Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of ...Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of such patients in our hospital,to reduce the incidence of volume overload during this period.Methods:A total of 86 patients in the peri-dialysis period(glomerular filtration rate eGFR less than 15 mL/(min·1.73 m')to three months after dialysis)who received outpatient treatment,inpatient treatment,and hemodialysis in the hospital from June 2022 to December 2023 were selected as the research objects.General information,clinical symptoms,and laboratory data of the patients were collected.According to the disease evolution process of the patients,they were divided into the non-dialysis stage and the initial dialysis stage.The volume load index of the patients,namely the overhydration(OH)value,was measured by the multi-frequency bioelectrical impedance method.The relevant factors affecting the volume load of patients in the peri-dialysis period were compared and analyzed.Results:In the non-dialysis stage,68 patients(86%)had volume overload,and 21 patients(21%)had normal volume load.In the initial dialysis stage,53 patients(61%)had volume overload,and 33 patients(38%)had normal volume load.Among the patients with volume overload in the two stages combined,the primary diseases were diabetic nephropathy at 29%,hypertensive nephropathy at 29%,primary nephropathy at 34%,and other renal damage at 8%.Complications included heart failure at 29%,respiratory tract infection at 32%,coronary heart disease at 9%,and anemia at 21%.Among the patients with volume overload,69%were male,52%were over 60 years old,53%had no family member accompaniment,57%had insomnia,and 55%had an educational level of junior high school or below.Conclusion:More than half of the patients in the peri-dialysis period in the hospital are in a state of volume overload,which should arouse the attention of the department.For male patients,those with hypertension,diabetes,insomnia,respiratory tract infection,anemia,and without family member accompaniment,corresponding intervention measures should be taken to reduce the incidence of volume overload during the peri-dialysis period.展开更多
BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to det...BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to determine which assessment tool is most relevant to the prognosis of this population.AIM To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer surgery.METHODS This single-centre,observational,prospective cohort study was conducted at the Affiliated Lianyungang Hospital of Xuzhou Medical University from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this study.We collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL scale.The outcome measures were the postoperative severe complications and increased hospital RESULTS The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL scale.Using the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both P<0.001).Postoperative severe complications and increased hospital costs were observed in 29(12.7%)and 57(24.9%)patients,respectively.Multivariate logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe complications.CONCLUSION The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.展开更多
文摘Objective:To analyze the risk factors influencing volume overload in patients during the pre-dialysis and early post-dialysis period(peri-dialysis period)by investigating the current situation of volume management of such patients in our hospital,to reduce the incidence of volume overload during this period.Methods:A total of 86 patients in the peri-dialysis period(glomerular filtration rate eGFR less than 15 mL/(min·1.73 m')to three months after dialysis)who received outpatient treatment,inpatient treatment,and hemodialysis in the hospital from June 2022 to December 2023 were selected as the research objects.General information,clinical symptoms,and laboratory data of the patients were collected.According to the disease evolution process of the patients,they were divided into the non-dialysis stage and the initial dialysis stage.The volume load index of the patients,namely the overhydration(OH)value,was measured by the multi-frequency bioelectrical impedance method.The relevant factors affecting the volume load of patients in the peri-dialysis period were compared and analyzed.Results:In the non-dialysis stage,68 patients(86%)had volume overload,and 21 patients(21%)had normal volume load.In the initial dialysis stage,53 patients(61%)had volume overload,and 33 patients(38%)had normal volume load.Among the patients with volume overload in the two stages combined,the primary diseases were diabetic nephropathy at 29%,hypertensive nephropathy at 29%,primary nephropathy at 34%,and other renal damage at 8%.Complications included heart failure at 29%,respiratory tract infection at 32%,coronary heart disease at 9%,and anemia at 21%.Among the patients with volume overload,69%were male,52%were over 60 years old,53%had no family member accompaniment,57%had insomnia,and 55%had an educational level of junior high school or below.Conclusion:More than half of the patients in the peri-dialysis period in the hospital are in a state of volume overload,which should arouse the attention of the department.For male patients,those with hypertension,diabetes,insomnia,respiratory tract infection,anemia,and without family member accompaniment,corresponding intervention measures should be taken to reduce the incidence of volume overload during the peri-dialysis period.
基金the Postgraduate Research&Practice Innovation Program,No.SJCX22_1293Lianyungang City Aging Health Research Project,No.L202206.
文摘BACKGROUND Few studies have simultaneously compared the predictive value of various frailty assessment tools for outcome measures in patients undergoing gastrointestinal cancer surgery.Therefore,it is difficult to determine which assessment tool is most relevant to the prognosis of this population.AIM To investigate the predictive value of three frailty assessment tools for patient prognosis in patients undergoing gastrointestinal cancer surgery.METHODS This single-centre,observational,prospective cohort study was conducted at the Affiliated Lianyungang Hospital of Xuzhou Medical University from August 2021 to July 2022.A total of 229 patients aged≥18 years who underwent surgery for gastrointestinal cancer were included in this study.We collected baseline data on the participants and administered three scales to assess frailty:The comprehen-sive geriatric assessment(CGA),Fried phenotype and FRAIL scale.The outcome measures were the postoperative severe complications and increased hospital RESULTS The prevalence of frailty when assessed with the CGA was 65.9%,47.6%when assessed with the Fried phenotype,and 34.9%when assessed with the FRAIL scale.Using the CGA as a reference,kappa coefficients were 0.398 for the Fried phenotype and 0.291 for the FRAIL scale(both P<0.001).Postoperative severe complications and increased hospital costs were observed in 29(12.7%)and 57(24.9%)patients,respectively.Multivariate logistic analysis confirmed that the CGA was independently associated with increased hospital costs(odds ratio=2.298,95%confidence interval:1.044-5.057;P=0.039).None of the frailty assessment tools were associated with postoperative severe complications.CONCLUSION The CGA was an independent predictor of increased hospital costs in patients undergoing surgery for gastro-intestinal cancer.
