ObjectiveTo systematically review the associations of cognitive frailty with mortality and hospitalization in the elderly. MethodsThe VIP, PubMed, CNKI, WanFang Data, CBM, Embase, Cochrane Library and Web of Science databases were electronically searched to collect cohort studies on the association of cognitive frailty with mortality or hospitalization in the elderly from inception to May, 2023. Two reviewers independently screened the literature, extracted data and assessed risk of bias of the included studies. Meta-analysis was performed by R 4.2.2 software. ResultsA total of 19 cohort studies involving 63 624 elderly were included. The results of meta-analysis showed that compared with healthy elder, the elder with cognitive frailty had a higher mortality (OR=2.75, 95%CI 2.10 to 3.59, P<0.01) and hospitalization (OR=1.67, 95%CI 1.40 to 2.00, P<0.01). Subgroup analysis showed that cognitive frailty was related to the risk of death in different status of frailty and cognitive function, different assessment tools, different countries of development, different follow-up time and research sites. At the same time, different status of frailty and cognitive function and different levels of development of countries were related to the risk of hospitalization. ConclusionCurrent evidence shows that cognitive frailty can increase the risk of hospitalization and mortality in the elderly. It is suggested that early screening and intervention of cognitive frailty should be carried out to effectively reduce the risk of adverse consequences, so as to achieve healthy aging.
Risk stratifications are valuable aids for stratifying patients by disease severity, driving informed clinical decisions, because they allow the selection of the most appropriate strategy of treatment based on the patient's individual characteristics. The clinical algorithms help patients and their families to get a better understanding of issues relevant to treatment strategies and subsequent risks as part of the process to obtain informed consent. The current risk stratifications of coronary artery bypass grafting included the Society of Thoracic Surgeons Score, the European System for Cardiac Operative Risk Evaluation, SinoSystem for Coronary Operative Risk Evaluation. This review focuses on the progress of risk stratifications of coronary artery bypass grafting for patients undergoing cardiac surgery.
Objective To analyze the epidemic trend of prostate cancer in China from 1992 to 2021, and predict its epidemic trends from 2022 to 2032. Methods Based on the data of Chinese population and prostate cancer incidence and mortality from Global Burden of Disease Database, the Joinpoint log-linear model was used to analyze the trends of prostate cancer incidence and mortality, use the age-period-cohort model to analyze the effects of age, period and cohort on changes in incidence and mortality, and the gray prediction model was used to predict the trends of prostate cancer. Results From 1992 to 2021, the incidence and mortality of prostate cancer in China showed an upward trend, with AAPC of 5.652% (P<0.001) and 3.466% (P<0.001), and the AAPC of age-standardized incidence decreased to 1.990% (P<0.001), the age-standardized mortality showed a downward trend and was not statistically significant. The results of the age-period-cohort model showed that the net drift values of prostate cancer incidence and mortality were 3.03% and −1.06%, respectively, and the risk of incidence and mortality gradually increased with age and period. The results of the grey prediction model showed that the incidence and mortality of prostate cancer showed an upward trend from 2022 to 2032, and the incidence trend was more obvious. Conclusion The incidence and mortality of prostate cancer in China showed an increasing trend, with a heavy disease burden and severe forms of prevention and control, so it is necessary to do a good job in monitoring the incidence and mortality of prostate cancer, and strengthen the efficient screening, early diagnosis and treatment of prostate cancer.
ObjectiveTo analyze the trends of incidence, mortality, and burden of disease of cervical cancer in Chinese females from 1990 to 2019.MethodsThe global burden of disease database (GBD) and China health statistics yearbook data was used to analyze the incidence, standardized incidence, mortality, standardized mortality, urban and rural mortality, and burden of cervical cancer among Chinese females using Excel, SPSS 21.0 and Joinpoint Regression Program 4.8.0.1.ResultsThe standardized incidence of cervical cancer among Chinese females increased from 9.21/100 000 in 1990 to 12.06/100 000 in 2019, and the standardized mortality decreased from 8.40/100 000 to 7.36/100 000. The standardized mortality of cervical cancer in 2018 decreased when compared with 2015 in both urban and rural areas. Changes in age-group incidence and mortality indicated that there was a younger trend in cervical cancer. The disease burden indicators (DALY, YLL, and YLD) were increased from 86.49, 84.01, and 1.52 ten thousand person/years to 162.22, 157.40, and 4.83 ten thousand person/years, in which the YLD increased the most (217.76%). The APC of DALY, YLL and YLD were 2.39%, 2.56% and 4.25%, respectively. The proportion of cervical cancer disease burden in female cancer increased in 2019 compared with 1990. And DALY, YLL and YLD increased in the age group of 40 or over, in which DALY of the age group 50-54 increased 167.15%.ConclusionsThe situation of cervical cancer is not optimistic in China. Although the mortality of cervical cancer has decreased in recent years, the number of cases and mortalities is still increasing. Not only the burden of disease is continuously increasing, there is also a younger trend in cervical cancer. Active preventive measures should be taken to reduce the burden of cervical cancer.
ObjectivesTo systematically review the association between body mass index (BMI) and mortality of chronic obstructive pulmonary disease (COPD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect cohort studies on the association between BMI and mortality of COPD from inception to February, 2019. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software.ResultsA total of 14 cohort studies involving 494 060 COPD patients were included. The results of meta-analysis showed that, compared with patients having a normal weight, underweight individuals were associated with higher mortality (RR=1.40, 95%CI 1.15 to 1.71, P=0.000 8), whereas overweight (RR=0.65, 95%CI 0.54 to 0.79, P<0.000 1) and obese (RR=0.37, 95%CI 0.20 to 0.67, P=0.001) patients were associated with lower mortality.ConclusionsCurrent evidence shows that underweight is associated with a higher risk of all-cause mortality among patients with COPD, whereas overweight and obese are associated with lower risk of all-cause mortality in these patients. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.
Abstract: Objective To summarize the experience of combined coronary artery bypass grafting(CABG) and valve replacement. Methods From May 1997 to March 2006, the results of 80 consecutive patients undergone valve replacement (MVR) and CABG were analyzed. CABG were performed withtotal grafts in 159 grafts (mean 1.99 grafts), with mitral valve replacement (MVR) in 49 patients, with aortic valve replacement (AVR) in 18 patients, with MVR+AVR in 13 patients(mechanical valve replacement in 68 and biological valve replacement in 12). Results The hospital time after operation was 19.2±13.4d. The hospital mortality rate was 12.5% (10/80). The primary cause of death included low cardiac output yndrome, acute renal failure, nervous system complications ,ventricular fibrillation and cardiac arrest. Multivariate testing of preoperative and operative description identified that preoperative myocardial infarction, worse cardiac function, radiographic cardiac enlargement and low ejection fraction were associated with an increase of hospital mortality (P＜0.05). There were postoperative complications including bleeding, severe ventricular arrhythmia, nervous system complications and incision infection. Followup of 58 patients (82.86%, range 6 to 60 months) showed the symptoms of angina pectoris and heart failure were significantly relieved. There were 2 longterm deaths (cerebral infarction and lung infection). Conclusion Combined CABG and valve replacement is an effective way for treatment of coronary artery and valvular heart disease. Improving the heart function preoperatively, strengthening myocardial protection, shortening operation and myocardial ischemia time, and complete revascularization are the key factors for success operation.
Objective To investigate the death rate and life lost of the Xinjian district residents in Nanchang city, and to provide scientific evidence for the health administrators to formulate relevant policies and improve the life expectancy of the residents. Methods Based on the population and the death data in this area from 2011 to 2015, the mortality, the cause of death spectrum, the life expectancy, the life expectancy for death causes, the potential years of life lost (PYLL), the potential years of life lost rate (PYLLR), the average potential years of life lost (APYLL), the standardized potential years of life lost (SPYLL), the standardized potential years of life lost rate (SPYLLR) were analyzed by SPSS 20.0 software. Results From 2011 to 2015, the crude death rate of Xinjian district was 538.38/10 million, the standardized mortality rate was 563.00/10 million, the crude death rate of males is higher than that of females (χ2=788.91, P<0.01); the causes of death in the top five were follows: circulatory system diseases, tumor, respiratory system diseases, injury, endocrine, nutrition and metabolic diseases. The causes of death were in the same order whether in male or female. Mortality rates of different age groups showed that the mortality rates began to rise substantially after the age of 30, the main causes of death were different between the low age group and the high age group. The life expectancy of residents was 78.38 years, the PYLL for all causes of death was 129 087.5 years, the PYLLR was 39.84‰, the APYLL was 17.44 years, the SPYLL was 134 057.00 years, the SPYLLR was 38.61‰. The PYLL caused by injury was 46 191.5 years, the PYLLR was 14.26‰, APYLL was 33.14 years, of which were all ranked first. The SPYLL caused by tumor was 48 414.95 years, the SPYLLR was 13.94‰, of which were ranked first. Conclusion The mortality rate of Xinjian district residents is higher than that of Nanchang urban residents, but lower than the average level of Jiangxi province and the whole country. Life reduction analysis shows that chronic non-communicable diseases and injuries are the main causes of death for residents in the area. The three levels prevention is of great significance to reduce the death of residents and improve their life expectancy.
Objectives To assess the relationship between subclinical hyperthyroidism and the incidence of coronary heart disease (CHD). Methods PubMed, EMbase, The Cochrane Library, Web of Science, CNKI, VIP, WanFang Data and CBM databases were searched for studies on the relationship between subclinical hyperthyroidism and the incidence of CHD from inception to October 2016. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 and Stata 12.0 software. Results In total, 14 cohort studies were included. The results of meta-analysis showed that subclinical hyperthyroidism was associated with the incidence of coronary heart disease (RR=1.19, 95%CI 1.01 to 1.40, P=0.04) and all-cause mortality (RR=1.36, 95%CI 1.11 to 1.67, P=0.003). Conclusions Subclinical hyperthyroidism is associated with an increased risk of CHD and all-cause mortality. Due to the limitation of quality and quantity of the studies, the above conclusions are required to be verified by large-scale and high quality research.
Blood pressure variability (BPV) is a novel predictor related to blood pressure level, and a large number of studies based on the hypertension cohort have shown that BPV is an independent predictor of target organ damages and cardiovascular adverse outcomes. Due to the significant hemodynamic changes, BPV in patients with chronic kidney disease (CKD) and hemodialysis is higher than the simple hypertension cohort, suggesting that BPV may be of great significance to patients with chronic kidney disease and hemodialysis. In recent years, studies based on CKD and hemodialysis cohort have published in succession whose results revealed that BPV of this cohort is of great prognostic significance for predicting target organ damages and cardiovascular disease risks. This article aims to provide an overview on these research, so as to survey and predict the clinical significance of BPV in CKD and hemodialytic patients.