Handgrip Strength as a Predictor of Nutritional Status in Chinese Elderly Inpatients at Hospital Admission

Objective To assess nutritional status and define gender-and age-specific handgrip strength（HGS） cut-point values for malnutrition or nutritional risk in elderly inpatients. Methods A cross-sectional study of 1,343 elderly inpatients was conducted in the Chinese PLA General Hospital. Nutrition Risk Screening（NRS 2002） and Subjective Global Assessment（SGA） were administered. Anthropometric measurements and blood biochemical indicators were obtained using standard techniques. The gender-and age-specific receiver operating characteristic（ROC） curves were constructed to evaluate the HGS for nutritional status by SGA and NRS 2002. Sensitivity, specificity, and areas under the curves（AUCs） were calculated. Results According to NRS 2002 and SGA, 63.81% of elderly inpatients were at nutritional risk and 28.22% were malnourished. Patients with higher HGS had an independently decreased risk of malnutrition and nutritional risk. The AUCs varied between 0.670 and 0.761. According to NRS 2002, the optimal HGS cut-points were 27.5 kg（65-74 years） and 21.0 kg（75-90 years） for men and 17.0 kg（65-74 years） and 14.6 kg（75-90 years） for women. According to SGA, the optimal HGS cut-points were 24.9 kg（65-74 years） and 20.8 kg（75-90 years） for men and 15.2 kg（65-74 years） and 13.5 kg（75-90 years） for women. Conclusion Elderly inpatients had increased incidence of malnutrition or nutritional risk. HGS cut-points can be used for assessing nutritional status in elderly inpatients at hospital admission in China.

Study on Influence Factors of Pressure Injury Risk in the Elderly Inpatients with Kidney Disease Based on LASSO Regression

Objective: This paper aims to explore clinical status and related influence factors of pressure injury (PI) in the elderly inpatients with kidney disease, so as to provide reference for the prevention and treatment of PI in the elderly inpatients with kidney disease. Methods: Retrospective collection method is adopted to collect 158 clinical cases of the elderly inpatients with kidney disease aged ≥ 60 in the Nephrology Department, the First Affiliated Hospital of Jinan University from January 2017 to December 2019, and then least absolute shrinkage and selection Operator (LASSO) regression analysis is used to analyze 17 possible influence factors;finally Logistic regression model is established to analyze and screen influence factors of risk. Results: 1) Among 158 elderly inpatients with medium and high risk of PI, the incidence of PI is 20.25%;the most common stage of injury is stage I (42.5%);sacrococcygeal (60%) is the high-risk site of pressure injury. 2) LASSO regression analysis shows that history of present respiratory infection/respiratory failure (β = 1.2714. P < 0.05) and hospitalization time (β = 0.4177. P < 0.05) are independent factors influencing PI risk in the elderly inpatients with kidney disease. Conclusion: The elderly patients with kidney disease and PI risk are the high incidence population of hospital acquired PI;for the elderly inpatients with kidney disease and having respiratory infection history or respiratory failure, prolonged hospitalization will significantly increase the risk of PI. Therefore, targeted preventive and control measures should be taken to reduce the incidence of PI.

An investigation of vitamin B12 deficiency in elderly inpatients in neurology department

Objective To investigate the status of vitamin B 12 deficiency in elderly inpatients in the department of neurology. Methods A total number of 827 patients in the department of neurology of Shanghai Punan hospital, from March 2007 to July 2008, were employed in the present study. They were 60 years or older, and the average age was 77.1±7.5 years old. All the patients were diagnosed with no severe hepatic or renal dysfunction, without any usage of vitamin B 12 during the previous 3 months before the detection. The levels of serum vitamin B 12, folate and homocysteine （Hcy） were evaluated. The patients with vitamin B 12 deficiency were screened. The resulting symptoms, positive signs of neurological examination, and the neuroelectricphysiological results were compared between patients with or without vitamin B 12 deficiency. Results Vitamin B 12 deficiency was found in 163 patients （19.71% of the total patients）, and was more prevalent in female than in male patients, also with increased incidences with aging. Patients with low levels of serum vitamin B 12 exhibited higher rate of gastrointestinal diseases, while only 9.82% of the vitamin B 12 deficient patients had megaloblastic anemia. Symptoms of vitamin B 12 deficiency included unsteadily walking in the darkness and hypopallesthesia, and some chronic diseases such as cerebral ischemia, hypertension, Parkinson＇s disease （Parkinsonism）, diabetes mellitus and coronary heart disease. Most of the vitamin B 12 deficient patients had neuroelectricphysiological abnormalities. Conclusion Vitamin B 12 deficiency is remarkably common in elderly patients in neurology department, with various and atypical clinical manifestations, and the neurological symptoms are more common than megaloblastic anemia symptoms.

Association factors of target organ damage： analysis of 17 682 elderly hypertensive patients in China

Background Hypertensive target organ damage （TOD） is the main reason for mortality or disability in elderly hypertensive patients. The studies on TOD of hypertension in Asia, especially in Chinese elderly hypertensive patients, are very limited. The aim of this study was to evaluate the prevalence and correlative factors of TOD in older Chinese hypertensive inpatients. Methods This is a retrospective survey and data were collected from the computerized medical files of hypertensive inpatients from January of 1993 to December of 2008. The analysis was done on 17 682 inpatients, aged 60 years or older, with a diagnosis of essential hypertension （EH）. The evidence of hypertensive TOD and associated factors with TOD were collected. Results The prevalence of any hypertensive target organ involvement among these subjects was high. In multivariable Logistic regressions adjusted for potentially confounding factors, older age, male gender, diabetes, EH grade 3, systolic blood pressure （SBP）, and low-density lipoprotein cholesterol （LDL-C）, were independently associated with coronary artery disease. Age, duration of EH, EH grade 3, SBP, pulse pressure （PP）, and homocysteine （Hcy） were independently associated with cerebrovascular disease. Age, diabetes, duration of EH, EH grade 3, SBP, PP and estimated glomerular filtration rate （eGFR） were independently associated with chronic kidney disease. Male gender, EH grade 3 and SBP were independently associated with aortic dissection. Conclusions The prevalence of hypertensive TOD is high in older Chinese hypertensive inpatients. Various cardiovascular risk factors are associated with hypertensive TOD. The level of SBP and severe hypertension （grade 3 hypertension） are common independent risk factors of TOD.