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20 December 2023, Volume 37 Issue 12 Previous Issue    Next Issue

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Comprehensive geriatric assessment status and coping strategies for patients with dementia complicated with COVID-19 MA Zong-juan, LUO Chang-chun, DENG Bao-feng, WANG Hui-min, HU Yue-qing 2023, 37 (12):  1189-1192.  doi: 10.3969/j.issn.1003-9198.2023.12.001 Abstract ( 166 )   PDF (1096KB) ( 998 )   Save Objective To analyze the results of comprehensive geriatric assessment (CGA) of the patients with dementia complicated with COVID-19, and to provide reference for the nursing strategies for the patients with dementia combined with COVID-19. Methods A total of 249 patients with dementia (aged≥60 years) who were admitted to the Center for Diagnosis of Cognitive Disorders of Beijing Geriatric Hospital from December 2022 to February 2023 were enrolled in this retrospective study. The patients diagnosed with COVID-19 at admission or during hospitalization were enrolled as the study group (n=124), and the others were enrolled as the control group (n=125). The results of CGA and relevant data of the patients were statistically analyzed. Results There were statistically significant differences in the scores of cognitive function, activity of daily living, falls and pressure sore between the study group and the control group during the COVID-19 pandemic (all P<0.05). At discharge, the status of cognitive function, activity of daily living, falls, pressure sore and urinary incontinence in both groups were all improved significantly (all P<0.05). Conclusions The cognitive function and activity of daily living are declining, and the risk of falls and pressure sores is increasing in the patients with dementia due to COVID-19. Based on this finding, it is recommended to develop the strategies of nutritional intervention, caregiver education and “long COVID-19” management, and to improve the quality of life of patients with dementia combined with COVID-19. References | Related Articles | Metrics

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Clinical analysis of COVID-19 combined with fungal infection in the elderly SHAN Shan, CHEN Ji-hai, QIU Liang, OUYANG Xiao-jun 2023, 37 (12):  1193-1198.  doi: 10.3969/j.issn.1003-9198.2023.12.002 Abstract ( 133 )   PDF (1163KB) ( 924 )   Save Objective To retrospectively analyze the clinical characteristics, treatment and prognosis of the elderly patients with COVID-19 combined with fungal infection, and to explore the risk factors of COVID-19 combined with fungal infection. Methods The clinical data of the patients with COVID-19 who were hospitalized in the Geriatric Hospital of Nanjing Medical University from December 13, 2022 to January 31, 2023 were collected. The patients with positive fungal results in sputum culture, alveolar lavage fluid culture, blood culture, urine culture, stool culture and gastric juice culture were screened. The data of gender, age, Charlson comorbidity index (CCI), clinical symptoms, complete blood count, liver and kidney function, serum albumin, fasting blood glucose (FPG), glycosylated hemoglobin (HbA1c), high-sensitivity C-reactive protein (hs-CRP), procalcitonin, arterial partial pressure of oxygen (PaO2), arterial partial pressure of carbon dioxide (PaCO2), oxygenation index (PaO2/FiO2), D-dimer, carcinoembryonic antigen (CEA), thyroid function, interleukin-6 (IL-6), lymphocyte subgroup analysis, pathogenic culture results, days from fungal positive to admission, treatment and prognosis were analyzed. Results A total of 169 patients with COVID-19 were collected, including 21 patients combined with fungal infection. Among the patients with COVID-19 combined with fungal infection, the median length of hospital stay was 20.0 (15.0, 28.5) d, male constituted the majority of 81.0%, the median age was 89.0 (81.5, 92.5) years, and CCI was 6 (5, 9); The main clinical classification of COVID-19 among the patients was critical type (52.4%); The main fungi were Candida albicans and Candida glabrata; Six patients (28.6%) ultimately died. 169 patients with COVID-19 were divided into fungal infection group and non-fungal infection group. There were significant differences in age, hospitalization days, clinical classification, procalcitonin, serum albumin, blood urea nitrogen (BUN), FPG, D-dimer, CEA, PaO2/FiO2, and the highest respiratory support mode between the two groups (all P<0.05). Further Logistic regression analysis showed that procalcitonin (OR=1.411) and invasive ventilation as the highest respiratory support mode (OR=27.482) were the independent influencing factors for COVID-19 combined with fungal infection. Conclusions Procalcitonin and invasive ventilation as the highest respiratory support mode may be independent risk factors for COVID-19 combined with fungal infection. Early screening and early treatment should be carried out for the high-risk groups of COVID-19 combined with fungal infection, so as to protect the patients. References | Related Articles | Metrics

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Clinical value of blood magnesium levels in elderly patients with maintenance hemodialysis LIU Hong-ling, WANG Bao-kui, LEI Jie, LIU Yu, LI Su-tong 2023, 37 (12):  1206-1209.  doi: 10.3969/j.issn.1003-9198.2023.12.005 Abstract ( 101 )   PDF (1056KB) ( 1071 )   Save Objective To investigate the blood magnesium levels of the elderly patients undergoing maintenance hemodialysis (MHD), and to analyze the levels of blood pressure, intact parathyroid hormone (iPTH) and nutritional status in the patients with different levels of blood magnesium. Methods A total of 99 elderly MHD patients were enrolled and divided into low-magnesium group (＜0.75 mmol/L, n=24), normal-magnesium group(0.75-1.02 mmol/L, n=45) and high-magnesium group (＞1.02 mmol/L, n=30) according to the level of blood magnesium before hemodialysis. The levels of calcium, phosphorus, iPTH, plasma albumin, hemoglobin before hemodialysis and the blood pressure during hemodialysis and hemodialysis interval were observed and compared among the three groups. Results There was no significant difference in interdialytic blood pressure among the groups with different magnesium levels. The systolic blood pressure in the low-magnesium group was significantly lower than that in the normal-magnesium group and high-magnesium group (P<0.01), and the diastolic blood pressure in the low-magnesium group was significantly lower than that in the normal-magnesium group (P<0.01). The levels of iPTH, calcium, phosphorus and hemoglobin were significantly increased in the low-magnesium group, followed by the normal-magnesium group and the high-magnesium group (P<0.01). The plasma albumin level in the normal-magnesium group was significantly higher than that in the low-magnesium group (P<0.05). Conclusions Elderly MHD patients with normal or elevated blood magnesium levels usually have relatively normal nutritional status, relatively stable blood pressure and high level of iPTH during dialysis. References | Related Articles | Metrics

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Clinical application of goal-directed fluid therapy combined with ultrasound-guided dynamic monitoring of extravascular pulmonary water in elderly patients receiving total hip arthroplasty SUN Xiao-yan, ZHANG Zhen-en, LI Tong, XU Jun 2023, 37 (12):  1210-1214.  doi: 10.3969/j.issn.1003-9198.2023.12.006 Abstract ( 95 )   PDF (1023KB) ( 804 )   Save Objective To explore the value of goal-directed fluid therapy(GDFT) combined with ultrasound-guided dynamic monitoring of extravascular lung water (EVLW) in the elderly patients receiving total hip arthroplasty (THA). Methods A total of 97 elderly patients who underwent THA surgery at Jianhu County People's Hospital were enrolled and randomly divided into the observation group (n=48) and the control group (n=49). The observation group received GDFT, while the control group received conventional perioperative fluid management. The levels of mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), stroke volume index (SVI), blood lactic acid, oxygen index (OI), peak airway pressure (PIP), and the incidence of pulmonary-related complications were recorded and compared between the two groups at different time points.Meanwhile, score of B line was observed by lung ultrasomd and EVLW was monitored. Results The fluid replenishment amount in the observation group was significantly lower than that in the control group (P<0.01). The level of MAP and B line score in the observation group 30 min after tracheal intubation and after the operation were significantly lower than those in the control group (P<0.05).The level of CI 15 min,30 min after tracheal intubation and the level of SVI 30 min after tracheal intubation in the observation group were significantly higher than those in the control group (P<0.05). The levels of blood lactic acid and PIP 15 min, 30 min after tracheal intubation and after the operation in the observation group were significantly lower and the level of OI was higher than those in the control group (P<0.05). There was significant difference in the incidence rate of pulmonary complications between the observation group and the control group (4.2% vs 16.3%,P<0.05). Conclusions For elderly patients undergoing THA, GDFT combined with ultrasound-guided dynamic monitoring of EVLW can help to supplement the appropriate total amount of fluid and maintain stable hemodynamics, reduce the incidence of lung complications, protect the lung function. References | Related Articles | Metrics

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Expression level and significance of serum progranulin in elderly patients with chronic obstructive pulmonary disease treated by high-flow nasal cannula oxygen therapy QIN Ke, LI Tong-lin, HUA Jun-ping, JIANG Mei-fang 2023, 37 (12):  1215-1218.  doi: 10.3969/j.issn.1003-9198.2023.12.007 Abstract ( 96 )   PDF (1059KB) ( 831 )   Save Objective To explore the efficacy of high-flow nasal cannula oxygen therapy (HFNC) in the elderly patients with stable chronic obstructive pulmonary disease(COPD), as well as the expression level of serum progranulin (PGRN) and its significance. Methods A total of 96 elderly patients with moderate to severe stable COPD who were admitted to our hospital from June 2019 to June 2021 were selected and randomly divided into group A and group B. Group A was treated with HFNC, and group B was treated with bilevel positive airway pressure (BiPAP) ventilators. All the patients received expectorant, spasmolytic, anti-asthmatic and anti-inflammatory treatment at the same time. The levels of serum PGRN, interleukin-8 (IL-8), IL-6, tumor necrosis factor (TNF) -α and the blood gas parameters before and after treatment were detected and compared between the two groups. The correlations between PGRN and inflammatory factors were analyzed. Receiver operating characteristic curve(ROC)was drawn to analyze the value of PGRN in predicting the first acute exacerbation in the elderly patients with stable COPD. Results After treatment, the levels of serum PGRN, IL-8, IL-6, TNF-α and partial pressure of arterial carbon dioxide (PaCO2) in two groups were significantly lower and partial pressure of arterial oxygen (PaO2) was significantly higher than those before treatment, especially in group A (P<0.05). The difference in serum PGRN before and after treatment was positively correlated with the difference in IL-8, IL-6 and TNF-α in COPD patients (r= 0.724, 0.421, 0.322, P<0.05). The time of first acute exacerbation was statistically different between group A and group B (24 months vs 15 months,P<0.05). ROC analysis showed that the area under the curve (AUC) of difference of PGRN in predicting the first acute exacerbation in COPD patients was 0.717 (95%CI :0.619-0.812) and the cut-off value was 49.2 μg/L. According to the cut-off value, group A was divided into high-oscillation group and low-oscillation group, with a time of the first acute exacerbation of 27 months and 21 months, respectively (P<0.05). Conclusions HFNC has a good effect on the elderly patients with stable COPD, and the change level of serum PGRN during treatment is associated with the first acute exacerbation of the patients. References | Related Articles | Metrics

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Association of estimated glomerular filtration rate with insulin resistance and β-cell function in elderly patients with type 2 diabetes mellitus DAI Ling-li, YU Yun 2023, 37 (12):  1219-1223.  doi: 10.3969/j.issn.1003-9198.2023.12.008 Abstract ( 109 )   PDF (1026KB) ( 868 )   Save Objective To explore the association of estimated glomerular filtration rate (eGFR)with insulin resistance and β-cell function in the elderly patients with type 2 diabetes mellitus(T2DM). Methods A total of 944 elderly patients with T2DM were divided into three groups according to the level of eGFR:normal renal function group[eGFR≥90 mL/(min·1.73 m2), n=315], mild renal dysfunction group [eGFR: 60-<90 mL/(min·1.73 m2), n=357] and moderate and severe renal dysfunction group[eGFR<60 mL/(min·1.73 m2), n=272]. All the patients underwent oral glucose tolerance test (OGTT) and insulin releasing test. According to the levels of blood glucose and insulin 0, 30, 60 and 120 min after taking glucose, the insulin resistance indexes [homeostasis model assessment of insulin resistance (HOMA-IR),GluAUC30×InsAUC30] and islet secretion function indexes (HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120, IG120) were counted. The correlations of eGFR with insulin resistance and β-cell function indexes were analyzed. Results With the decrease of the level of eGFR, HOMA-IR, GluAUC30×InsAUC30, HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120 and IG120 increased gradually (all P<0.05). After adjustment for confounders, eGFR was still negatively correlated with HOMA-IR, GluAUC30×InsAUC30, HOMA-β, ΔI30/ΔG30, InsAUC30, IG30, InsAUC120 and IG120(all P<0.01). Conclusions eGFR is negatively influenced by insulin resistance and compensatory secretion of islet cells in the elderly patients with T2DM. References | Related Articles | Metrics

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Comparison of anticoagulation effects between nafamostat and argatroban during continuous renal replacement therapy in elderly patients aged≥75 years old WANG Ting, LI Min, ZENG Ping, CHAI Chun-yan, ZHAO Yuan, LI Yan-ling 2023, 37 (12):  1224-1227.  doi: 10.3969/j.issn.1003-9198.2023.12.009 Abstract ( 127 )   PDF (1045KB) ( 634 )   Save Objective To investigate the anticoagulation efficacy and safety of argatroban and nafamostat (NM) during continuous renal replacement therapy (CRRT) in the patients aged≥75 years old. Methods Twelve patients aged≥75 years old treated with argatroban and NM for 4 times respectively during CRRT were enrolled in this study. The monitoring data of the last 3 times of the two kinds of anticoagulant therapy were statistically analyzed. The levels of blood urea nitrogen (BUN), creatinine (Cr), hemoglobin (Hb), platelet count (PLT) and activated partial thromboplastin time (APTT) were detected before and after CRRT, and the level of APTT at venous and arterial ends 4 h and 8 h after treatment were also detected. The incidence rates of clotting events in filter tubes and bleeding during CRRT were recorded. Results There were no significant differences in the D-value of BUN, Cr and PLT between the two groups before and after CRRT (all P>0.05). There was no significant difference in the classification of dialyzer and tube coagulation between the two groups (P=0.40). The incidence rate of fecal occult blood in NM group was significantly lower than that in argatroban group (P=0.03), and there were no significant differences in the incidence rates of blood in sputum or hematuria between the two groups (P>0.05). After treatment, the level of Hb in argatroban group was significantly decreased compared to NM group (P<0.01), and the level of APTT in peripheral blood in argatroban group was significantly increased compared to NM group (P<0.01). Affter 4 h and 8 h of treatment, there were no significant differences in the level of APTT at venous end between the two groups (P>0.05), but the level of APTT at arterial end in NM group was significantly lower than that in argatroban group (P<0.01). Conclusions NM has considerable anticoagulant effect comparable to argatroban, with no significant effect on coagulation function during and after CRRT, and has less effect on Hb. It is a better choice for anticoagulants during CRRT in the patients aged≥75 years old. References | Related Articles | Metrics

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Predictive and evaluative value of peripheral blood PLR and NLR in elderly patients with Parkinson's disease YANG Jing, ZHANG Jia-sheng, YANG Gui-ying 2023, 37 (12):  1228-1232.  doi: 10.3969/j.issn.1003-9198.2023.12.010 Abstract ( 115 )   PDF (1209KB) ( 647 )   Save Objective To explore the predictive and evaluative value of platelet to lymphocyte ratio (PLR) and neutrophil to lymphocyte ratio (NLR) in the elderly patients with Parkinson's disease (PD). Methods Ninety-eight elderly patients with PD hospitalized in the Department of Neurology of Jiangsu Shengze Hospital from 2020 to 2022 were enrolled as PD group. Another 98 elderly who were outpatients or received physical examinations were enrolled as control group. The baseline clinical data were collected. According to the results of Hoehn-Yahr stage, the PD patients were divided into early-stage group (grade 1-2, n=35) and mid- to late-stage group (grade 3-5, n=63). The correlations between various indicators were analyzed by Spearman correlation coefficient. The risk factors for the occurrence and progression of PD were analyzed by multivariate Logistic regression analysis. The receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of PLR, NLR, and the combination of two indicators for the onset of PD. Results There were significant differences in the levels of D-dimer, lymphocytes, neutrophils, PLR and NLR between PD group and control group (P<0.05). Multivariate Logistic regression analysis showed that PLR (OR=1.012) and NLR (OR=1.695) were the independent influencing factors for the occurrence of PD in the elderly. Spearman correlation analysis showed that PLR was positively correlated with the course of disease and Hoehn-Yahr stage in the elderly patients with PD (r=0.225, P=0.026; r=0.316, P=0.002). ROC curve analysis showed that the area under curve (AUC) of NLR and PLR predicting the occurrence of PD was 0.688 and 0.703, respectively. The AUC of the combination of the two indicators was 0.721. There were significant differences in the course of disease and PLR between the early-stage group and mid- to late-stage group (P<0.01). The course of disease (OR=1.250) and PLR (OR=1.010) were the independent influencing factors for the progression of PD. Conclusions NLR and PLR are the independent influencing factors for the occurrence of PD in the elderly. The combination of the two indicators can predict the occurrence of PD. Meanwhile, PLR also affects the severity of PD in the elderly. References | Related Articles | Metrics

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Assessment effect of Caprini scale on venous thromboembolism in elderly patients with diabetes FAN Ting-yong, YUAN Li, YANG Xiao-ling, CHEN Qian 2023, 37 (12):  1233-1237.  doi: 10.3969/j.issn.1003-9198.2023.12.011 Abstract ( 85 )   PDF (1027KB) ( 690 )   Save Objective To analyze the assessment effect of Caprini scale on venous thromboembolism (VTE) in the elderly patients with diabetes and the risk factors of the incidence of VTE. Methods The clinical data of 1573 elderly patients with diabetes who were hospitalized at West China Hospital, Sichuan University from January 2017 to September 2021 were collected. Among them, 306 patients presenting with VTE were assigned to the VTE group, while 1267 patients without VTE were assigned to the non-VTE group. The score and risk stratification of Caprini scale were compared between the two groups. Univariate analysis and Multivariate Logistic regression analysis were used to analyze the influencing factors for VTE in the elderly patients with diabetes. Results The score and the proportion of high-risk patients in the VTE group were significantly higher than those in the non-VTE group (all P<0.01). Univariate analysis showed that there were statistically significant differences in the levels of D-dimer and fasting plasma glucose (FPG), the proportion of severe pulmonary disease, abnormal lung function, major surgery (>45 min), elevated transaminase, and bedridden patients of Internal Medicine between the two groups (P<0.05 or P<0.01). Multivariate Logistic regression analysis showed that abnormal lung function, major surgery (>45 min), bedridden patients of Internal Medicine, D-dimer and FPG were the independent influencing factors for VTE in the elderly patients with diabetes. Conclusions Caprini scale can be used to assess the risk of VTE in the elderly patients with diabetes. However, Caprini scale lacks blood glucose. In the future, it is necessary to develop a simple and easy thrombosis assessment scale for the elderly patients with diabetes. References | Related Articles | Metrics

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Correlation between serum cholinesterase and ventricular remodeling in elderly patients with heart failure REN Li-yan 2023, 37 (12):  1238-1241.  doi: 10.3969/j.issn.1003-9198.2023.12.012 Abstract ( 84 )   PDF (1005KB) ( 475 )   Save Objective To explore the correlation between serum cholinesterase (ChE) and ventricular remodeling in the elderly patients with chronic heart failure. Methods A retrospective study was conducted in 118 elderly inpatients with chronic heart failure aged ≥70 years from Department of Geriatric Medicine of our hospital from March 2018 to July 2021. The levels of ChE and N-terminal brain natriuretic peptid (NT-proBNP), the baseline data of liver and kidney function, nutritional status and New York Heart Association (NYHA) cardiac function grading were collected. All patients were divided into the low-level group (<4000 U/L, n=50) and the high-level group (≥4000 U/L, n=68) based on the level of ChE. The left ventricular internal diameter (LVD), left atrium diameter (LAD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPEWT) and left ventricular ejection fraction (LVEF) were measured and compared between the two groups. Results Compared with the high-level group, the levels of hemoglobin (Hb), creatinine, blood urea nitrogen(BUN), total cholesterol (TC) and LVEF were lower, while the levels of LVD and NT-proBNP were higher, and the proportion of the patients with grade Ⅳ heart function was significantly increased in the low-level group(all P<0.05 or P<0.01). Pearson correlation analysis showed that ChE was positively correlated with LVEF (r=0.263, P=0.004), and negatively correlated with NT-proBNP and LVD(r=-0.490, P<0.001; r=-0.233, P=0.011).Spearman correlation analysis showed that ChE was negatively correlated with NYHA cardiac function grading (r=-0.621, P<0.001). Conclusions The level of ChE is negatively correlated with LVD, and positively correlated with LVEF in the elderly patients with heart failure.ChE might be helpful for clinical evaluation of ventricular remodeling in the elderly patients with heart failure. References | Related Articles | Metrics

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Nutrition status and the efficiency comparison of subjective global assessment and Objective Score of Nutrition on Dialysis in evaluating the nutritional status of elderly patients undergoing hemodialysis HAN Meng-ling, MA Xun, XU Wei, WANG Mi, YANG Jia-hui 2023, 37 (12):  1242-1245.  doi: 10.3969/j.issn.1003-9198.2023.12.013 Abstract ( 86 )   PDF (1026KB) ( 764 )   Save Objective To explore the nutrition status in the elderly patients undergoing hemodialysis,and to compare the efficiency of subjective global assessment (SGA) and Objective Score of Nutrition on Dialysis (OSND)in evaluating the nutritional status. Methods A total of 120 elderly hemodialysis patients were enrolled in the observation group, and 120 healthy elderly receiving physical examination were enrolled in the control group. The nutrient composition-related indicators and blood biochemical indicators of the two groups were detected and compared. SGA and OSND were used to assess the nutritional status of the elderly patients undergoing hemodialysis. The correlations of SGA and OSND with nutritional indexes and blood biochemial indicators were analyzed. Results The level of high-sensitivity C-reaction protein (hs-CRP) in observation group was higher than that in the control group (P<0.01); The levels of body fat, body fat ratio, protein, hemoglobin (Hb), blood urea nitrogen(BUN), high-density lipoprotein cholesterol (HDL-C), albumin (Alb), total cholesterol (TC) and triglyceride(TG)in the observation group were lower than those in the control group (P<0.01). Among 120 elderly hemodialysis patients, 3 cases (2.50%) presented with normal nutrition and 117 cases (97.50%) presented with malnutrition according to SGA evaluation criteria; According to the OSND standard, 5 cases (4.17%) presented with normal nutrition and 115 cases (95.83%) presented with malnutrition. Correlation analysis showed that SGA was negatively correlated with body fat ratio, the levels of protein, HDL-C, Alb, TC and low-density lipoprotein cholesterol (LDL-C) (P<0.05); OSND was negatively correlated with body fat ratio, the levels of body fat,HDL-C, Alb, TC, LDL-C, TG, Hb, BUN(P<0.05), and positively correlated with the levels of protein and hs-CRP(P<0.05). Conclusions SGA and OSND are suitable for nutritional evaluation in the elderly hemodialysis patients. The nutrition status of elderly hemodialysis patients is poor, and it is necessary to conduct comprehensive intervention timely. References | Related Articles | Metrics

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Intervention effect of post-stroke dysphagia nursing program based on information-motivation-behavioral skills model theory in elderly patients HUANG Hong-tai, WANG Li, PANG Shu-xian, ZHANG Qian, FANG Jin-ju, LI Cheng-lin 2023, 37 (12):  1278-1282.  doi: 10.3969/j.issn.1003-9198.2023.12.021 Abstract ( 105 )   PDF (1170KB) ( 865 )   Save Objective To construct a post-stroke dysphagia nursing program based on the theory of information-motivation-behavioral skills model (IMB), and to explore its intervention effect in the elderly patients with post-stroke dysphagia. Methods By convenience sampling methods, 100 elderly patients with post-stroke dysphagia hospitalized in Department of Neurology of the Third Affiliated Hospital of Guangxi Medical University from May to September 2022 were selected, and they were divided into observation group (n=50) and control group (n=50) according to random number table. First, A multi-core team of IMB nursing intervention was established, and then the first draft of the post-stroke dysphagia nursing program was formed after the literature review. Finally, the final nursing plan was formed after the expert group meeting. The observation group received the post-stroke dysphagia nursing program based on IMB theory, and the control group received regular care. The degree of dysphagia, changes in Swallow-Specific Quality of Life (SWAL-QOL) scores, and the incidence rate of aspiration pneumonia after four weeks of intervention were compared between the two groups. Results After 4 weeks of intervention, the degree of dysphagia in the observation group was lower than that in the control group, and the total score of SWAL-QOL and the scores in all dimensions were higher than those in the control group, and the incidence rate of aspiration pneumonia was lower than that in the control group (P<0.05 or P<0.01). Conclusions The post-stroke dysphagia nursing program based on IMB theory can not only significantly improve the quality of life and swallowing function in the elderly patients with post-stroke dysphagia, but also effectively reduce the incidence of aspiration pneumonia. References | Related Articles | Metrics

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Study on compliance and influencing factors of pre-rehabilitation program in elderly patients with colorectal cancer WANG Xia-yun, LI Yao, WU Qian 2023, 37 (12):  1283-1288.  doi: 10.3969/j.issn.1003-9198.2023.12.022 Abstract ( 96 )   PDF (1044KB) ( 841 )   Save Objective To investigate the compliance and influencing factors of pre-rehabilitation in the elderly patients with colorectal cancer (CRC). Methods From June 2021 to March 2022, 123 elderly patients with colorectal cancer who underwent selective surgery in Department of Gastrointestinal Surgery of Shanghai Tenth People's Hospital were enrolled in this study, and the pre-rehabilitation compliance of the patients was calculated according to the actual pre-rehabilitation time to the planned pre-rehabilitation time ratio.Compliance rate ≥75% was defined as high compliance and compliance rate <75% was defined as low compliance. Indicators of clinical outcome were compared between the two groups. Logistic regression analysis was used to analyze influencing factors for pre-rehabilitation. Results The mean compliance rate of pre-rehabilitation in the elderly patients with CRC was 81.34%, and 82 patients presented with high compliance and 41 patients with low compliance. The time of postoperative hospital day in the high compliance group was significant shorter than that in the low compliance group (P=0.009). Binary Logistic regression analysis showed that age, frailty, anxiety and pre-rehabilitation days were the independent influencing factors for pre-rehabilitation compliance in the elderly patients with CRC. Conclusions The pre-rehabilitation compliance of elderly CRC patients was at an intermediate level. Medical staff should pay attention to the assessment of compliance in the patients with advanced age, frailty, anxiety, and longer pre-rehabilitation days, then adopt targeted interventions to improve the patients'compliance for pre-rehabilitation. References | Related Articles | Metrics

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Establishment of home adverse event evaluation system for elderly patients with diabetes LI Qiu-chen, ZHAO Lian-hui, QIAO Ai-chun 2023, 37 (12):  1289-1293.  doi: 10.3969/j.issn.1003-9198.2023.12.023 Abstract ( 54 )   PDF (1012KB) ( 411 )   Save Objective To establish a home adverse event evaluation system for elderly patients with diabetes. Methods Through literature review and research group discussion, the basic framework of home adverse event evaluation system for elderly patients with diabetes was initially formed, and primary and secondary indexes were determined. After selecting the consulting experts, Delphi method was adopted and two rounds of expert consulting questionnaires were sent out by E-mail or questionnaire star. The experts rated the importance, familiarity and judgment basis of each indicator of home adverse events in the elderly patients with diabetes. After each round of consultation, the authority coefficient (Cr) of the experts and the importance score and variation coefficient of each index were calculated. Kendall's W test was used to analyze the coordination degree of the experts. Results In the first round, 17 questionnaires were sent out, and 15 valid questionnaires were collected, with a questionnaire recovery rate of 88.24%, and the Cr of the experts was 0.933. The first round of questionnaire included 5 first-level indicators and 26 second-level indicators. The Kendall concordance coefficient of first-level indicators and second-level indicators were 0.418 and 0.470, respectively. The coefficient of variation of each indicator ranged from 0.05 to 0.34, and the importance scores ranged from 3.20 to 4.93. In the second round, 15 questionnaires were sent out, and 15 valid questionnaires were collected. The questionnaire recovery rate was 100.00%, and the Cr of the experts was 0.947. The second round of questionnaire included 5 first-level indicators and 27 second-level indicators. The Kendall concordance coefficient of first-level indicators and second-level indicators were 0.436 and 0.398, respectively. The coefficient of variation of each indicator ranged from 0.05 to 0.21, and the importance scores ranged from 3.53 to 4.93. After two rounds of deletion, addition and modification of indicators, 5 first-level indicators and 27 second-level indicators were finally formed. Conclusions In this study, the evaluation system of home adverse events for elderly patients with diabetes is preliminarily established, which can provide an evaluation basis for home management of elderly patients with diabetes. References | Related Articles | Metrics