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Objective:To evaluate dynamic changes of functional status in elderly emergency inpatients by using the interRAI Acute Care for Comprehensive Geriatric Assessment(interRAI AC-CGA), and to analyze whether assessment results are helpful for clinical decision-making.Methods:Elderly patients(aged 60 years and older)who were hospitalized in the Acute Care Unit of PLA General Hospital from October 2017 to March 2018 were included.Each patient received the interRAI AC-CGA instrument-based assessment at admission(day 1), on day 7 and day 28 after admission.Analysis of collected data was conducted using interRAI AC-CGA scales, geriatric syndrome screening and risk identification of adverse outcomes, in order to examine dynamic changes of functional status in patients at and after admission and to explore the relationship between functional status at admission and outcomes(at discharge).Results:Thirty-four patients were evaluated, including 26 males and 8 females, aged from 60 to 101 years, with a mean age of(84.2±10.1)years.Patients had a variety of functional abnormalities at admission and during hospitalization, in which the ability to perform activities of daily living(ADL)and instrumental activities of daily living(IADL)decreased significantly.Compared with evaluation results on day 1, the incidences of functional abnormalities on day 7 and day 28 declined, and there was improvement in transient depression, pain and falls( χ2=6.298, 6.027 and 7.766, P=0.043, 0.049 and 0.021). After evaluation on day 28, 16 patients were discharged and 18 remained hospitalized(including 2 deaths). The rate for most abnormality was lower in the discharge group than in the continued hospitalization group, and the rates for abnormal communication and falls were lower in the discharge group than in the continued hospitalization group( χ2=6.349 and 5.443, P=0.019 and 0.030). Age(≥85 years old)had no effect on discharge.There was no significant difference in hospital discharge rate between the advanced age group(≥85 years old)and the elderly group(60-84 years old)(40.0% or 8/20 vs.57.1% or 8/14, χ2=0.971, P=0.324). Conclusions:The interRAI AC-CGA instrument can systematically and dynamically estimate functional changes in elderly emergency inpatients.Functional status at admission is related to prognosis(performance at discharge)of patients.
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Objective@#To investigate the correlation between age-related hearing loss and cognitive impairment.@*Methods@#201 elderly patients, who were admitted to the Department of Otorhinolaryngology of Peking University People′s Hospital from March 1, 2017 to March 31, 2017, were evaluated with hearing screening and the Montreal Cognitive Assessment Scale. Among them, 101 were female and 100 were male, aged 60-90 years old. Taking the cognitive level as the dependent variable, and taking the age, sex, education, occupation, marital status, residence, and average hearing loss (average hearing threshold of 500, 1 000, 2 000, and 4 000 Hz), as well as the length of conscious hearing loss as the independent variables, the single factor analysis and multivariate linear regression analysis were used to screen the main factors affecting the cognitive level of the elderly.@*Results@#Of the 201 elderly patients, 39 had normal hearing, 65 had mild hearing loss, 80 had moderate hearing loss, 16 had severe hearing loss, and 1 had profound hearing loss. The average degree of hearing loss was the influencing factor of cognitive impairment, and it mainly affected the directional force and abstract ability in the cognitive domains (P<0.05); The age, self-reported hearing loss, years of education, marital status, past ear diseases, and hypertension were relatively independent factors that affected the cognitive level(P<0.05).@*Conclusions@#Age-related hearing loss is the risk factor for the cognitive impairment, especially for abstraction and orientation, in the elderly. The self-reported hearing loss is an independent risk factor for cognitive impairment.
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OBJECTIVE To measure the dexamethasone concentration in the cochlear tissue after postaurical and intramuscular administration. METHODS After bilateral adrenalectomy,animals were divided into three groups:postaurical injection group,intramuscular injection group,and physiological saline injected blank control group.At 0.25,0.5, 2.5,5,12,24,72 h after injection(1mg/100g), cochleae together with the intact endolymphatic sac were removed and homogenated.After that, the dexamethasone was detected by enzymelinked immunosorbent assay(ELISA).RESULTS The dexamethasone levels in the cochlear tissue in postaurical injection group were significantly higher than that in the intramuscular injection group.In the postaurical administration group,a mean peak cochlear tissue concentration of(175.2?36.0) ng/ml was detected at 0.25 h after injection,then declined obviously 12 h and was below detection limits by 24h.While in the intramuscular administration group, a mean peak concentration was observed 2.5 h at the concentration of(141.1?8.9) ng/ml,then rapidly declined from 5h and beyond detection by 24 h.CONCLUSION Compared with intramuscular administration,the dexamethasone levels in the postaurical injection group were significantly higher, with peak concentration reached earlier,and last longer.