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Characteristics associated with falls among the elderly within aged care wards in a tertiary hospital： a retrospective case-control study

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Chinese Medical Journal 2010年第13期123卷 1668-1672页

作者： CHEN Xue-li LIU Yun-hu Daniel ky chan SHEN Qing Huong Van Nguyen Department of Rehabilitation Beijing Geriatric Hospital Beijing 100095 China Aged Care Bankstown-Lidcombe Hospital Sydney New South Wales Australia Faculty of Medicine University of New South Wales Sydney Anetralia

Background Falls are the most frequently reported adverse events in inpatient settings. We conducted a retrospective case-control study of inpatient falls within aged care wards in a tertiary hospital to investigate the associated characteristics of elderly patients suffering from falls and fall-related characteristics. Methods Consecutive retrospective cross-sectional design spanned July 2006 to December 2008. Patient group： Information on all aged care inpatients who suffered from 1 or more falls was extracted from Incident Information Management System （IIMS）. Further details about the particular admission（s） were obtained from patients＇ medical records, e.g., patients＇ characteristics and circumstances surrounding the falls. Randomly selected aged care patients who did not suffer from a fall and who were discharged from the hospital in the same period served control group. Characteristics among patients with single fall and recurrent falls, as well as non-railers were compared. Results Of the 438 falls evaluated, 71.9% occurred in patients＇ room and 18.9% in patients＇ bathroom/toilet. The common activities were moving/transferring and taking shower/toileting, respectively, 70.3%, 12.1% while occurring falls; and time of falls had a high peak during 9：00-11：00 a.m. Many were unassisted while falling. The common contributing factors for fall were intrinsic factors. Patients with recurrent falls were more likely to have lower Mini-Mental State Examination （MMSE） score. Logistic regression analysis showed length of stay longer than five weeks, dementia and stroke were independent risk factors for recurrent falls; and living in hostel/nursing home preadmission, needing assistance with mobility, cognitive impairment, stroke, incontinence and arthritis/osteoporosis were independent risk factors for fall. Conclusions In an aged care ward, falls are independently associated with recurrent factors. Cognitive impairment/dementia was a strong risk factor for falls, and main

关键词： falls recurrent falls inpatients the elderly

Mortality Trend and Predictors of Mortality in Dysphagic Stroke Patients Postpercutaneous Endoscopic Gastrostomy

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Chinese Medical Journal 2015年第10期128卷 1331-1335页

作者： Yue-Long Jiang Nyoka Ruberu Xin-Sheng Liu Ying-Hua Xu Shu-Tian Zhang Daniel ky chan Department of Gastroenterology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China Department of Gastroenterology Beijing HospitalBeijing 100730China Department of Aged Care and Rehabilitation Bankstown-Lidcombe HospitalBankstownNew South WalesAustralia Department of Gastroenterology Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

Background：Percutaneous endoscopic gastrostomy （PEG） feeding is widely used in stroke patients suffering from persistent dysphagia;however,predicting the risks and benefits of PEG insertion in the individual patient is *** aim of our study was to investigate if candidate risk factors could predict short-term mortality risk in poststroke patients who had PEG tube insertion for persistent ***：This was a retrospective study of 3504 consecutive stroke patients admitted to two metropolitan hospitals during the period January 2005 to December 2013 and who also underwent PEG insertion for feeding due to persistent ***：A total of 102 patients were included in the *** were 22 deaths in 6 months after insertion of PEG tubes and 20 deaths of those occurred within 3 months post *** who survived beyond 6 months showed significantly lower mean age （75.9 ± 9.0 years vs.83.0 ± 4.9 years,P 〈 0.001）,a lower mean American Society of Anesthesia （ASA） score （3.04 ± 0.63 vs.3.64 ± 0.58,P 〈 0.001） compared to *** multiple Logistic,age （P =0.004,odds ratio [OR] =1.144;95% confidence interval [CI]：1.044-1.255）;ASA （P =0.002,OR =5.065;95% CI：1.815-14.133） and albumin level pre-PEG insertion （P =0.033,OR =0.869;95% CI：0.764-0.988）were the independent determinants of mortality ***：We propose that age,ASA score and albumin level pre-PEG insertion to be included as factors to assist in the selection of patients who are likely to survive more than 3 months post PEG insertion.

关键词： Age Albumin American Society of Anesthesia Mortality Percutaneous Endoscopic Gastrostomy Stroke

The association between frailty and vascular dementia

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中华老年医学杂志 2015年第12期34卷 1293-1299页

作者： Daniel ky chan Vivek Srinivasan Ciaran Upton Xueli Chen Roman Romero-Ortuno 2052 Sydney Faculty of Medicine University of New South Wales Australia Department of Aged Care and Rehabilitation Bankstown HospitalNSW Australia 北京老年医院康复医学科 Addenbrooke's Hospital Hills Rd Cambridge England

Frailty is a clinically recognized syndrome that results from an age-associated decline in reserve and function across multiple physiological *** are two commonly used clinical definitions. The Rockwood definition (1994) is essentially a Cumulative Burden Index which includes health conditions and deficits (therefore embracing cognitive impairment). The Fried definition (2001) proposes that frailty definition is met if the person has at least 3 of the following criteria:1) low grip strength 2) low energy 3) slowed walking speed 4) low physical activity and 5) unintentional weight *** is associated with increased risk for falls,decreased mobility, mortality and institutionalisation. Data from the Chinese longitudinal healthy longevity survey, the largest nationally representative sample of older adults in China,has concluded that higher levels of frailty increase relative risk ratios of mortality for all types of death. Another syndrome of which increasing incidence occurs with increasing age,is dementia. Eight million and four hundred thousand,or 4.6% of the population aged 60 and over in mainland China, Hong Kong and Taiwan, live with dementia.

关键词：临床症候群临床分析健康状况医学知识

Post-fontan circulation hepatocellular carcinoma:Open and laparoscopic hepatectomy

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 90-93页

作者： Karin ky Ho Wong Hoi She Simon HY Tsang Kevin S Lo Tan To Cheung Department of Surgery The University of Hong Kong102 Pok Fu Lam RoadHong KongChina Department of Anaesthesiology Queen Mary Hospital102 Pok Fu Lam RoadHong KongChina

To the Editor:Fontan-associated liver disease shows increasing incidence as advances in pediatric cardiology have prolonged life expectancy in patients with single ventricle congenital heart defects[1].Their unique physiology and procedure-related sequelae present an increasingly relevant challenge in hepatic *** hereby reported a series of patients suffering from hepatocellular carcinoma(HCC)who successfully underwent open and laparoscopic hepatectomy.

关键词： hepatocellular hepatectomy surgery

Infant Hearing Screening in Maternal and Child Health Centres in Hong Kong Using Automated Otoacoustic Emission Screening Machines

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Infant Hearing Screening in Maternal and Child Health Centre...

经皮内镜下胃造瘘在治疗中风后患者中的应用进展

第五届亚太地区新生儿筛查学术交流会

作者： chan ky TSO KKP LEUNG SSL LAM STS Family Health Service Department of Health Hong Kong SAR Family Health Service Department of Health Hong Kong SAR Family Health Service Department of Health Hong Kong SAR Family Health Service Department of Health Hong Kong SAR

＜正＞The Maternal and Child Health Centre （MCHCs） of the Department of Health have been using the Distraction Test （DT） as the main tool for infant hearing screening. Recognizing the limitations of the test, a on...

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世界华人消化杂志 2012年第23期20卷 2162-2166页

作者：姜跃龙 Daniel ky chan 卫生部北京医院消化内科 Department of Geriatric Bankstown-Lidcombe HospitalNew South Wales 2200Australia

中风后很多患者都会出现吞咽困难,并且在短时间内无法恢复.经皮内镜下胃造瘘术(percutaneous endoscopic gastrostomy,PEG)可以为中风后吞咽功能障碍的患者提供长期的营养支持,与静脉营养以及传统的鼻胃管治疗相比有很多的优势,因此传... 详细信息

中风后很多患者都会出现吞咽困难,并且在短时间内无法恢复.经皮内镜下胃造瘘术(percutaneous endoscopic gastrostomy,PEG)可以为中风后吞咽功能障碍的患者提供长期的营养支持,与静脉营养以及传统的鼻胃管治疗相比有很多的优势,因此传统的观念认为PEG可以减少并发症,提高患者的生活质量,但是近年来的关于并发症和死亡率的研究有相反的结果.因此如何选择合适的患者,合适的时机,预测可能出现的各种并发症以及生存时间才能使患者从中获益.本文全面地分析了近年来的研究并对比了早期的研究,阐述了PEG在中风患者中的应用应该个体化综合分析的理念,为临床上PEG应用前提供参考依据.

关键词：胃造瘘中风经皮内镜下胃造瘘术

住院期间反复跌倒的老年患者认知损伤特点的临床回顾性研究

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中国康复医学杂志 2010年第8期25卷 740-743页

作者：王玉波陈雪丽 Qing Shen Daniel ky chan Huong Van Nguyen 北京老年医院康复科北京海淀区温泉路118号100095 澳大利亚新南威尔士州悉尼市Bankstown-Lidcombe医院老年科澳大利亚新南威尔士州悉尼大学

目的:探索导致老年患者住院期间反复跌倒的相关因素,焦点在其认知损伤的特点,目的是探索可借鉴的管理经验。方法:回顾性地研究了在澳大利亚新南威尔士州Bankstown-Lidcombe医院老年科住院治疗期间发生跌倒的患者,其中住院期间跌倒1次以... 详细信息

目的:探索导致老年患者住院期间反复跌倒的相关因素,焦点在其认知损伤的特点,目的是探索可借鉴的管理经验。方法:回顾性地研究了在澳大利亚新南威尔士州Bankstown-Lidcombe医院老年科住院治疗期间发生跌倒的患者,其中住院期间跌倒1次以上的70例、1次的269例,并随机抽取没发生过跌倒的70例为对照组。同时,分析了部分患者的简易智能检查量表(MMSE)总分和各亚项目分数。结果:住院老年患者反复跌倒的独立危险因素是痴呆、脑卒中、房颤和住院时间>5周,保护性因素有英语背景。反复跌倒的患者的MMSE分值明显低于单次跌倒和未发生跌倒的患者(分别为17.3±6.7,20.2±6.2,24.0±5.1,P<0.01),反复跌倒患者在"瞬间记忆"、"注意力和计算力"和"视空间结构"方面分值明显低于单次跌倒患者。结论:认知功能障碍是住院老年患者反复跌倒的主要原因,尤其是在瞬间记忆、延时记忆和视空间结构方面。老年人住院期间跌倒应规范管理,预防为主,尤其是认知功能损伤的患者。

关键词：住院患者老年人反复跌倒认知障碍