Application Value and Safety Analysis of Warfarin, Rivaroxaban, and Dabigatran Ester in Elderly Patients With Atrial Fibrillation.

BACKGROUND: This study aimed to evaluate the application value and safety of Warfarin, Rivaroxaban, and Dabigatran in elderly patients with atrial fibrillation. METHODS: A total of 180 elderly patients with atrial fibrillation admitted to our hospital were retrospectively analyzed. According to their anticoagulant treatment regimen, patients were divided into three groups: Warfarin (57 cases), Rivaroxaban (61 cases), and Dabigatran (62 cases). General demographic information was collected, and coagulation function indicators-including fibrinogen (FIB), thrombin time (PT), activated partial thrombin time (APTT), and D-dimer (D-D)-as well as liver function indexes-including total bilirubin (TbiL), alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine transferase (ALT)-were compared before and after 4 weeks of treatment. RESULTS: There were no significant differences in demographic characteristics such as gender, age, body mass index, or disease course among the three groups. The total effective rate in the Warfarin group (84.21%) was significantly lower than in the Rivaroxaban (98.36%) and Dabigatran (96.77%) groups (p < 0.05). However, there was no significant difference in the total effective rate between the Rivaroxaban and Dabigatran groups (p > 0.05). Additionally, no significant differences were found in the effects of the three drugs on coagulation function, liver function, or the incidence of bleeding (p = 0.052). CONCLUSION: Warfarin, Rivaroxaban, and Dabigatran can effectively prevent thrombosis in elderly patients with atrial fibrillation, with Rivaroxaban and Dabigatran showing superior effectiveness. All three drugs demonstrated similar low rates of bleeding events and had no significant impact on coagulation and liver function.

Post-discharge Follow-up of Standardized Management for Patients with Post-stroke Cognitive Impairment.

Context: Severe cases of stroke can lead to cognitive impairment or even dementia. The most critical factor related to cognitive impairment after strokes is patients' lack of understanding about or attention to their conditions. Strengthening standardized management post-stroke has become a common goal for clinical workers and patients. Objective: The study intended to explore, during post-discharge follow-up, the effectiveness of standardized management of patients with post-stroke cognitive impairment, which could provide guidance for patients and doctors to improve patients' follow-up plans. Design: The research team conducted a randomized controlled trial. Setting: The study took place at Huangshi Central Hospital, an Affiliated Hospital of Hubei Polytechnic University, Edong Healthcare Group, in Huangshi, Hubei, China. Participants: Participants were 112 patients with post-stroke cognitive impairment at the hospital between February 2021 and March 2023. Intervention: The research team randomly divided the participants into two groups, using a random-number-table method: (1) a control group with 56 participants who received routine management and (2) an intervention group with 56 participants who received standardized management. Outcome Measures: At baseline and 6 months postintervention, the research team measured participants': (1) cognitive function using the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), (2) quality of life (QoL) using the World Health Organization Quality of Life-Bref (WHOQOL-BREF) questionnaire, and (3) self-efficacy using the General Self-Efficacy Scale (GSES). At one and 6 months postintervention, the team analyzed participants' medication adherence using the Morisky Medication Adherence Scale (MMAS-8). Results: At baseline, no significant difference (P > .05) existed between the groups in the scores: (1) for cognitive function on the MMSE or MoCA, (2) for the physiological, psychological, social, and environmental domains and the total score on the WHOQOL-BREF, or (3) for self-efficacy on the GSES scores. At 6 months postintervention, the intervention group's scores were significantly higher than those of the control group: (1) on the MMSE and MoCA (both P < .001), (2) on the four domains and total score on the WHOQOL-BREF (all P < .001), and (3) on the GSES (P < .001). At one month and six months postintervention, the intervention group's score for medication adherence on the MMAS-8 was significantly higher than those of the control group (both P < .001). Conclusions: Standardized management for patients with post-stroke cognitive impairment provided beneficial outcomes in improving their cognitive function, QoL, self-efficacy, and medication adherence, and the research team highly recommends it for wide application in clinical practice.

Effects of balance training in addition to auxiliary activity on balance function of patients with stroke at high risk for falls.

Objective: The aim of this study was to investigate the effect of balance training in addition to auxiliary activity on the balance function of patients with stroke at high risk for falls. Methods: A total of 112 patients with stroke at high risk for falls in our hospital from inception to January 2020 to December 2020 were selected as the research objects who were equally divided into the control group and study group according to the random number table method. Patients in the control group were intervened with auxiliary activity, and the patients in the study group received additional balance training for auxiliary activity. The balance function, lower extremity motor function, fall risk, walking ability, and other indicators were compared between the two groups of patients before and after treatment. The hospitalization time and the frequency of falls 3 months after discharge were also compared between the two groups. Results: Before treatment, there was no significant difference in balance function, lower extremity motor function, fall risk, and walking ability scores between the two groups (P > 0.05). After 3 months of treatment, the balance function, lower extremity motor function, and walking ability scores of the study group were significantly higher than those of the control group, with the fall risk score significantly lower than that of the control group (P < 0.05). Evidently, lower hospitalization time and the frequency of falls in the 3-month follow-up of the study group were observed than those in the control group (P < 0.05). However, there was no significant difference in the frequency of falls between the two groups during hospitalization (P > 0.05). Conclusion: Our results indeed revealed that balance training in addition to auxiliary activity elicited beneficial outcomes in terms of effectively improving the balance function and walking ability of patients with stroke at high risk of falling, which may have the potential for wide clinical application.