Background: Previous studies have suggested that triglyceride glucose-body mass index (TyG-BMI) is associated with cardiovascular mortality in patients undergoing peritoneal dialysis. However, the predictive value of TyG-BMI in the prognosis of acute myocardial infarction (AMI) remains unclear. Methods: In total, 408 AMI patients who underwent PCI were consecutively included in this study. All included patients were then divided into three groups according to tertiles of TyG-BMI. The association between TyG-BMI and major adverse cardiovascular and cerebrovascular events (MACCEs) were investigated. Results: Participants were divided into three groups: tertile 1(≤ 199.4, n=136), tertile 2 (199.4– 231.8, n=136), and tertile 3 (≥ 231.8, n=136). Eighty (19.6%) patients had MACCEs: 18 (13.2%) in tertile 1, 26 (19.1%) in tertile 2, and 36 (25.7%) in tertile 3. The incidence of MACCEs increased as the tertiles of TyG-BMI increased (p< 0.05). Multivariate Cox regression analysis revealed that diabetes mellitus and TyG-BMI were independent predictors of MACCEs in AMI patients after PCI (p< 0.05). The receiver operating characteristic (ROC) curve showed that when TyG-BMI was ≥ 192.4, the sensitivity and specificity were 60.1% and 65.4%, respectively, and the area under the ROC curve (AUC) was 0.632 (95% confidence interval [CI]: 0.562– 0.703; p < 0.001). Conclusion: Elevated TyG-BMI level was an independent predictor of the composite MACCEs in patients with AMI after PCI.
{"title":"Triglyceride Glucose Body Mass Index as 3 Year Prognostic Indicator for Major Adverse Cardiovascular and Cerebrovascular Events in Patients with Acute Myocardial Infarction After PCI: A Prospective Cohort Study","authors":"Yan Yang, Yong Wang, Xiao-Yang Pei","doi":"10.2147/cia.s473481","DOIUrl":"https://doi.org/10.2147/cia.s473481","url":null,"abstract":"<strong>Background:</strong> Previous studies have suggested that triglyceride glucose-body mass index (TyG-BMI) is associated with cardiovascular mortality in patients undergoing peritoneal dialysis. However, the predictive value of TyG-BMI in the prognosis of acute myocardial infarction (AMI) remains unclear.<br/><strong>Methods:</strong> In total, 408 AMI patients who underwent PCI were consecutively included in this study. All included patients were then divided into three groups according to tertiles of TyG-BMI. The association between TyG-BMI and major adverse cardiovascular and cerebrovascular events (MACCEs) were investigated.<br/><strong>Results:</strong> Participants were divided into three groups: tertile 1(≤ 199.4, n=136), tertile 2 (199.4– 231.8, n=136), and tertile 3 (≥ 231.8, n=136). Eighty (19.6%) patients had MACCEs: 18 (13.2%) in tertile 1, 26 (19.1%) in tertile 2, and 36 (25.7%) in tertile 3. The incidence of MACCEs increased as the tertiles of TyG-BMI increased (p< 0.05). Multivariate Cox regression analysis revealed that diabetes mellitus and TyG-BMI were independent predictors of MACCEs in AMI patients after PCI (p< 0.05). The receiver operating characteristic (ROC) curve showed that when TyG-BMI was ≥ 192.4, the sensitivity and specificity were 60.1% and 65.4%, respectively, and the area under the ROC curve (AUC) was 0.632 (95% confidence interval [CI]: 0.562– 0.703; p < 0.001).<br/><strong>Conclusion:</strong> Elevated TyG-BMI level was an independent predictor of the composite MACCEs in patients with AMI after PCI.<br/><br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nesreen Alissa, Andrea Goldstein Shipper, Lindsay Zilliox, Kelly P Westlake
Background: Falls are a significant issue in people with diabetic peripheral neuropathy. Balance interventions have been broadly administered in individuals with diabetic peripheral neuropathy, but the effects on static and dynamic balance in those who are at risk of falling have not yet been comprehensively reviewed. Objective: To provide a synthesis of the literature regarding the effectiveness of physical rehabilitation interventions to improve balance in people with diabetic peripheral neuropathy who are at risk of falling. Methods: Four databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, Cumulated Index in Nursing and Allied Health Literature) were systematically searched from inception to July 2022. Articles meeting the eligibility criteria (ie, participants with diabetic peripheral neuropathy and at risk of falling based on validated fall balance outcome risk cut off scores; inclusion of physical rehabilitation intervention) underwent a quality assessment using the Physiotherapy Evidence Database scale. Data regarding fall risk was extracted. Results: Sixteen studies met the eligibility criteria. Participants in six studies improved balance such that their fall risk was reduced from a moderate-high risk of falls to no or low risk of falls from pre- to post-intervention. Interventions within these six studies were variable and included balance exercise, gait training, endurance, tai-chi with mental imagery, proprioceptive training, aerobic training, and yoga. Participants in seven of the remaining studies showed no improvement and participants in three studies showed mixed results regarding improved balance and reduced fall risk status by post-intervention. Conclusion: While physical rehabilitation is sufficient to improve balance in individuals with diabetic peripheral neuropathy who are at risk of falling, few interventions led to improved balance and reduced fall risk. Interventions involving intentional weight shifting, manipulation of the base of support, and displacement of the center of mass such as tai-chi and yoga appear to provide the most consistent results in terms of decreasing fall risk. To better understand the effectiveness of rehabilitation on balance and fall risk, future studies should examine the impact of physical interventions on prospective fall rates.
背景：跌倒是糖尿病周围神经病变患者的一个重要问题。平衡干预已在糖尿病周围神经病变患者中广泛实施，但对有跌倒风险的患者的静态和动态平衡的影响尚未进行全面审查：综述有关物理康复干预对改善有跌倒风险的糖尿病周围神经病变患者平衡能力的有效性的文献：方法：系统检索了从开始到 2022 年 7 月的四个数据库（PubMed、Embase、Cochrane Central Register of Controlled Trials、Cumulated Index in Nursing and Allied Health Literature）。符合资格标准的文章（即参与者患有糖尿病周围神经病变，且根据经验证的跌倒平衡结果风险截断分数有跌倒风险；包含物理康复干预措施）均使用物理治疗证据数据库量表进行了质量评估。提取了有关跌倒风险的数据：结果：16 项研究符合资格标准。有六项研究的参与者平衡能力得到改善，因此从干预前到干预后，他们的跌倒风险从中度-高度跌倒风险降至无跌倒风险或低跌倒风险。这六项研究的干预措施各不相同，包括平衡锻炼、步态训练、耐力训练、太极拳与心理想象、本体感觉训练、有氧训练和瑜伽。其余七项研究的参与者在干预后的平衡能力改善和跌倒风险降低方面没有任何改善，三项研究的参与者在改善平衡能力和降低跌倒风险方面的结果不一：结论：虽然物理康复足以改善有跌倒风险的糖尿病周围神经病变患者的平衡能力，但很少有干预措施能改善平衡能力并降低跌倒风险。在降低跌倒风险方面，太极拳和瑜伽等涉及有意转移重心、操纵支撑基础和移动质心的干预措施似乎能提供最一致的效果。为了更好地了解康复治疗对平衡和跌倒风险的效果，未来的研究应考察物理干预对预期跌倒率的影响。
{"title":"A Systematic Review of the Effect of Physical Rehabilitation on Balance in People with Diabetic Peripheral Neuropathy Who are at Risk of Falling","authors":"Nesreen Alissa, Andrea Goldstein Shipper, Lindsay Zilliox, Kelly P Westlake","doi":"10.2147/cia.s459492","DOIUrl":"https://doi.org/10.2147/cia.s459492","url":null,"abstract":"<strong>Background:</strong> Falls are a significant issue in people with diabetic peripheral neuropathy. Balance interventions have been broadly administered in individuals with diabetic peripheral neuropathy, but the effects on static and dynamic balance in those who are at risk of falling have not yet been comprehensively reviewed.<br/><strong>Objective:</strong> To provide a synthesis of the literature regarding the effectiveness of physical rehabilitation interventions to improve balance in people with diabetic peripheral neuropathy who are at risk of falling.<br/><strong>Methods:</strong> Four databases (PubMed, Embase, the Cochrane Central Register of Controlled Trials, Cumulated Index in Nursing and Allied Health Literature) were systematically searched from inception to July 2022. Articles meeting the eligibility criteria (ie, participants with diabetic peripheral neuropathy and at risk of falling based on validated fall balance outcome risk cut off scores; inclusion of physical rehabilitation intervention) underwent a quality assessment using the Physiotherapy Evidence Database scale. Data regarding fall risk was extracted.<br/><strong>Results:</strong> Sixteen studies met the eligibility criteria. Participants in six studies improved balance such that their fall risk was reduced from a moderate-high risk of falls to no or low risk of falls from pre- to post-intervention. Interventions within these six studies were variable and included balance exercise, gait training, endurance, <em>tai-chi</em> with mental imagery, proprioceptive training, aerobic training, and yoga. Participants in seven of the remaining studies showed no improvement and participants in three studies showed mixed results regarding improved balance and reduced fall risk status by post-intervention.<br/><strong>Conclusion:</strong> While physical rehabilitation is sufficient to improve balance in individuals with diabetic peripheral neuropathy who are at risk of falling, few interventions led to improved balance and reduced fall risk. Interventions involving intentional weight shifting, manipulation of the base of support, and displacement of the center of mass such as <em>tai-chi</em> and yoga appear to provide the most consistent results in terms of decreasing fall risk. To better understand the effectiveness of rehabilitation on balance and fall risk, future studies should examine the impact of physical interventions on prospective fall rates.<br/><br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"34 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mengli Li, Tongtong Yin, Jiaying Qi, Minhao Shi, Fangfang Wang, Zhiyu Mao, Hui Zhang, Li Wang
Objective: To explore the cut-off values and health evaluations of upper arm circumference (AC) and calf circumference (CC) on sarcopenia in Chinese community-dwelling older people. Methods: In this cross-sectional study, AC, CC, handgrip strength, muscle mass and gait speed were measured in 1537 Chinese community-dwelling older people in Sub-study 1. Correlation analysis, receiver operator characteristic curve (ROC curve) analysis, and consistency analysis were used for determination of AC and CC cut-off values for sarcopenia diagnosis (sarcopenia-AC and CC). Thereafter, 269 participants accepted additional assessments on physical function, body composition and muscle strength in Sub-study 2. T-test or Mann-Whitney U-test was used to explore the differential effects of sarcopenia-AC and CC on health indicators between sarcopenic and non-sarcopenic participants. Results: In Sub-study 1, the Area Under ROC (AUC) of AC and CC for sarcopenia screening were greater than 0.700 (P< 0.05). The cut-off values, sensitivity and specificity of AC and CC on sarcopenia in males were 25.9 cm (86.0%, 83.6%) and 33.7 cm (90.7%, 81.4%) whereas in females were 26.5 cm (70.8%, 69.7%) and 33.0 cm (86.5%, 69.4%), respectively. In Sub-study 2, the participants with sarcopenia-AC or sarcopenia-CC showed lower muscle strength and lower fat and muscle mass than the ones without (P< 0.05). Additionally, males instead of females with sarcopenia-AC or sarcopenia-CC showed worse performance in time-up and go test and 6-Minute Walk Test (P< 0.05). However, the 30-second chair stand test was not different between participants with and without sarcopenia-AC or sarcopenia-CC in both sexes. Conclusion: We found accurate and Chinese population targeted cut-off values of AC and CC on sarcopenia diagnosis (25.9 cm and 33.7 cm in males; 26.5 cm and 33.0 cm in females) and a good evaluation effect of AC and CC on fat and muscle mass, muscle strength and physical functions in males, not females.
Keywords: sarcopenia, upper arm circumference, calf circumference, health assessment
{"title":"The Optimal Cut-off Value of Upper Arm Circumference and Calf Circumference for Assessing Sarcopenia Among Chinese Community-Dwelling Older Adults","authors":"Mengli Li, Tongtong Yin, Jiaying Qi, Minhao Shi, Fangfang Wang, Zhiyu Mao, Hui Zhang, Li Wang","doi":"10.2147/cia.s468036","DOIUrl":"https://doi.org/10.2147/cia.s468036","url":null,"abstract":"<strong>Objective:</strong> To explore the cut-off values and health evaluations of upper arm circumference (AC) and calf circumference (CC) on sarcopenia in Chinese community-dwelling older people.<br/><strong>Methods:</strong> In this cross-sectional study, AC, CC, handgrip strength, muscle mass and gait speed were measured in 1537 Chinese community-dwelling older people in <em>Sub-study 1</em>. Correlation analysis, receiver operator characteristic curve (ROC curve) analysis, and consistency analysis were used for determination of AC and CC cut-off values for sarcopenia diagnosis (sarcopenia-AC and CC). Thereafter, 269 participants accepted additional assessments on physical function, body composition and muscle strength in <em>Sub-study 2. T</em>-test or Mann-Whitney <em>U</em>-test was used to explore the differential effects of sarcopenia-AC and CC on health indicators between sarcopenic and non-sarcopenic participants.<br/><strong>Results:</strong> In <em>Sub-study 1</em>, the Area Under ROC (AUC) of AC and CC for sarcopenia screening were greater than 0.700 (<em>P</em>< 0.05). The cut-off values, sensitivity and specificity of AC and CC on sarcopenia in males were 25.9 cm (86.0%, 83.6%) and 33.7 cm (90.7%, 81.4%) whereas in females were 26.5 cm (70.8%, 69.7%) and 33.0 cm (86.5%, 69.4%), respectively. In <em>Sub-study 2</em>, the participants with sarcopenia-AC or sarcopenia-CC showed lower muscle strength and lower fat and muscle mass than the ones without (<em>P</em>< 0.05). Additionally, males instead of females with sarcopenia-AC or sarcopenia-CC showed worse performance in time-up and go test and 6-Minute Walk Test (<em>P</em>< 0.05). However, the 30-second chair stand test was not different between participants with and without sarcopenia-AC or sarcopenia-CC in both sexes.<br/><strong>Conclusion:</strong> We found accurate and Chinese population targeted cut-off values of AC and CC on sarcopenia diagnosis (25.9 cm and 33.7 cm in males; 26.5 cm and 33.0 cm in females) and a good evaluation effect of AC and CC on fat and muscle mass, muscle strength and physical functions in males, not females.<br/><br/><strong>Keywords:</strong> sarcopenia, upper arm circumference, calf circumference, health assessment<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"63 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141742989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the Levels of Nucleotide-binding, leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) and Adiponectin (APN) and their relationship with the severity of coronary artery disease in patients with Unstable Angina (UA) and Type 2 Diabetes (T2D). Methods: Two hundred and thirty-one patients with UA were diagnosed by CAG in the Department of Cardiology of the Affiliated Hospital of Xuzhou Medical University from July 2022 to May 2023 were included, and 74 healthy subjects were included as the control group. The levels of NLRP3 and APN in each group were detected by ELISA and the Gensini score in each patient according to the results of CAG. The correlations between NLRP3, APN, and Gensini score were analyzed. According to whether complicated with T2D or not, we further analyze the effect of NLRP3 and APN levels of patients with UA and T2D on the severity of coronary artery stenosis. Results: The levels of NLRP3 in UA with T2D group were the highest, followed by simple UA group, and the lowest in the control group, and the level of APN was the opposite. Spearman Correlation analysis showed that the level of NLRP3 was positively correlated with Gensini score (ρ1=0.688, P< 0.05) and the level of APN was negatively associated with Gensini score (ρ2= − 0.515, P< 0.05). There was a negative correlation between NLRP3 and the level of APN (ρ3= − 0.366, P< 0.05). High NLRP3 and low APN levels are the risk factors for atherosclerosis. Conclusion: The NLRP3 and APN were abnormally expressed in patients with UA complicated with T2D. With the aggravation of atherosclerosis, the level of NLRP3 increased and the level of APN decreased.
{"title":"The Relationship Between the Serum NLRP3 and Adiponectin Levels and Coronary Lesions in Patients with Unstable Angina with Type 2 Diabetes","authors":"Siyu Pan, Yixiao Wang, Yuchen Zhang, Xiaoyu Ma, Jingfeng Peng, Fangfang Li, Wenhao Qian, Jing Zong","doi":"10.2147/cia.s467291","DOIUrl":"https://doi.org/10.2147/cia.s467291","url":null,"abstract":"<strong>Objective:</strong> To investigate the Levels of Nucleotide-binding, leucine-rich repeat and pyrin domain-containing protein 3 (NLRP3) and Adiponectin (APN) and their relationship with the severity of coronary artery disease in patients with Unstable Angina (UA) and Type 2 Diabetes (T2D).<br/><strong>Methods:</strong> Two hundred and thirty-one patients with UA were diagnosed by CAG in the Department of Cardiology of the Affiliated Hospital of Xuzhou Medical University from July 2022 to May 2023 were included, and 74 healthy subjects were included as the control group. The levels of NLRP3 and APN in each group were detected by ELISA and the Gensini score in each patient according to the results of CAG. The correlations between NLRP3, APN, and Gensini score were analyzed. According to whether complicated with T2D or not, we further analyze the effect of NLRP3 and APN levels of patients with UA and T2D on the severity of coronary artery stenosis.<br/><strong>Results:</strong> The levels of NLRP3 in UA with T2D group were the highest, followed by simple UA group, and the lowest in the control group, and the level of APN was the opposite. Spearman Correlation analysis showed that the level of NLRP3 was positively correlated with Gensini score (ρ<sub>1</sub>=0.688, <em>P<</em> 0.05) and the level of APN was negatively associated with Gensini score (ρ<sub>2</sub>= − 0.515, <em>P<</em> 0.05). There was a negative correlation between NLRP3 and the level of APN (ρ<sub>3</sub>= − 0.366, <em>P<</em> 0.05). High NLRP3 and low APN levels are the risk factors for atherosclerosis.<br/><strong>Conclusion:</strong> The NLRP3 and APN were abnormally expressed in patients with UA complicated with T2D. With the aggravation of atherosclerosis, the level of NLRP3 increased and the level of APN decreased.<br/><br/><strong>Keywords:</strong> NLRP3, adiponectin, gensini score, diabetes<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"38 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141721899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract: Postmenopausal osteoporosis (PMOP) is a major health problem affecting millions of women worldwide. PMOP patients are often accompanied by abnormal accumulation of bone marrow adipose tissue (BMAT). BMAT is a critical regulator of bone homeostasis, and an increasing BMAT volume is negatively associated with bone mass reduction or fracture. BMAT regulates bone metabolism via adipokines, cytokines and the immune system, but the specific mechanisms are largely unknown. This review emphasizes the impact of estrogen deficiency on bone homeostasis and BMAT expansion, and the mechanism by which BMAT regulates PMOP, providing a promising strategy for targeting BMAT in preventing and treating PMOP.
Keywords: postmenopausal osteoporosis, bone marrow adipose tissue, bone metabolism, immune system, cytokines
{"title":"Bone Marrow Adipose Tissue as a Critical Regulator of Postmenopausal Osteoporosis - A Concise Review","authors":"Huifang Niu, Minfeng Zhou, Xiaoyun Xu, Xiaojuan Xu","doi":"10.2147/cia.s466446","DOIUrl":"https://doi.org/10.2147/cia.s466446","url":null,"abstract":"<strong>Abstract:</strong> Postmenopausal osteoporosis (PMOP) is a major health problem affecting millions of women worldwide. PMOP patients are often accompanied by abnormal accumulation of bone marrow adipose tissue (BMAT). BMAT is a critical regulator of bone homeostasis, and an increasing BMAT volume is negatively associated with bone mass reduction or fracture. BMAT regulates bone metabolism via adipokines, cytokines and the immune system, but the specific mechanisms are largely unknown. This review emphasizes the impact of estrogen deficiency on bone homeostasis and BMAT expansion, and the mechanism by which BMAT regulates PMOP, providing a promising strategy for targeting BMAT in preventing and treating PMOP.<br/><br/><strong>Keywords:</strong> postmenopausal osteoporosis, bone marrow adipose tissue, bone metabolism, immune system, cytokines<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"41 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141585268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hiroko Kiyoshi-Teo, Bryanna De Lima, Nathan F Dieckmann, Jennifer L Vincenzo, Elizabeth Eckstrom
Purpose: Individuals identified as high fall risk are expected to have high concern about falling. However, perception and individual factors that influence concern about falling have yet to be thoroughly studied. We aimed to understand factors that influence concern about falling among older adults with increased risk for falling. Patients and Methods: This was a secondary analysis of a clinical trial among community-dwelling older adults (age ≥ 65 years old) at high risk for falls (n = 178). Descriptive and regression analyses were used. We analyzed the relationship between participants’ baseline concern about falling – categorized into three groups: low (7– 8), moderate (9– 13), and high (≥ 14) – and factors that may impact their concern. Exploratory factors included age, sex, self-reported health status and confidence to address fall risks, fall risk scores, and physical performance measures. Results: Among these individuals, 15.2% reported low concern about falling. On average, individuals in higher concern about falling groups had higher fall risk scores (low [5.7], moderate [6.4], and high [8.0]; p < 0.001). Our regression model showed that the odds of being in a higher concern group increased by 21% for every one unit increase in fall risk score and increased by 67% for every one unit increase toward poorer health rating. Conversely, for every one unit increase in self-reported confidence, the odds of being in a higher concern group decreased by 27.5%. Conclusion: Knowledge of older adults’ fall risk, health status, and concerns about falling can be used to assist in the personalization of fall prevention interventions for a more holistic approach.
Keywords: accidental falls, risk factors, perception, regression analysis
{"title":"Impact of Documented Fall-Risk, Self-Reported Health and Confidence to Prevent Falls on Concern About Falling Among Community-Dwelling Older Adults: Secondary Analysis of a Randomized Clinical Trial","authors":"Hiroko Kiyoshi-Teo, Bryanna De Lima, Nathan F Dieckmann, Jennifer L Vincenzo, Elizabeth Eckstrom","doi":"10.2147/cia.s453789","DOIUrl":"https://doi.org/10.2147/cia.s453789","url":null,"abstract":"<strong>Purpose:</strong> Individuals identified as high fall risk are expected to have high concern about falling. However, perception and individual factors that influence concern about falling have yet to be thoroughly studied. We aimed to understand factors that influence concern about falling among older adults with increased risk for falling.<br/><strong>Patients and Methods:</strong> This was a secondary analysis of a clinical trial among community-dwelling older adults (age ≥ 65 years old) at high risk for falls (n = 178). Descriptive and regression analyses were used. We analyzed the relationship between participants’ baseline concern about falling – categorized into three groups: low (7– 8), moderate (9– 13), and high (≥ 14) – and factors that may impact their concern. Exploratory factors included age, sex, self-reported health status and confidence to address fall risks, fall risk scores, and physical performance measures.<br/><strong>Results:</strong> Among these individuals, 15.2% reported low concern about falling. On average, individuals in higher concern about falling groups had higher fall risk scores (low [5.7], moderate [6.4], and high [8.0]; p < 0.001). Our regression model showed that the odds of being in a higher concern group increased by 21% for every one unit increase in fall risk score and increased by 67% for every one unit increase toward poorer health rating. Conversely, for every one unit increase in self-reported confidence, the odds of being in a higher concern group decreased by 27.5%.<br/><strong>Conclusion:</strong> Knowledge of older adults’ fall risk, health status, and concerns about falling can be used to assist in the personalization of fall prevention interventions for a more holistic approach.<br/><br/><strong>Keywords:</strong> accidental falls, risk factors, perception, regression analysis<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"21 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141585273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: To investigate the benefit (90-day mRS score) and rate of major complications (early symptomatic intracranial hemorrhage-SICH) after reperfusion therapy (RT) (including intravenous thrombolysis -IVT and mechanical thrombectomy -MT) in patients over 80 years with acute ischemic stroke (AIS). Patients and Methods: AIS patients aged over 80 admitted to Huizhou Central People’s Hospital from September 2018 to 2023 were included in this study. Data on SICH, NIHSS, and mRS were analyzed. A good prognosis was defined as a mRS ≤ 2 or recovery to pre-stroke status at 90 days. Results: Of 209 patients, 80 received non-RT, 100 received IVT and 29 underwent MT. The non-RT group had the lowest baseline NIHSS while the MT group had the highest (non-RT 6.0 vs IVT 12.0 vs MT 18.0, P < 0.001). Higher NIHSS was associated with increased SICH risk (OR 1.083, P=0.032), while RT was not (OR 5.194, P=0.129). The overall SICH rate in the RT group was higher but not significantly different after stratification by stroke severity. Poor prognosis was associated with higher admission NIHSS, stroke due to large artery atherosclerosis (LAA) combined with cardioembolism (CE), and stroke-associated pneumonia (SAP) (OR 0.902, P< 0.001; OR 0.297, P=0.029; OR 0.103, P< 0.001, respectively). The RT group showed a greater reduction in NIHSS (delta NIHSS) than the non-RT group (non-RT 2.0 vs IVT 4.0 vs MT 6.0, P< 0.005). For severe AIS, the IVT group had a better prognosis at 90 days (non-RT 0% vs IVT 38.2%, P=0.039). No 90-day mortality difference was found between groups after stratification. Conclusion: Stroke severity, rather than RT, is an independent risk factor for SICH in AIS patients over 80. RT in severe stroke patients improves NIHSS at 90 days, suggesting RT is safe and effective in this demographic. Further studies with larger samples are required to confirm these findings.
目的：探讨80岁以上急性缺血性脑卒中（AIS）患者接受再灌注治疗（RT）（包括静脉溶栓-IVT和机械取栓-MT）后的获益（90天mRS评分）和主要并发症（早期症状性颅内出血-SICH）发生率：本研究纳入2018年9月至2023年惠州市中心人民医院收治的80岁以上AIS患者。分析SICH、NIHSS和mRS数据。mRS≤2或90天后恢复至卒中前状态为预后良好：在209名患者中，80人接受了非RT治疗，100人接受了IVT治疗，29人接受了MT治疗。非 RT 组的基线 NIHSS 最低，而 MT 组最高（非 RT 6.0 vs IVT 12.0 vs MT 18.0，P < 0.001）。较高的 NIHSS 与 SICH 风险增加有关（OR 1.083，P=0.032），而 RT 与之无关（OR 5.194，P=0.129）。根据卒中严重程度分层后，RT 组的总体 SICH 发生率更高，但无显著差异。预后较差与入院 NIHSS 较高、大动脉粥样硬化（LAA）导致的卒中合并心脑血管栓塞（CE）和卒中相关肺炎（SAP）有关（OR 0.902，P< 0.001；OR 0.297，P=0.029；OR 0.103，P< 0.001）。与非 RT 组相比，RT 组的 NIHSS（δ NIHSS）下降幅度更大（非 RT 2.0 vs IVT 4.0 vs MT 6.0，P< 0.005）。对于重度 AIS，IVT 组 90 天的预后更好（非 IVT 组 0% vs IVT 组 38.2%，P=0.039）。分层后，各组间的90天死亡率无差异：结论：卒中严重程度而非 RT 是 80 岁以上 AIS 患者发生 SICH 的独立危险因素。严重卒中患者的 RT 可改善 90 天后的 NIHSS，这表明 RT 对这一人群是安全有效的。关键词：急性缺血性卒中、老年人、静脉溶栓、机械取栓、症状性颅内出血、疗效
{"title":"Comparison of the Clinical Outcomes Between Reperfusion and Non-Reperfusion Therapy in Elderly Patients with Acute Ischemic Stroke","authors":"Xuanwen Luo, Suqin Chen, Weiliang Luo, Qingyun Li, Yening Zhu, Jiming Li","doi":"10.2147/cia.s464010","DOIUrl":"https://doi.org/10.2147/cia.s464010","url":null,"abstract":"<strong>Purpose:</strong> To investigate the benefit (90-day mRS score) and rate of major complications (early symptomatic intracranial hemorrhage-SICH) after reperfusion therapy (RT) (including intravenous thrombolysis -IVT and mechanical thrombectomy -MT) in patients over 80 years with acute ischemic stroke (AIS).<br/><strong>Patients and Methods:</strong> AIS patients aged over 80 admitted to Huizhou Central People’s Hospital from September 2018 to 2023 were included in this study. Data on SICH, NIHSS, and mRS were analyzed. A good prognosis was defined as a mRS ≤ 2 or recovery to pre-stroke status at 90 days.<br/><strong>Results:</strong> Of 209 patients, 80 received non-RT, 100 received IVT and 29 underwent MT. The non-RT group had the lowest baseline NIHSS while the MT group had the highest (non-RT 6.0 vs IVT 12.0 vs MT 18.0, P < 0.001). Higher NIHSS was associated with increased SICH risk (OR 1.083, P=0.032), while RT was not (OR 5.194, P=0.129). The overall SICH rate in the RT group was higher but not significantly different after stratification by stroke severity. Poor prognosis was associated with higher admission NIHSS, stroke due to large artery atherosclerosis (LAA) combined with cardioembolism (CE), and stroke-associated pneumonia (SAP) (OR 0.902, P< 0.001; OR 0.297, P=0.029; OR 0.103, P< 0.001, respectively). The RT group showed a greater reduction in NIHSS (delta NIHSS) than the non-RT group (non-RT 2.0 vs IVT 4.0 vs MT 6.0, P< 0.005). For severe AIS, the IVT group had a better prognosis at 90 days (non-RT 0% vs IVT 38.2%, P=0.039). No 90-day mortality difference was found between groups after stratification.<br/><strong>Conclusion:</strong> Stroke severity, rather than RT, is an independent risk factor for SICH in AIS patients over 80. RT in severe stroke patients improves NIHSS at 90 days, suggesting RT is safe and effective in this demographic. Further studies with larger samples are required to confirm these findings.<br/><br/><strong>Keywords:</strong> acute ischemic stroke, elderly, intravenous thrombolysis, mechanical thrombectomy, symptomatic intracranial hemorrhage, therapeutic efficacy<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"22 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141577204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lijie Ma, Fang Sun, Kaiyi Zhu, Qiuxia Han, Qianmei Sun
Purpose: The serum lipid level is strongly associated with atherosclerosis. However, research on the relationship between lipid-derived indices and acute ischemic stroke (AIS) occurrence in hemodialysis populations is limited. This study aimed to explore the predictive value of lipid-derived indices, including atherogenic index of plasma (AIP), Non- high density lipoprotein cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, and lipoprotein combine index (LCI) in clinical practice for the occurrence and prognosis of AIS in hemodialysis patients. Methods: A total of 451 patients undergoing maintenance hemodialysis were screened and 350 were enrolled in this study. The lipid parameters exhibit a progressive increase across the tertiles, with values rising from Q1 through Q3. Enrolled patients were divided into three groups (Q1, Q2, and Q3) based on tertiles of AIP, Non-HDL-C, Non-HDL-C/HDL-C, and LCI values. Kaplan-Meier curves were performed to investigate the association between the AIP, Non-HDL-C, Non-HDL-C/HDL-C, LCI and AIS-free survival in hemodialysis patients. Chi-square analysis was used to explore the association between the AIP, Non-HDL-C, Non-HDL-C/HDL-C, LCI and AIS outcomes in hemodialysis patients. AIS outcomes were assessed using the modified Rankin Scale (mRS). Results: Kaplan-Meier analysis revealed that the AIS-free survival rates were significantly higher in the Q1 group compared to Q2 and Q3 groups for AIP, Non-HDL-C, Non-HDL-C/HDL-C, and LCI. Log rank tests showed statistically significant differences between the Q1 group and the Q2 and Q3 groups (p < 0.05 for all). The proportion of patients with a good outcome mRS was higher in the Q1 group compared to the Q2-Q3 groups (AIP: 0.818 vs 0.792; Non- HDL-C: 0.866 vs 0.767; Non- HDL-C/HDL-C: 0.867 vs 0.767; LCI: 0.938 vs 0.750). Conclusion: The four lipid-derived parameters are effective predictors of AIS in patients undergoing hemodialysis, and AIP has a strongest correlation with the risk of AIS. Hemodialysis patients with elevated levels of the four lipid-derived indices had a higher incidence of AIS and poorer functional outcomes compared to those with lower levels. Our conclusions may require confirmation by further research in the future.
Keywords: hemodialysis, acute ischemic stroke, atherogenic index of plasma, non-high density lipoprotein cholesterol, lipoprotein combine index
{"title":"The Predictive Value of Atherogenic Index of Plasma, Non- High Density Lipoprotein Cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, and Lipoprotein Combine Index for Stroke Incidence and Prognosis in Maintenance Hemodialysis Patients","authors":"Lijie Ma, Fang Sun, Kaiyi Zhu, Qiuxia Han, Qianmei Sun","doi":"10.2147/cia.s461150","DOIUrl":"https://doi.org/10.2147/cia.s461150","url":null,"abstract":"<strong>Purpose:</strong> The serum lipid level is strongly associated with atherosclerosis. However, research on the relationship between lipid-derived indices and acute ischemic stroke (AIS) occurrence in hemodialysis populations is limited. This study aimed to explore the predictive value of lipid-derived indices, including atherogenic index of plasma (AIP), Non- high density lipoprotein cholesterol (Non-HDL-C), Non-HDL-C/HDL-C, and lipoprotein combine index (LCI) in clinical practice for the occurrence and prognosis of AIS in hemodialysis patients.<br/><strong>Methods:</strong> A total of 451 patients undergoing maintenance hemodialysis were screened and 350 were enrolled in this study. The lipid parameters exhibit a progressive increase across the tertiles, with values rising from Q1 through Q3. Enrolled patients were divided into three groups (Q1, Q2, and Q3) based on tertiles of AIP, Non-HDL-C, Non-HDL-C/HDL-C, and LCI values. Kaplan-Meier curves were performed to investigate the association between the AIP, Non-HDL-C, Non-HDL-C/HDL-C, LCI and AIS-free survival in hemodialysis patients. Chi-square analysis was used to explore the association between the AIP, Non-HDL-C, Non-HDL-C/HDL-C, LCI and AIS outcomes in hemodialysis patients. AIS outcomes were assessed using the modified Rankin Scale (mRS).<br/><strong>Results:</strong> Kaplan-Meier analysis revealed that the AIS-free survival rates were significantly higher in the Q1 group compared to Q2 and Q3 groups for AIP, Non-HDL-C, Non-HDL-C/HDL-C, and LCI. Log rank tests showed statistically significant differences between the Q1 group and the Q2 and Q3 groups (p < 0.05 for all). The proportion of patients with a good outcome mRS was higher in the Q1 group compared to the Q2-Q3 groups (AIP: 0.818 vs 0.792; Non- HDL-C: 0.866 vs 0.767; Non- HDL-C/HDL-C: 0.867 vs 0.767; LCI: 0.938 vs 0.750).<br/><strong>Conclusion:</strong> The four lipid-derived parameters are effective predictors of AIS in patients undergoing hemodialysis, and AIP has a strongest correlation with the risk of AIS. Hemodialysis patients with elevated levels of the four lipid-derived indices had a higher incidence of AIS and poorer functional outcomes compared to those with lower levels. Our conclusions may require confirmation by further research in the future.<br/><br/><strong>Keywords:</strong> hemodialysis, acute ischemic stroke, atherogenic index of plasma, non-high density lipoprotein cholesterol, lipoprotein combine index<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"13 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141548109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lengnan Xu, Chen Yu, Aiqun Chen, Chuanbao Li, Yonghui Mao
Background: This study aims to investigate GFR decline in elderly subjects with varying physical conditions and analyze key risk factors impacting renal function changes. Methods: We obtained data from patients between 2017 and 2019, and matched healthy elderly subjects based on gender and age. Data collected for all subjects included annual measurements of fast blood glucose (GLU), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c), blood albumin (ALB), blood uric acid (UA), urine protein (UP), and systolic blood pressure (SBP). Additionally, information on coexisting diseases was gathered. The Full Age Spectrum (FAS) equation was used to calculate eGFR. Results: A total of 162 patients with complete 3-year renal dynamic imaging were included, including 84 patients in the kidney disease group (K group) and 78 patients in the non-kidney disease group (NK group). Ninety individuals were selected as the healthy group (H group). The annual decline rate in the K group was the fastest, which exceeded 5mL/min/1.73m2 (P < 0.05). Group (K group: β=− 40.31, P< 0.001; NK group: β=− 26.96, P< 0.001), ALB (β=− 0.38, P=0.038) and HbA1c (β=1.36, P=0.029) had a significant negative impact on the eGFR changes. For participants who had negative proteinuria: K group had the most significant annual eGFR decline. Conclusion: The presence of kidney disease, along with proteinuria nor not, can lead to a marked acceleration in kidney function decline in elderly. We categorize elderly individuals with an annual eGFR decline of more than 5 mL/min/1.73m2 as the “kidney accelerated aging” population.
{"title":"Longitudinal Analysis of Renal Function Changes in Elderly Populations: Health Status Evaluation and Risk Factor Assessment","authors":"Lengnan Xu, Chen Yu, Aiqun Chen, Chuanbao Li, Yonghui Mao","doi":"10.2147/cia.s450388","DOIUrl":"https://doi.org/10.2147/cia.s450388","url":null,"abstract":"<strong>Background:</strong> This study aims to investigate GFR decline in elderly subjects with varying physical conditions and analyze key risk factors impacting renal function changes.<br/><strong>Methods:</strong> We obtained data from patients between 2017 and 2019, and matched healthy elderly subjects based on gender and age. Data collected for all subjects included annual measurements of fast blood glucose (GLU), glycated hemoglobin (HbA1c), low-density lipoprotein cholesterol (LDL-c), blood albumin (ALB), blood uric acid (UA), urine protein (UP), and systolic blood pressure (SBP). Additionally, information on coexisting diseases was gathered. The Full Age Spectrum (FAS) equation was used to calculate eGFR.<br/><strong>Results:</strong> A total of 162 patients with complete 3-year renal dynamic imaging were included, including 84 patients in the kidney disease group (K group) and 78 patients in the non-kidney disease group (NK group). Ninety individuals were selected as the healthy group (H group). The annual decline rate in the K group was the fastest, which exceeded 5mL/min/1.73m<sup>2</sup> (<em>P</em> < 0.05). Group (K group: β=− 40.31, P< 0.001; NK group: β=− 26.96, P< 0.001), ALB (β=− 0.38, P=0.038) and HbA1c (β=1.36, P=0.029) had a significant negative impact on the eGFR changes. For participants who had negative proteinuria: K group had the most significant annual eGFR decline.<br/><strong>Conclusion:</strong> The presence of kidney disease, along with proteinuria nor not, can lead to a marked acceleration in kidney function decline in elderly. We categorize elderly individuals with an annual eGFR decline of more than 5 mL/min/1.73m<sup>2</sup> as the “kidney accelerated aging” population.<br/><br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"33 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141531469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Purpose: This study aimed to evaluate the impact of the Hip Fracture Fast-Track (HFFT) protocol, designed specifically for older patients at our hospital, which commenced on January 1, 2022, on the management of emergency department (ED) pain in older adults with hip fractures. Patients and Methods: Retrospective pre- and post-study data from electronic health records (EHR) at our hospital, using the International Classification of Diseases (ICD)-10 codes S72.0, S72.1, S72.8, and S72.9, were utilized. The study included patients aged 65 years or older who presented to the ED with low-energy, non-pathologic isolated hip fractures or proximal femur fractures. The pre-HFFT period included patients from January 1, 2020, to December 31, 2021, and the post-HFFT period included patients from January 1, 2022, to October 31, 2023. Data were compared for the proportion of patients undergoing pain evaluation in the ED, before discharge, time to first analgesia, number of patients receiving pain relief in the ED, and the use of fascia iliaca compartment blocks (FICBs) and pericapsular nerve group blocks (PENGBs). Results: The final analysis involved 258 patients, with 116 in the pre-protocol group and 142 in the post-protocol group. The rate of analgesic use increased significantly in the post-HFFT group (78 [67.24%] vs 111 [78.17%], P = 0.049). The rate of pain score screening at triage increased from 51.72% before the HFFT protocol to 86.62% post-HFFT protocol (p < 0.001). Compared with the pre-HFFT protocol, the post-HFFT protocol exhibited a higher rate of FICB (0% vs 14.08%, p < 0.001) and PENGB (0% vs 5.63%, p = 0.009) administration. Conclusion: The HFFT protocol’s implementation was associated with improved ED pain evaluation and analgesic administration in older adults with hip fractures. These findings indicate that tailored protocols, such as the HFFT, hold promise for enhancing emergency care for this vulnerable population.
Keywords: older adult, hip fracture fast-track protocol, middle-income country
{"title":"Enhancing Emergency Department Pain Management for Older Adults with the Hip Fracture Fast-Track (HFFT) Protocol in a Middle-Income Country","authors":"Jiraporn Sri-On, Thitarat Worawiwat, Kitchai Luksameearunothai, Pornsak Nirunsuk, Alissara Vanichkulbodee, Yupadee Fusakul, Krit Phisaiphun, Pornsiri Kanokkarnjana, Danaiphat Lerdruttanasoontorn, Kwannapa Thong-on","doi":"10.2147/cia.s465006","DOIUrl":"https://doi.org/10.2147/cia.s465006","url":null,"abstract":"<strong>Purpose:</strong> This study aimed to evaluate the impact of the Hip Fracture Fast-Track (HFFT) protocol, designed specifically for older patients at our hospital, which commenced on January 1, 2022, on the management of emergency department (ED) pain in older adults with hip fractures.<br/><strong>Patients and Methods:</strong> Retrospective pre- and post-study data from electronic health records (EHR) at our hospital, using the International Classification of Diseases (ICD)-10 codes S72.0, S72.1, S72.8, and S72.9, were utilized. The study included patients aged 65 years or older who presented to the ED with low-energy, non-pathologic isolated hip fractures or proximal femur fractures. The pre-HFFT period included patients from January 1, 2020, to December 31, 2021, and the post-HFFT period included patients from January 1, 2022, to October 31, 2023. Data were compared for the proportion of patients undergoing pain evaluation in the ED, before discharge, time to first analgesia, number of patients receiving pain relief in the ED, and the use of fascia iliaca compartment blocks (FICBs) and pericapsular nerve group blocks (PENGBs).<br/><strong>Results:</strong> The final analysis involved 258 patients, with 116 in the pre-protocol group and 142 in the post-protocol group. The rate of analgesic use increased significantly in the post-HFFT group (78 [67.24%] vs 111 [78.17%], P = 0.049). The rate of pain score screening at triage increased from 51.72% before the HFFT protocol to 86.62% post-HFFT protocol (p < 0.001). Compared with the pre-HFFT protocol, the post-HFFT protocol exhibited a higher rate of FICB (0% vs 14.08%, p < 0.001) and PENGB (0% vs 5.63%, p = 0.009) administration.<br/><strong>Conclusion:</strong> The HFFT protocol’s implementation was associated with improved ED pain evaluation and analgesic administration in older adults with hip fractures. These findings indicate that tailored protocols, such as the HFFT, hold promise for enhancing emergency care for this vulnerable population.<br/><br/><strong>Keywords:</strong> older adult, hip fracture fast-track protocol, middle-income country<br/>","PeriodicalId":10417,"journal":{"name":"Clinical Interventions in Aging","volume":"1 1","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141520782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号