru Mizuguchi

  Nursing in Critical Care ( Wiley )  28   554 - 565  2023.01  [Refereed]  [International journal]

  DOI

• Transitional Care Programs for Patients with High Nursing Activity Scores Reduce Unplanned Readmissions to Intensive Care Units.

  Junpei Haruna, Yoshiki Masuda, Hiroomi Tatsumi

  Medicina (Kaunas, Lithuania)   58 ( 11 )  2022.10  [Refereed]  [International journal]

  　View Summary

  Background and Objectives: The main objective of a transitional care program (TCP) is to detect patients with early deterioration following intensive care unit (ICU) discharge in order to reduce unplanned ICU readmissions. Consensus on the effectiveness of TCPs in preventing unscheduled ICU readmissions remains lacking. In this case study assessing the effectiveness of TCP, we focused on the association of unplanned ICU readmission with high nursing activities scores (NASs), which are considered a risk factor for ICU readmission. Materials and Methods: This retrospective observational study analyzed the data of patients admitted to a single-center ICU between January 2016 and December 2019, with an NAS of >53 points at ICU discharge. The following data were extracted: patient characteristics, ICU treatment, acute physiology and chronic health evaluation II (APACHE II) score at ICU admission, Charlson comorbidity index (CCI), 28-day mortality rate, and ICU readmission rate. The primary outcome was the association between unplanned ICU readmissions and the use of a TCP. The propensity score (PS) was calculated using the following variables: age, sex, APACHE II score, and CCI. Subsequently, logistic regression analysis was performed using the PS to evaluate the outcomes. Results: A total of 143 patients were included in this study, of which 87 (60.8%) participated in a TCP. Respiratory failure was the most common cause of unplanned ICU readmission. The unplanned ICU readmission rate was significantly lower in the TCP group. In the logistic regression model, TCP (odds ratio, 5.15; 95% confidence interval, 1.46-18.2; p = 0.01) was independently associated with unplanned ICU readmission. Conclusions: TCP intervention with a focus on patients with a high NAS (>53 points) may prevent unplanned ICU readmission.

  DOI PubMed

• Nursing Activities Score at Discharge from the Intensive Care Unit Is Associated with Unplanned Readmission to the Intensive Care Unit.

  Junpei Haruna, Yoshiki Masuda, Hiroomi Tatsumi, Tomoko Sonoda

  Journal of clinical medicine   11 ( 17 )  2022.09  [Refereed]  [International journal]

  　View Summary

  This study evaluated the accuracy of predicting unplanned the intensive care unit (ICU) readmission using the Nursing Activities Score (NAS) at ICU discharge based on nursing workloads, and compared it to the accuracy of the prediction made using the Stability and Workload Index for Transfer (SWIFT) score. Patients admitted to the ICU of Sapporo Medical University Hospital between April 2014 and December 2017 were included, and unplanned ICU readmissions were retrospectively evaluated using the SWIFT score and the NAS. Patient characteristics, such as age, sex, the Charlson Comorbidity Index, and sequential organ failure assessment score at ICU admission, were used as covariates, and logistic regression analysis was performed to calculate the odds ratios for the SWIFT score and NAS. Among 599 patients, 58 (9.7%) were unexpectedly readmitted to the ICU. The area under the receiver operating characteristic curve of NAS (0.78) was higher than that of the SWIFT score (0.68), and cutoff values were 21 for the SWIFT and 53 for the NAS. Multivariate analysis showed that the NAS was an independent predictor of unplanned ICU readmission. The NAS was superior to the SWIFT in predicting unplanned ICU readmission. NAS may be an adjunctive tool to predict unplanned ICU readmission.

  DOI PubMed

• Current standard values of health utility scores for evaluating cost-effectiveness in liver disease: A meta-analysis.

  Tomohiro Ishinuki, Shigenori Ota, Kohei Harada, Masaki Kawamoto, Makoto Meguro, Goro Kutomi, Hiroomi Tatsumi, Keisuke Harada, Koji Miyanishi, Toru Kato, Toshio Ohyanagi, Thomas T Hui, Toru Mizuguchi

  World journal of gastroenterology   28 ( 31 ) 4442 - 4455  2022.08  [Refereed]  [International journal]  [International coauthorship]

  　View Summary

  BACKGROUND: Health utility assessments have been developed for various conditions, including chronic liver disease. Health utility scores are required for socio-economic evaluations, which can aid the distribution of national budgets. However, the standard health utility assessment scores for specific health conditions are largely unknown. AIM: To summarize the health utility scores, including the EuroQOL 5-dimensions 5-levels (EQ-5D-5L), EuroQol-visual analogue scale, short from-36 (SF-36), RAND-36, and Health Utilities Index (HUI)-Mark2/Mark3 scores, for the normal population and chronic liver disease patients. METHODS: A systematic literature search of PubMed and MEDLINE, including the Cochrane Library, was performed. Meta-analysis was performed using the RevMan software. Multiple means and standard deviations were combined using the StatsToDo online web program. RESULTS: The EQ-5D-5L and SF-36 can be used for health utility evaluations during antiviral therapy for hepatitis C. HUI-Mark2/Mark3 indicated that the health utility scores of hepatitis B patients are roughly 30% better than those of hepatitis C patients. CONCLUSION: The EQ-5D-5L is the most popular questionnaire for health utility assessments. Health assessments that allow free registration would be useful for evaluating health utility in patients with liver disease.

  DOI PubMed

• Frequent tracheal suctioning is associated with extubation failure in patients with successful spontaneous breathing trial: a single-center retrospective cohort study.

  Junpei Haruna, Hiroomi Tatsumi, Satoshi Kazuma, Aki Sasaki, Yoshiki Masuda

  JA clinical reports   8 ( 1 ) 5 - 5  2022.01  [Refereed]  [International journal]

  　View Summary

  BACKGROUND: Extubation failure, i.e., reintubation in ventilated patients, is a well-known risk factor for mortality and prolonged stay in the intensive care unit (ICU). Although sputum volume is a risk factor, the frequency of tracheal suctioning has not been validated as a predictor of reintubation. We conducted this study to examine whether frequent tracheal suctioning is a risk factor for reintubation. PATIENTS AND METHODS: We included adult patients who were intubated for > 72 h in the ICU and extubated after completion of spontaneous breathing trial (SBT). We compared the characteristics and weaning-related variables, including the frequency of tracheal suctioning between patients who required reintubation within 24 h after extubation and those who did not, and examined the factors responsible for reintubation. RESULTS: Of the 400 patients enrolled, reintubation was required in 51 (12.8%). The most common cause of reintubation was difficulty in sputum excretion (66.7%). There were significant differences in sex, proportion of patients with chronic kidney disease, pneumonia, ICU admission type, the length of mechanical ventilation, and ICU stay between patients requiring reintubation and those who did not. Multivariate analysis showed frequent tracheal suction (> once every 2 h) and the length of mechanical ventilation were independent factors for predicting reintubation. CONCLUSION: We should examine the frequency of tracheal suctioning > once every 2 h in addition to the length of mechanical ventilation before deciding to extubate after completion of SBT in patients intubated for > 72 h in the ICU.

  DOI PubMed

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Misc 【 display / non-display 】

Misc 【 display / non-display 】

• 肝がん患者のSSI発生に関連する要因の検討

  石貫 智裕, 合田 恵理香, 巽 博臣, 加藤 透, 原田 敬介, 升田 好樹, 大西 浩文, 秦 史壯, 大柳 俊夫, 水口 徹

  日本外科系連合学会誌 ( 日本外科系連合学会 )  48 ( 3 ) 409 - 409  2023.05

• 集中治療後の身体的・精神的介入におけるエビデンスに関する報告

  水口 徹, 石貫 智裕, 野口 美花, 間山 明子, 和泉 美保, 原田 敬介, 巽 博臣, 加藤 透, 大柳 俊夫, 大西 浩文, 成松 英智, 升田 好樹

  日本腹部救急医学会雑誌 ( (一社)日本腹部救急医学会 )  43 ( 2 ) 575 - 575  2023.02

• 一次縫合創に対するNPWTの最適な適応とは SSI予防ガイドラインの次期改定に必要な予防的NPWTに関する有効性の再考

  水口 徹, 石貫 智裕, 張 苓, 巽 博臣, 久野 芳佳, 原田 敬介, 大西 浩文, 加藤 透, 沖田 憲司, 川本 雅樹, 目黒 誠, 秦 史壯, 大柳 俊夫

  日本外科感染症学会雑誌 ( (一社)日本外科感染症学会 )  19 ( 1 ) 185 - 185  2022.10

• 肝臓

  水口 徹, 石貫 智裕, 張 苓, 巽 博臣, 久野 芳佳, 原田 敬介, 大西 浩文, 加藤 透, 沖田 憲司, 川本 雅樹, 永山 稔, 竹政 伊知朗, 大柳 俊夫

  日本外科感染症学会雑誌 ( (一社)日本外科感染症学会 )  19 ( 1 ) 230 - 230  2022.10

• 肝切除術を受ける患者の健康関連QOL 系統的レビューとメタ解析

  石貫 智裕, 巽 博臣, 原田 敬介, 加藤 透, 永山 稔, 田口 裕紀子, 大柳 俊夫, 成松 英智, 升田 好樹, 水口 徹

  日本外科系連合学会誌 ( 日本外科系連合学会 )  47 ( 3 ) 461 - 461  2022.05

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Research Projects 【 display / non-display 】

Research Projects 【 display / non-display 】

• The Web System and Prognostic Model for Mental Support of Critically Ill Patients and Families

  Grant-in-Aid for Scientific Research (C)

  Project Year :

  2021.04

  -

  2024.03

   

  石貫 智裕, 原田 敬介, 升田 好樹, 水口 徹, 大柳 俊夫, 成松 英智, 巽 博臣

  　View Summary

  ICUダイアリーが重症患者の精神状態やQOLに与える影響を検証するためにメタ解析を行った。ICUダイアリーを使用したRCT研究は5件が該当した(#CRD42020198973)。対照群は一般的なケアが行われ、アウトカムは精神状態についてHADS (不安・抑うつ)とIES-R (PTSD)、QOLについてSF-36 (PCSとMCS) が使用された文献を採用した。メタ解析の結果、ICUダイアリーにより不安は有意に改善することが明らかとなった（P=0.01）。一方で、抑うつ (P=0.05)とPTSD (P=0.10)は改善しなかった。また、SF-36はPCS (P=.28)も MCS (P=0.35) も改善しなかった。よって、ICUダイアリーのみの介入では重症患者の精神状態やQOLに対する効果が十分でないことが明らかとなった。 ウェアラブルデバイスから得られる睡眠データの精度の検証、および従来の睡眠評価方法 (RCSQ) との関連の検証を目的にパイロット研究を実施した。2名の対象者が30日間FitbitとGo2sleepを装着し、RCSQとともに毎日データを収集した。Fitbitの睡眠スコア (平均値±標準偏差) は77.93±7.42、睡眠時間 (分) は376.23±82.85だった。また、Go2sleepの睡眠スコアは73.83±19.73、睡眠時間 (分) は358.79±129.60だった。さらに、RCSQは47.01±10.52であった。Fitbitの睡眠スコアとRCSQの相関係数は0.88 (P<0.001)、決定係数は0.78であった。この結果から、ウェアラブルデバイスはGo2sleepよりもFitbitのデータの方が精度が高いことが明らかとなった。Fitbitのデータは従来の評価方法との相関も強く、睡眠研究に十分耐えられることが明らかとなった。

• Evaluation of effect of thrombomodulin on the regulation of extra-cellular histone in sepsis

  Grant-in-Aid for Challenging Exploratory Research

  Project Year :

  2016.04

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  2018.03

   

  MASUDA YOSHIKI, MIYAHOU Taku

  　View Summary

  Changes in serum histone level in sepsis rat model and the effect of thrombomodulin(TM) on the regulation of histone level were evaluated. Serum histone level was increased later followed by reaching at maximal serum level of TNF-α. Increased serum histone level was attenuated by TM administration. Fragmented TM that was deficit of lectin like domain of TM inhibited favorable action of TM in septic rat model. It was clarified that serum histone level increases in the period of late phase of sepsis and that reduction in increased serum histone level is associated with lectin like domain of TM in sepsis rat model. These results may be the rationale for development of new drugs for treatment of sepsis.

• Evaluation of impaired gastric peristalsis, ghrelin concentration and effectiveness of Rikkunshito after severe insult

  Grant-in-Aid for Scientific Research (C)

  Project Year :

  2015.10

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  2018.03

   

  Tatsumi Hiroomi

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  On the reduction of gastrointestinal peristalsis after invasion, we studied for the purpose of elucidating the mechanism of the effectiveness of rikkunshito. Peritonitis model was prepared and plasma ghrelin concentration involved in gastric peristalsis was measured. We also examined the mechanism of the effectiveness of rikkunshito against the decrease in gastric peristalsis from the viewpoint of the influence on ghrelin concentration. Dietary intake and water intake decreased after invasion recovered early by rikkunshito administration. It was suggested that the recovery of body weight was several days earlier than that of the control group in the group treated with rikkunshito. In the treated group, the concentration of activated ghrelin was high and the inactivated ghrelin concentration tended to be low, suggesting that a shift to activated ghrelin was involved in recovery of oral intake, and rikkunshito was thought to be involved in the increase of activated ghrelin.

• Fundamental Researches for the Application of Human Small Hepatocytes in Clinical Treatment

  Grant-in-Aid for Scientific Research (B)

  Project Year :

  2013.04

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  2016.03

   

  HIRATA Koichi, MITAKA Toshihiro, MIZUGUCHI Toru, TANIGUCHI Naoki, ISHII Masayuki, HONMOU Osamu, MEGURO Makoto, KAWAMOTO Masaki, TATSUMI Hiroomi, ZENBUTSU Hitoshi

  　View Summary

  The researches for the clinical application of human small hepatocyte stem cells (hu-SHSC) for cell transplantation in liver resulted as follows. (1) The hu-SHSC isolation were stable, using the step-wise collagenase perfusion method and the Percoll○R gradient centrifugation method. To identify the specificity of hu-SHSC, histochemical examinations and molecular analysis were reffered. The cytological influence under several kinds of preservation intervals in freezed condition were analysed. Finally, it has been proven that the purification and preservation of hu-SHSC were steadied. (2) The possibility of artificial control on proliferation, differentiation and promotion in hepatic regeneration were satisfied. (3) The transplantation of hu-SHSC in rodent liver was succeeded in proliferation and differentiation. (4)No characteristics concerned to tumorigenicity of SHSC has been examined, but now is ongoing. SHSC may be a candidate as the donor cell in injured liver.

• Clinical and Basic Researches of Hepatic Stem Cells onLiver Regeneration as Defense Mechanism.

  Grant-in-Aid for Scientific Research (B)

  Project Year :

  2010

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  2012

   

  HIRATA Koichi, MITAKA Toshihiro, MIZUGUCHI Toru, NAKAMURA Yukio, MEGURO Makoto, KAWAMOTO Masaki, IMAMURA Masafumi, YAMAGUCHI Hiroshi, YAMA Naoya, TATSUMI Hiroomi, OTA Shigenori, KOJIMA Takashi, SAWADA Norimasa

  　View Summary

  We have achieved the results by the clinical and basic studies.【Study 1】We developed a rat model of acute liver failure after 2/3 partial hepatectomy (PH) for non-alcoholic steatohepatitis (NASH)-related cirrhosis. The mechanism by which HT improved the survival of the model rats was examined in short- and long-term investigations. Overall survival was significantly longer in the HT group than the non-HT group (7-day survival rates: 46.7% and 7.7%, respectively). Preoperative HT might improve the survival of rats with NASH-related cirrhosis after PH by preventing the host hepatocytes from accelerating their growth and falling into apoptosis. 【Study 2】We developed software to calculate the pixels of interest in the area between the hepatic and heart curves (ABC) of 99mTc-galactocyl human serum albumin (GSA) scintigraphy. The area under the receiver operating characteristic curve (AUC) was calculated for evaluation of Child-Pugh score grade B (Child B), pathological chronic hepatitis (CH), and liver cirrhosis (LC). We developed a novel liver functional indicator, the ABC, to count radioactivity in sequence.

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