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Objective:To explore the local prevalence of early cognitive dysfunction after a stroke in some hospital of Qinghai province, analyze its risk factors and construct a risk factor model.Methods:A prospective cross-sectional survey was conducted among 854 stroke patients at 3 hospitals in Qinghai Province. The survey solicited demographic data, clinical data, and information about the respondents′ diet and leisure activities. Within 14 days after stroke onset, all of the participants′ cognitive performance was quantified using the Mini-Mental State Examination (MMSE). Those with scores ≤27 formed the cognitive impairment group ( n=569), while the rest were the normal cognition group ( n=285). Through univariate analysis and multivariate logistic regression analysis, the relationship between each factor and the outcome was clarified, and a prediction model was established in the form of a regression equation. The model′s receiver operating characteristics (ROC) curve was computed. Results:The incidence of acute cognitive impairment after stroke was 66.6%. Univariate analysis showed that there were significant differences between the two group in terms of age, sex, ethnicity, education, occupation, altitude, living with a spouse and social support. Stroke type, hemiplegia, a history of hypertension, and triglyceride and D-2 polymer levels were significant predictors, as were ADL score, leisure activity level, and weekly consumption of fruits, nuts and salt. The multivariate logistic regression analysis showed that age, being female, hemorrhagic stroke, hypertension, and living at high altitude were independent risk factors for cognitive impairment at the acute stage of stroke. However, education, occupation, leisure activity and consumption of triglycerides and nuts were independent protective factors. The prediction model showed an area under the ROC curve of 0.832, with sensitivity of 0.698 and specificity of 0.814.Conclusions:The prevalence of cognitive dysfunction in the acute stage of stroke is high in some hospital of Qinghai province. Age, being female, hemorrhagic stroke, hypertension and high altitude living are independent risk factors for stroke, while education, an occupation, leisure activity and triglyceride and nut consumption are protective factors. The risk factor model established in this study has good predictive ability with this population, with whom it can be used to formulate interventions to improve the life quality of stroke survivors.
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Objective:To evaluate the cognitive function of elderly inpatients in Qinghai and analyze the influencing factors in this prospective study.Methods:A total of 1077 elderly inpatients were enrolled for general information investigation, including the Mini Nutritional Assessment-Short form(MNA-SF), Geriatric Depression Scale 15(GDS-15), FRAIL Scale, activities of daily living(ADL), instrumental ability of daily living(IADL)and the Mini-Mental State Examination(MMSE).Results:The 1077 elderly inpatients being subjected in this study, included 470 in the cognitive impairment(CI)group and 607 in the normal group.The prevalence of CI in hospitalized elderly patients was 43.64%(470/1077). The results of univariate analysis showed that as compared with the normal group, the proportion of cognitive impairment was higher in female, elder patients, and boiling tea-drinker, otherwise the proportion of CI was lower in patients living with the spouse, normal sleep, often eating beef and mutton( P<0.01 or P<0.05); FRAIL Scale, ADL total score, and IADL total score were higher in the normal group than in the CI group( P<0.01); the elderly depression score and frailty score were higher in the CI group than in the normal group( P<0.01). The results of logistic regression analysis showed that the risk of CI was higher in female and people frequently drinking boiling tea than in male and people not frequently drinking boiling tea( OR=0.740, 1.211, both P<0.05), and that frequent consumption of beef and mutton, and reasonable levels of nutrition, ADL, and IADL were protective factors for CI in elderly hospitalized patients( OR=0.780, 0.938, 0.956, 0.895, all P<0.05). Conclusions:The incidence of cognitive impairment in hospitalized elderly patients in Qinghai is relatively high.Female and often drinking boiling tea may increase the risk of cognitive impairment.Regularly eating beef and mutton, reasonable levels of nutrition, maintaining good daily life ability can delay cognitive impairment.
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Objective To investigate the basic status and the 15 quality indicators in clinical laboratory of medical institutionin in Qinghai provinces, and to understand the quality status.Methods Clinet-EQA system was applied by Qinghai Center for Clinical Laboratories to provide the electronic questionnaire for the clinical laboratory of 106 medical institutions in April 2016 and report related results online.The software of Clinet-EQA system and SPSS13.0 were used for 15 quality indicators for statiatical analysis,13 indicators expressed in rate were further evaluated with sigma scales.Results Totally 102 laboratories returned questionnaires, the rate was of 96.2%.8/13 quality indicators of the overall sigma levels were all >3.The average level of 4 quality indicators such as the sample type error rate was slightly lower than the national.Comparison of the 4 quality indicators of each grade hospital in Qinghai and the same grade hospital in the national, secondary hospital in clinical chemistry, immunology, clinical examination,microbiology in the four major performed better than tertiary hospital.In routine examination, pre-analytical TAT average level of clinical chemistry and immunology was about 50 min,and of blood,urine and stool was 45 min.Pre-analytical TAT in emergency examination for all four disciplines were about 15 min.Intra-analytical TAT for clinical chemistry was the longest,which was 120 min for routine examination and 40 min for emergency examination,respectiely.The average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.For example of clinical chemistry, routine examination both in pre-analytical TAT and in Intra-analytical TAT was statistically significant in different scales of laboratories,and emergency examination in pre-analytical TAT and in Intra-analytical TAT was not statistically significant.Conclusions 4/13 quality indicators which expressed in rate in the average level in Qinghai province were lower than the national,the average level of the median TAT of blood,urine and stool in routine examination of Intra-analytical in Qinghai was longer than the national.The laboratory should focus on the weak links and continue improvement.