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Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer:A real-world population-based study

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World Journal of Cardiology 2024年第8期16卷 458-468页

作者： Jia-Yu Tan Shuo-Hao Shen Department of Medical Ultrasound The First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan HospitalJinan 250000Shandong ProvinceChina Department of General Surgery Qilu Hospital of Shandong UniversityJinan 250000Shandong ProvinceChina

BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer(CRC).Cardiovascular disease(CVD)-specific mortality is the second-most frequent cause of *** risk factors for CVDspecific mortality among older patients with CRC are still poorly *** To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with *** The data on older patients diagnosed with CRC were retrieved from The Surveillance,Epidemiology,and End Results database from 2004 to *** prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox *** A total of 141251 eligible patients with CRC were enrolled,of which 41459 patients died of CRC and 12651 patients died of *** age at diagnosis,sex,marital status,year of diagnosis,surgery,and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with *** used these variables to develop a model to predict CVD-specific *** calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual *** C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734,*** The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with *** model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.

关键词： older patients Colorectal cancer Cardio-oncology Nomogram Outcome

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Low-level laser acupuncture reduces postoperative pain and morphine consumption in older patients with total knee arthroplasty: A randomized placebo-controlled trial

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Journal of Integrative Medicine 2022年第4期20卷 321-328页

作者： Chiung-Hui Huang Mei-Ling Yeh Fang-Pey Chen Daphne Wu Department of Nursing Taipei Veterans General HospitalTaipei City 11217TaiwanChina School of Nursing National Taipei University of Nursing and Health SciencesTaipei City 11219TaiwanChina Center for Traditional Medicine Taipei Veterans General HospitalTaipei City 11217TaiwanChina Scool of Nursing National Taipei University of Nursing and Health Sciences and School of MedicineTaipei City 11217TaiwanChina

Background: patients commonly develop postoperative pain after total knee arthroplasty(TKA).Acupuncture-related techniques and low-level laser therapy could be beneficial for pain management for older ***: To examine the effect of low-level laser acupuncture(LA) in reducing postoperative pain, painrelated interference in daily life, morphine consumption, and morphine-related side effects in older patients with knee osteoarthritis who underwent ***, setting, participants and intervention: A single-blind randomized placebo-controlled trial was conducted. patients(N = 82) were recruited and randomly assigned via a computer-generated list to the LA group or a placebo group. The LA group received low-level laser therapy at Sanyinjiao(SP6), Taixi(KI3),Kunlun(BL60), Fengshi(GB31), Futu(ST32) and Neiguan(PC6) after TKA, while the placebo acupuncture group received the same treatment procedure without laser energy *** outcome measures: The primary outcome was postoperative pain intensity, and it was measured at baseline and hours 2, 6, 10, 24, 48 and 72 after TKA. The secondary outcomes, including relative pain,postoperative pain-related interference in daily life and morphine consumption, were measured at hours24, 48 and 72 after ***: Generalized estimating equations revealed significant between-group differences in pain intensity(P = 0.01), and trend differences in pain intensity for the LA group starting at hours 10 to 72(P older patients’ postoperative pain intensity and morphine consumption within the first 72 h after their TKA for osteoarthritis. Low-le

关键词： Acupuncture Morphine Low-level laser older patients Osteoarthritis Pain Total knee arthroplasty Randomized controlled trial

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Clinical outcomes of Clutch Cutter endoscopic submucosal dissection for older patients with early gastric cancer

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World Journal of Gastrointestinal Oncology 2017年第10期9卷 416-422页

作者： Yoshihiro Otsuka Kazuya Akahoshi Kayoko Yasunaga Masaru Kubokawa Junya Gibo Shigeki Osada Kayo Tokumaru Kazuaki Miyamoto Takao Sato Yuki Shiratsuchi Masafumi Oya Hidenobu Koga Eikichi Ihara Kazuhiko Nakamura Department of Gastroenterology Aso Iizuka Hospital Diagnosis Procedure Combination Coding Management Office Aso Iizuka Hospital Department of Pathology Aso Iizuka Hospital Clinical Research Supportive Office Aso Iizuka Hospital Department of Medicine and Bioregulatory Science Graduate School of Medical SciencesKyushu University

AIM To evaluate the clinical outcome of endoscopic submucosal dissection using the Clutch Cutter(ESDCC) in older patients. METHODS We reviewed 232 consecutive patients with early gastric cancer who underwent ESDCC between June 2010 and February 2014 at Aso Iizuka Hospital. We divided patients into two groups according to age: older patients(> 80 years, n = 64) and non-older patients(≤ 80 years, n = 168). We retrospectively compared the prevalence rates of pre-existing comorbidities, anticoagulant therapy, en bloc resection, mean duration of hospitalization, incidence of ESDCC-related complications, change in performance status(PS) before and after ESDCC, and financial cost of admission. RESULTS The older group comprised 64 patients with a mean age of 84.1 years, and the non-older group comprised 168 patients with a mean age of 69.5 years. older patients had significantly more pre-existing comorbidities than did non-older patients, specifically heart disease(P older patients was significantly higher than that in older patients(100% vs 95.3%, P = 0.02). There were no significant differences between the older and non-older groups in the incidence of ESDCC-related complications(i.e., postoperative bleeding and perforation) and the post-ESDCC change in PS. There were also no significant differences between the older and non-older groups in the mean duration of hospitalization(11.4 and 10.7 d, respectively) and financial cost of admission(657040 JPY and 574890 JPY, respectively).CONCLUSION ESDCC has a good clinical outcome in older patients.

关键词： older patients Clutch Cutter Endoscopic submucosal dissection Early gastric cancer Financial cost Duration of hospitalization

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The Systemic Immune Inflammatory Index Predicts No-Reflow Phenomenon after Primary Percutaneous Coronary Intervention in older patients with STEMI

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Cardiovascular Innovations and Applications 2023年第1期7卷 16-24页

作者： Jiaqi Wang Feifei Zhang Man Gao Yudan Wang Xuelian Song Yingxiao Li Yi Dang Xiaoyong Qi Hebei North University ZhangjiakouHebei ProvinceChina Department of Cardiology Hebei General HospitalShijiazhuang 050051Hebei ProvinceChina Department of Cardiology Tianjin Chest HospitalTianjin300222China

Purpose:Coronary no-reflow phenomenon(NRP),a common adverse complication in patients with ST-segment eleva-tion myocardial infarction(STEMI)treated by percutaneous coronary intervention(PCI),is associated with poor patient *** this study,the correlation between the systemic immune-inflammation index(SII)and NRP in older patients with STEMI was studied,to provide a basis for early identification of high-risk patients and improve their *** and methods:Between January 2017 and June 2020,578 older patients with acute STEMI admitted to the Department of Cardiology of Hebei General Hospital for direct PCI treatment were selected for this retrospective *** were divided into an NRP group and normal-flow group according to whether NRP occurred during the *** data and the examination indexes of the two groups were *** regression was used to analyze the independent predictors of NRP,and the receiver operating characteristic curve was used to further analyze the ability of SII to predict NRP in older patients with ***:Multivariate logistic analysis indicated that hypertension(OR=2.048,95%CI:1.252–3.352,P=0.004),lymphocyte count(OR=0.571,95%CI:0.368–0.885,P=0.012),platelet count(OR=1.009,95%CI:1.005–1.013,Polder patients with *** operating characteristic curve analysis demonstrated that SII had a high predictive value for NRP(AUC=0.738;95%CI:0.686–0.790),with the best cut-off value of 1814,a sensitivity of 52.85%and a specificity of 85.71%.Conclusion:For older patients with STEMI undergoing primary PCI,SII is a valid predictor of NRP.

关键词： no-reflow systemic immune-inflammation index older patients ST-segment elevation myocardial infarction

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Managing the Needs of older patients with Multimorbidity—A Systematic Review of the Challenges Faced by the Healthcare Services

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Open Journal of Nursing 2016年第10期6卷 881-901页

作者： Anne Lise Holm Astrid Karin Berland Elisabeth Severinsson Department of Health Science Stord/Haugesund University College Stord Norway Centre for Women’s Family and Child Health Faculty of Health Sciences University College of Southeast Norway Kongsberg Norway

Research fails to provide an overview of the challenges involved in caring for older patients with multimorbidity. Multimorbidity is defined as the presence of two or more chronic conditions in the same person, leading to a high risk of care dependency. The aim of this review was to illuminate the challenges faced by the healthcare services in managing the needs of older patients with multimorbidity. A systematic review was performed, a total of 1,965 abstracts were read and nine quantitative studies included. Data were analysed by thematic synthesis, revealing six themes: A frequent problem in older female patients;High healthcare expenditure and costs, Medication management problems, Social inequities, Complex healthcare and consultation needs and High mortality. The study highlights that healthcare professionals struggle to obtain suitable guidelines for the care of patients with multimorbidity while trying to respond to their needs. Patient-centred integration across settings and coordination in clinical practice are necessary. The healthcare system today does not seem to focus on patient safety and preventing harm. older patients should be reviewed by a healthcare professional responsible for coordinating their care. To ensure safe and effective care for elderly persons with multimorbidity, the healthcare services should abandon the current focus on managing innumerable individual diseases and conditions.

关键词： Healthcare Services Multimorbidity older patients Systematic Review Thematic Synthesis

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Continuing Care for older patients During the Transitional Period

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Chinese Nursing Research 2014年第1期1卷 1-13页

作者： Si-Yuan Wang Yue Zhao Xiao-Ying Zang School of Nursing Tianjin Medical University

Background： The world is facing increasing pressure with the continuous growth of the older population. older patients are usually discharged with complex medical problems, high stress and vulnerability, and these factors place the elderly at risk for poor outcomes. Purpose： The present review summarizes a method for providing appropriate and affordable health services by nursing professionals to meet older patient＇s health care needs during their transitional period which is defined as a period from discharge after hospitalization for a major disorder to recovery in a home setting. Summary： older patients with chronic diseases need seamless health care during a transitional period-a highly stressful and vulnerable period for them. Nurse professionals can conduct decent discharge planning to assist older patients with transitional problems through continuous healthcare. This review summarized the need of continuing care for older patients during the transitional period, the definition of discharge planning, the conceptual framework of discharge planning, and the professionals involved in discharge planning. It also highlighted the problems of discharge planning and follow-up intervention implementation in the mainland of China. Clinical implications： Inadequate discharge planning and follow-up were leading factors associ- ated with the readmission of discharged older patients. Further nursing-led discharge planning should be reinforced in China.

关键词： older patients Continuing care Transitional care Multidisciplinary Nurse-led Adherence

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Benefits and Safety of Tirofiban among older patients With Non-ST-elevation Acute Coronary Syndrome Who Underwent Percutaneous Coronary Intervention

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South China Journal of Cardiology 2009年第3期10卷 120-125页

作者：何鹏程谭宁陈纪言周颖玲罗建方陈竹君 Department of Cardiology Guangdong Cardiovascular InstituteGuangdong Academy of Medical SciencesGuangdong General Hospital

Background Glycoprotein （GP） Ⅱb/Ⅲa antagonist has been shown its efficacy and safety in high-risk patients with acute coronary syndrome （ACS） who underwent percutaneous coronary intervention （PCI）. Whether GP Ⅱb/Ⅲa antagonist is as effective and safe in older patients （ ≥ 65 years old ） as in younger patients remains unclear. Objectives Our objective was to determine whether GP Ⅱb/Ⅲa antagonist tirofiban was effective and safe in patients aged ≥65 years who underwent PCI. Methods From September 2006 to August 2008, 622 patients with non-ST-elevation ACS （NSTE ACS） were randomized to receive either tirofiban （n = 313 ） or placebo （n = 309）. The infusion duration was 48 hours for both groups. Incidence of major adverse cardiac events （MACE） was assessed at 180 days. Incidence of bleeding was monitored through 24 hours after trial therapy was discontinued. Results The incidence of MACE for the tirofiban group versus the placebo group was 7.3% vs 12. 6% （P 〈0. 05）. Among these MACE, death rate was 2.6% vs 4. 6 % （ P = 0. 198 ）, non-fatal MI was 3.8 % vs 6.5 % （ P = 0. 150）, and target vessel revascularization was 1.3% vs 1.6% （P =0. 751 ）, in the two groups, respectively. The total bleeding rate for the tirofiban group versus the placebo group was 28.1% vs 6.8% （P 〈0. 05 ）. The TIMI major and minor bleeding rates for the tirifiban versus the placebo group were 2.2% vs 1.6% （ P 〉 0. 05 ） and 25.9% vs 5.2% （ P 〈 0. 05 ）, respectively. Conclusions Tirofiban appears to be effective and safe in older patients with ACS who underwent PCI.

关键词： older patients non-ST-elevation acute coronary syndrome tirofiban

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A Spider in a Broken Web:Nurses’Views on Discharge Planning for older patients after Hip Fracture Surgery Who Live in their Own Homes in Rural Areas

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Open Journal of Nursing 2018年第7期8卷 405-418页

作者： Cecilia Segevall Kerstin Bjorkman Randstrom Siv Soderberg Department of Nursing Sciences Mid Sweden UniversityOstersundSweden

Introduction: The in-hospital rehabilitation of patients who have undergone surgery for hip fracture requires a team-based effort, in which nurses play an all-embracing role throughout the patients’ hospital stays. Although discharge planning has been widely studied, little is known about discharge planning from hospitals to homes in rural settings. Aim: To describe nurses’ views on discharge planning for older patients after hip fracture surgery who live in their own homes in rural areas. Methods: A qualitative method was used. Four focus group interviews were conducted with 18 nurses who work at an orthopaedic clinic. The interview texts were analysed with qualitative content analysis. Findings: Nurses expressed that patients needed support from healthcare personnel as well as relatives in order to prepare for life at home. They also expressed that patients were not supported in all aspects of discharge planning because they faced difficulties in having their voices heard. Nurses described that many of those aspects were beyond their own control, which had left them with little to non-ability to influence discharge planning. Findings additionally indicate that discharge planning seems not affected by occurring in rural settings. Conclusions: Although discharge planning is intended to meet the unique wishes and needs of each patient given the realities of existing resources, nurses’ responsibilities in discharge planning are unclear. This study shows an organisation in which healthcare personnel continue to make decisions for patients. Significance for nurses to perform a discharge planning that support patients’ participation seems to be a communication based on shared understanding.

关键词： Discharge Planning Nurses older patients Rural Area Qualitative Method

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Manual reduction with traditional small splints for distal radius fracture in older patients

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Journal of Acute Disease 2021年第2期10卷 78-82页

作者： Li-You Wei Hong-Wei Zhang De-Hong Dong Jin-Zeng Zuo Liang Li Guo-Qiang Wang Hua Chen Xin Geng Cheng Jiao Li-Jun Chen Hui Guo Yu-Long Zhang Lin Rong Jing Zhang Department of Orthopedics the Second Hospital of Tangshan(Orthopaedic Hospital Affiliated to North China University of Science and Technology)Tangshan 063000China Department of Orthopedics the People's Hospital of TangshanTangshan 063000China

Objective:To investigate the effect of manual reduction with traditional small splints fixation for distal radius fractures in older patients in the emergency ***:older patients(aged at least 60 years)with distal radius fractures were enrolled in this *** patients were randomly divided into the treatment group and the control *** treatment group was treated with manual reduction and small splints *** control group was treated with manual reduction and resin plaster *** treatment,after reduction,and 3 months after treatment,the palmar tilt angle,ulnar deviation angle,and radial length were *** treatment and 3 months after treatment,the Cooney wrist joint scores were *** time of fracture healing and related adverse events during the treatment were ***:Before treatment and after reduction,there were no statistically significant differences between the two groups in palmar tilt angle,ulnar deviation angle,or radial length(P>0.05).Three months after treatment,the palmar tilt angle,ulnar deviation angle,and radial length of the treatment group were better than those of the control group(P0.05).Conclusions:Compared with resin plaster fixation,traditional small splints fixation for distal radius fractures in older patients have the advantages of less loss of fracture reduction and faster functional ***,the method is simple and low cost thus,it needs to be promoted.

关键词： Traditional small splint Distal radius fracture older patients External fixation

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Total en-bloc surgery treats older patients with solitary spinal metastases

Total en-bloc surgery treats older patients with solitary sp...

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2019楚天骨科高峰论坛暨第二十六届中国中西医结合骨伤科学术年会

作者：董健刘鹏江立波梁运王厚磊周皓李熙雷林红周晓岗复旦大学附属中山医院骨科

Objective: Due to radical resection, total en-bloc spondylectomy(TES) is associated with significant levels of surgical injury and spinal instability, particularly in elderly patients with solitary spinal metastases(SM), whether the possible benefits outweigh the risk requires intense consideration. Our aim was to compare and analyze the impact of age on patient ***: This study investigated TES in 78 consecutive patients with solitary SM,who were divided into Group A(> 65 years, n=32) and group B(0.05). Furthermore, there was no significant difference in the median survival time between the two groups(p > 0.05). However, the perioperative complication rate in group A was higher than that in group B(p 0.05), and there were no significant differences in terms of improvements in neurological function, Visual Analogue Scale and Karnofsky scores of patients between the two groups(p > 0.05).Conclusion: older patients can experience survival and local recurrence rates that were similar to those of younger patients. Although older patients are at increased risk of perioperative complications, this factor does not appear to lead to serious adverse outcomes. older patients are still good candidates to receive TES to cure solitary SM after careful preparation and strict selection.

关键词： Total en-bloc surgery solitary spinal metastases older patients prognosis

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