ABSTRACT
Objetivo: Estimar a prevalência, a incidência e os fatores associados a quedas entre idosos atendidos em uma clínica escola. Método: O estudo foi dividido em dois componentes, sendo o seguimento transversal de agosto de 2016 a novembro de 2018 (n=129), e o de coorte de agosto de 2018 a novembro de 2018 (n=66). Realizaram-se análises estatísticas, a partir da Regressão Múltipla de Poisson, entre o desfecho e as ca- racterísticas sociodemográficas e de saúde. Resultados: A prevalência e a incidência de quedas foram de 44,2% e 36,4%, respectivamente. Na análise de regressão múltipla de Poisson do estudo transversal, as variáveis sintomas dispépticos, baixos valores no teste Time Up and Go e ter hipertensão foram associadas com a variável queda. No estudo de coorte, a análise reforçou associação entre não ser ex-etilista e ter constipação. Conclu- são: Considera-se elevada a prevalência e incidência de quedas entre os idosos avaliados, e ressalta-se a necessidade de identificação de grupos mais susceptíveis a esse desfecho. PALAVRAS-CHAVE: Acidentes por Quedas; Sarcopenia; Fragilidade; Incidência; Fatores de Risco.
Objective: To estimate the prevalence, incidence and factors associated with falls among elderly people attended at a teaching clinic. Method: The study was divided into two components, the cross-sectional follow-up from August 2016 to November 2018 (n=129), and the cohort from August 2018 to November 2018 (n=66). Statistical analyzes were carried out, based on Multiple Poisson Regression, between the outcome and sociodemographic and health characteristics. Results: The prevalence and incidence of falls were 44.2% and 36.4%, respectively. In Poisson's multiple regression analysis of the cross-sectional study, the variables dyspeptic symptoms, low values in the Time Up and Go test and having hypertension were associated with the variable fall. In the cohort study, the analysis reinforced the association between not being an ex-alcoholic and having constipation. Conclusion: The prevalence and incidence of falls among the elderly evaluated is considered high, and the need to identify groups more susceptible to this outcome is emphasized.
Objetivo: Estimar la prevalencia, incidencia y factores asociados a las caídas entre ancianos atendidos en una clínica docente. Método: El estudio se dividió en dos componentes, el seguimiento transversal de agosto de 2016 a noviembre de 2018 (n=129), y la cohorte de agosto de 2018 a noviembre de 2018 (n=66). Se realizaron análisis estadísticos, basados en Regresión Múltiple de Poisson, entre el desenlace y las características sociodemográficas y de salud. Resultados: La prevalencia e incidencia de caídas fue de 44,2% y 36,4%, respectivamente. En el análisis de regresión múltiple de Poisson del estudio transversal, las variables síntomas dispépticos, valores bajos en el test Time Up and Go y padecer hipertensión se asociaron a la variable caída. En el estudio de cohortes, el análisis reforzó la asociación entre no ser ex-alcohólico y tener estreñimiento. Conclusiones: La prevalencia e incidencia de caídas entre los ancianos evaluados se considera elevada, destacándose la necesidad de identificar grupos más susceptibles a este desenlace.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Accidental Falls/statistics & numerical data , Aged/physiology , Risk Factors , Incidence , Prevalence , Cross-Sectional Studies/methods , Cohort Studies , Frail Elderly/statistics & numerical data , SarcopeniaABSTRACT
ObjectiveTo explore the risk factors of stroke， and to provide reference for the prevention and health management of stroke. MethodsFrom February 2022 to March 2022， four community residents over 60 years old with stroke in Shanghai were randomly selected as the case group （n=100）， and non-stroke residents were selected as the control group （n=100）. The survey was in the form of questionnaires to record and compare the age， body mass index （BMI）， blood lipids， blood pressure-related indicators， family history of other diseases， living habits， mood and sleep conditions of all subjects. The value of predicting the incidence of stroke among the elderly in Shanghai community was analyzed by receiver operating characteristic （ROC）， and the influencing factors of stroke were analyzed by logistic model. ResultsBMI， hypertension， heart disease， diabetes， transient ischemic attack （TIA）， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP， DBP， TG levels were significantly higher in the case group （P<0.05）. The level of HDL-C was significantly lower than that in the control group （P<0.05）. BMI， SBP， DBP， TG， HDL-C predicted the incidence of stroke by ROC analysis （P<0.05）. Logistic regression analysis showed that BMI≥23.820 kg·m-2， heart disease， diabetes， TIA， dyslipidemia， family history of stroke， smoking， lack of exercise or only light physical labor， SBP≥139.535 mmHg， DBP≥89.605 mmHg， TG≥1.565 mmol·L-1 and HDL-C≤1.105 mmol·L-1 were risk factors for stroke （P<0.05）. ConclusionPhysical health status including blood lipids and blood pressure， family history of certain diseases， and living habits could be important risk factors for stroke in the elderly in Shanghai community. Preventive intervention measures for the above factors have important clinical significance.
ABSTRACT
Objective:To investigate the relationship between waist circumference and hyperuricemia in occupational population in Changsha city.Methods:Based on a retrospective cohort design, a total of 1 197 employees from 70 organizations who received 4 or more years of continuous physical examinations in Xiangya hospital from January 1, 2014 to December 31, 2018 were included in this study. The physical examination data of the year 2014 were set as baseline data, while the data between January 1, 2015 and December 31, 2018 were used as follow-up data. According to interquartile range of the waist circumference, the subjects was divided into four groups: the first quartile ( Q1),<77 cm for men and <68 cm for women; the second quartile ( Q2), 77 cm ≤ and<82 cm for men, 68 cm ≤ and <73 cm for women; the third quartile ( Q3), 82 cm ≤ and <87 cm for men, 73 cm ≤and <78 cm for women; the fourth quartile ( Q4), ≥87 cm for men, ≥78 cm for women. Among them, Q1 was set as the control group, and Q2, Q3 and Q4 as the exposed groups. Three models were established for the total population, men and women, respectively. The confounding factors were not adjusted in model Ⅰ. The model Ⅱ was adjusted for age, gender and body mass index (the male or female population were not adjusted for sex). Confounders including age, gender, body mass index, hypertension, fasting glucose, blood creatinine, triacylglycerol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol were adjusted for model Ⅲ. Cox regression analysis was used to compare the hazard ratio ( HR), adjusted hazardratio (a HR) and their 95% CIs for the development of hyperuricemia in the subjects with different waist circumference over the 4 years. Results:Total of 1 197 subjects were followed-up for (2.05±1.18) years and 2 448 person-years. A total of 208 cases of hyperuricemia were identified in the total population during the 4 years (45 women/163 men), with a cumulative incidence of 17.4% (6.4% in women/33.3% in men) and an incidence density of 84.9/1 000 person-years (31.8/1 000 person-years in women, 157.6/1 000 person-years in men). And 626, 609, 629, and 584 person-years were followed-up in the 4 groups, respectively; with 15, 30, 59, and 104 cases of hyperuricemia occurred during 4 years, respectively. The cumulative incidence rates of hyperuricemia in the 4 yearswas 5.5%, 9.2%, 20.8% and 32.8%, respectively; and the incidence densities was 24.0/1 000 person-years, 49.3/1 000 person-years, 93.8/1 000 person-years and 178.1/1 000 person-years, respectively. Compared with that in the Q1 group, the risk of hyperuricemia was increased in the Q4 group, with a HR (95% CI) of 2.70 (1.81 to 4.04), P<0.05. After adjusted for confounding factors in the total population, the a HR (95% CI) of hyperuricemia was 2.12 (1.39 to 3.24), P<0.05. This risk remained when stratified by gender and adjusted for confounding factors. Compared with the Q1 group, the a HR (95% CI) of hyperuricemia in the Q4 group was 1.91 (1.18 to 3.09) for the male population and 2.93 (1.14 to 7.56) for the female population, respectively (both P<0.05). Conclusion:Among the occupational population, the risk of hyperuricemia increases with increase of waist circumference.
ABSTRACT
Abstract@#Ischemic stroke is characterized by high morbidity, disability and mortality. At present, there is a lack of effective treatment for ischemic stroke, so it is of great significance to reduce the incidence risk of ischemic stroke. Studies show that vitamin C can prevent atherosclerosis, thus reduce the incidence risk of ischemic stroke. However, this point is controversial due to the differences of study population, inconsistent evaluation methods of vitamin C content and the influence of various confounding factors. This paper reviews the related animal experiments, clinical trials and cohort studies, in order to provide reference for subsequent studies on reducing the incidence risk of ischemic stroke.
ABSTRACT
To establish a prediction model for 6-year incidence risk of chronic kidney disease (CKD) in the elderly aged 65 years and older in China. In this prospective cohort study, we used the data of 3 742 participants collected during 2008/2009-2014 and during 2012-2017/2018 from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. Two follow up surveys for renal function were successfully conducted for 1 055 participants without CKD in baseline survey. Lasso method was used for the selection of risk factors. The risk prediction model of CKD was established by using Cox proportional hazards regression models and visualized through nomogram tool. Bootstrap method (1 000 resample) was used for internal validation, and the performance of the model was assessed by C-index and calibration curve. The mean age of participants was (80.8±11.4) years. In 4 797 person years of follow up, CKD was found in 262 participants (24.8). Age, BMI, sex, education level, marital status, having retirement pension or insurance, hypertension prevalence, blood uric acid, blood urea nitrogen and total cholesterol levels and estimated glomerular filtration rate in baseline survey were used in the model to predict the 6-year incidence risk of CKD in the elderly. The corrected C-index was 0.766, the calibration curve showed good consistence between predicted probability and observed probability in high risk group, but relatively poor consistence in low risk group. The incidence risk prediction model of CKD established in this study has a good performance, and the nomogram can be used as visualization tool to predict the 6-year risk of CKD in the elderly aged 65 years and older in China.
ABSTRACT
Objective@#To establish a prediction model for 6-year incidence risk of chronic kidney disease (CKD) in the elderly aged 65 years and older in China.@*Methods@#In this prospective cohort study, we used the data of 3 742 participants collected during 2008/2009-2014 and during 2012-2017/2018 from Healthy Aging and Biomarkers Cohort Study, a sub-cohort of the Chinese Longitudinal Healthy Longevity Survey. Two follow up surveys for renal function were successfully conducted for 1 055 participants without CKD in baseline survey. Lasso method was used for the selection of risk factors. The risk prediction model of CKD was established by using Cox proportional hazards regression models and visualized through nomogram tool. Bootstrap method (1 000 resample) was used for internal validation, and the performance of the model was assessed by C-index and calibration curve.@*Results@#The mean age of participants was (80.8±11.4) years. In 4 797 person years of follow up, CKD was found in 262 participants (24.8%). Age, BMI, sex, education level, marital status, having retirement pension or insurance, hypertension prevalence, blood uric acid, blood urea nitrogen and total cholesterol levels and estimated glomerular filtration rate in baseline survey were used in the model to predict the 6-year incidence risk of CKD in the elderly. The corrected C-index was 0.766, the calibration curve showed good consistence between predicted probability and observed probability in high risk group, but relatively poor consistence in low risk group.@*Conclusion@#The incidence risk prediction model of CKD established in this study has a good performance, and the nomogram can be used as visualization tool to predict the 6-year risk of CKD in the elderly aged 65 years and older in China.
ABSTRACT
Introduction: Our objectives are to identify the incidence of hypophosphatemia and the associated risk factors. We also want to establish intravenous replacement therapy that is effective for ICU patients. Methods: A prospective observational study assessing adults admitted to ICU in between March and May 2009. All patients without baseline phosphate level and renal failure were excluded. They were evaluated for the occurrence of common risk factors. Association with independent variables that includes age, gender and BMI were verified. Evaluation of IV replacement therapy was done in the treated patients. Results: From 50 patients that were reviewed, nine were excluded. There were 66% male and 34% female with mean age 46.88±17.89. The mean ICU stay was 8.00±6.41 days. The incidence of hypophosphatemia was 29% (n=12/41). Gender and creatinine clearance was found to be significantly different between normophosphatemia and hypophosphatemia patients. There was no significant association for each potential risk factor and the number of risk factors (≥3) with the incidence of hypophosphatemia. Multi-linear regression analysis showed that lactate, creatinine clearance and pH were significant predictors to the serum levels. A significant difference of mean serum phosphate was seen after repletion by total dose of 10, 20 and 40 mmols in the treatment subgroups. Conclusions: The incidence of hypophosphatemia in our ICU was high and comparable to previous studies. None of the commonly reported risk factors is associated with hypophosphatemia in this studied population. Among all significant correlated variables, only pH was found to be a significant predictor for serum phosphate. Baseline phosphate level may guide the initial replacement dose to prevent delay in normalization of serum levels.
ABSTRACT
Background: Post-traumatic seizure is a well-known and serious complication of traumatic brain injury (TBI). The incidence and risk factors vary among study populations. Very little data have been published concerning this in the Malaysian population. The aim of this study was to ascertain the risk factors for the development of early post-traumatic seizures among patients with TBI. Methods: This was a prospective observational study, carried out in Hospital Universiti Sains Malaysia, Kubang Kerian, Kelantan, under the Department of Neurosciences. A total of 157 patients, from all age groups, who were diagnosed with TBI were enrolled from June 2007 to December 2007. They were followed-up for 12 months until death or their first post-traumatic seizure. Survival analysis with Kaplan–Meier curves and Cox proportional hazards regression was performed. Results: A total of 11 (7.0%) of the patients developed early post-traumatic seizures. The risk factors for early post-traumatic seizures were young age (P = 0.021, 95% CI 0.806 to 0.982) and intubated patients (P = 0.029, 95% CI 1.194 to 25.913). The incidence of early post-traumatic seizures in the local population was 7.0%. Conclusion: The incidence of early post-traumatic seizures in the local population of Kelantan and Terengganu is comparable to the incidences reported elsewhere. Younger as well as intubated patients were at a higher risk of developing this condition. It may be necessary to give antiepileptic prophylaxis because any seizure could adversely affect morbidity and mortality. However, the study showed that antiepileptic drug was not beneficial in preventing late post-traumatic seizures, but may have a role in preventing early seizures.