1.Trends in death and life lost due to falls among the elderly in Wenzhou City from 2015 to 2023
LI Huijun ; YE Zhenmiao ; FAN Lihui ; ZHENG Yuhang ; XIE Yimin ; JIANG Xuexia ; GAO Haojun ; ZHANG Mohan ; LUO Yongyuan
Journal of Preventive Medicine 2025;37(5):460-464
Objective:
To investigate the trends in mortality and life loss due to falls among the elderly in Wenzhou City, Zhejiang Province, so as to provide the basis for formulating prevention and control measures for falls among the elderly.
Methods:
The data on fall-related deaths among the elderly aged 60 and above in Wenzhou City were collected through the Wenzhou Chronic Disease Monitoring and Management Information System from 2015 to 2023. The crude mortality was calculated and standardized using the data from the Sixth National Population Census in 2010. The life loss were measured using potential years of life lost (PYLL), average years of life lost (AYLL), and potential years of life lost rate (PYLLR). The trends in mortality and life loss among the elderly were analyzed using the annual percent change (APC) and average annual percent change (AAPC).
Results:
There were 11 378 deaths due to falls among the elderly in Wenzhou City from 2015 to 2023, with a crude mortality of 82.67/100 000 and a standardized mortality of 65.32/105, which appeared no significant changing trend (AAPC=3.401%、2.995%,both P>0.05). There was a tendency towards a rise from 2019 to 2023 (APC=12.592%、11.507%, both P<0.05). The majority of falls occurred at home, with 6 312 cases accounting for 55.48%. The primary types of fall-related deaths were slips, trips, and falls on the same level, with 8 541 cases representing 75.07%. The crude mortality and standardized mortality of falls in males were 76.63/105 and 60.86/105, which were lower than that in females at 88.72/100 000 and 70.33/100 000 (both P<0.05), and the trends were consistent with the overall population. The crude mortality of falls among the elderly increased with age (P<0.05). From 2015 to 2023, the crude mortality of falls among the elderly aged 60 to <65 years showed an upward trend (AAPC=4.860%, P<0.05), while no significant trend was observed in other age groups (all P>0.05). The PYLL was 5 123 person-years, the AYLL was 0.45 years per person, and the PYLLR was 0.37‰. From 2015 to 2023, PYLL showed an upward trend (AAPC=5.477%, P<0.05). The PYLL, AYLL, and PYLLR for males were 3.08 times, 3.48 times, and 2.67 times those of females, respectively.
Conclusions
From 2015 to 2023, the mortality of falls among the elderly in Wenzhou City had remained relatively stable. However, PYLL showed an upward trend. Males and older seniors were key groups for falls prevention. It is recommended to enhance health education and promote age-friendly home modifications to prevent falls among the elderly.
2.Six-minute walk distance and its influencing factors in patients underwent cardiac surgery before discharge
Mohan GAO ; Xingxing QIAN ; Ruobing WANG ; Tao LIANG
Chinese Journal of Nursing 2018;53(4):428-432
Objective To investigate six-minute walk distancc (6MWD) of inpatients underwent cardiac surgery before discharge and to identify its influencing factors,and to provide references for further studies of hospital rehabilitation.Methods Using convenience sampling,from August 2016 to June 2017,167 eligible patients underwent cardiac surgery were recruited from a cardiovascular hospital in Beijing.General and disease-related intormation were collected.According to requirements of six-minute walk tcst (6MWT) from American Thoracic Society,patients' rehabilitation was evaluated using 6MWD.Results After discharge from intensive care unit(ICU),6MWD of patients increased along with hospital stays.On the day before discharge,mean 6MWD of patients was (213.86±75.87).The influencing factors of 6MWD included types of surgery (P=0.019),cardiopulmonary bypass (P=0.004),postoperative left ventdcular ejection fraction (LVEF)(P=0.015),and hospital stays after discharge from ICU (P=0.003).Conclusion During hospitalization,6MWD of patients underwent cardiac surgery increased along with hospital stays.On the day before discharge,6MWD of patients tended to be stable,and ready for further rehabilitation process.Patients could have different rehabilitation differences in types of surgery,using cardiopulmonary bypass,LVEF and hospital stays after discharge from ICU.
3.Clinical analysis of 73 cases of intraspinal nerve sheath tumor.
Jian-Xiang LIU ; Hai-Zhen ZHOU ; Shu-Hua YANG ; Zeng-Wu SHAO ; Qi-Xin ZHENG ; Cao YANG ; Yong GAO ; Shrestha RAJ ; Dhakal Rabi MOHAN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2013;33(2):258-261
Seventy-three patients with spinal nerve sheath tumor who were surgically treated in our hospital during the years 2004-2010 were retrospectively reviewed with respect to recovery of neurological function, recurrence of the tumor and occurrence of kyphotic deformities. Preoperative clinical manifestations, imaging data, surgical records and follow-up results were comprehensively analyzed. The follow-up duration was 12-60 months with an average of 32.0 months. Out of the 73 cases enrolled, 69 had gradual recovery of sensation, motor and sphincter functions 1 week to 3 months after operation. Forty-six cases had incomplete paralysis, whose American Spinal Injury Association (ASIA) grades, however, were gradually increased during the follow-up period, 4 cases had no significant improvement of the clinical symptoms and no change in ASIA grades during the follow-up period. Two cases had postoperative recurrence of the tumor. There were no deaths, no spinal instability, and no kyphotic malformations found in any cases. Our study indicated that complete removal of the tumor is important for good recovery, and an ideal surgical method may reduce the recurrence of the tumor or the occurrence of complications.
Adolescent
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Adult
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Aged
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Aging
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pathology
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Female
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Humans
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Male
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Middle Aged
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Nerve Sheath Neoplasms
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pathology
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surgery
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Spinal Neoplasms
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pathology
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surgery
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Treatment Outcome
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Young Adult
4.Effect of continuous positive airway pressure ventilation on nocturnal ST-segment changes in patients with sleep-disordered breathing
Wenli ZHANG ; Shiwen WANG ; Rui CHEN ; Mohan LIU ; Lin WANG ; Lei GAO ; Caiyi LU
Journal of Geriatric Cardiology 2007;4(2):101-104
Objective To determine whether sleep-disordered breathing (SDB) may lead to nocturnal myocardial ischemia and whether the severity of this ischemia may be relieved by nasal continuous positive airway pressure (CPAP). Methods Overnight polysomnogram examination and simultaneous 3-channel Holter monitoring were performed on 76 patients with moderate to severe SDB and no history of coronary heart disease. All the cases were treated with CPAP for one night. ST depression was defined as a ST segment decrease of more than 1 mm from baseline and lasting 1 min or more. The total duration (minutes) of ST depression was indexed to the total sleep time (minutes per hour of sleep). Results Twenty-eight patients (37%) showed ST segment depression during their sleep. Before CPAP treatment, the respiratory disturbance index (RDI) and arousal index were significantly higher during periods of ST depression than when ST segments were isoelectric, whereas no significant difference was found in blood oxygen saturation (SaO2). After the CPAP treatment of patients with ST depression, the duration of ST depression was significantly reduced from 36.8±18.9 to 11.4±13.2 min/h (P<0.05). ST depression-related indexes, including RDI, arousal index and the percentage of sleep time spent at SaO2 below 90% (TS90/ TST), were all significantly decreased, with RDI from 63.4±23.8 to 8.1±6.6 /h, arousal index from 51.2±18.9 to 9.6±5.4 /h, and TS90/ TST from 50.6±21.4 to 12.9±14.7% (P<0.05). Conclusion ST-segment depression is rather common in patients with moderate to severe SDB, and CPAP treatment can significantly reduce the duration of ST depression. ST depression in these patients may reflect the myocardial ischemia that really exists and the non-ischemic changes associated with recurrent SDB.


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