Vol. 1 No. 1 (2025): A 50-Year Journey in Establishing a Position and Promoting Sustainable Development in Healthcare and Geriatrics

Established in 1975, Thong Nhat Hospital carries a historic mission: to provide healthcare for senior government officials and the elderly—individuals who have devoted their lives to national service. Over nearly five decades of development, the hospital has continually expanded its scope, enhanced service quality, and emerged as a leading institution in geriatric medicine in Vietnam. This article not only chronicles the hospital’s developmental journey but also analyzes the rapidly aging demographic landscape in Vietnam and globally. It further outlines a comprehensive strategic development plan through 2035. In response to the emergence of a “super-aged society,” Thong Nhat Hospital aims to become a high-tech national geriatric center of excellence. Its strategic vision is grounded on four foundational pillars: (1) developing a comprehensive and personalized care model that integrates advanced digital technologies and artificial intelligence; (2) cultivating a specialized workforce through nationally standardized and internationally aligned training programs; (3) fostering innovation in scientific research, particularly in disease modeling, interventions to enhance quality of life, and academic publication in geriatric health sciences; and (4) promoting international integration to adopt global best practices and contribute knowledge to the regional and global geriatric health community. These strategic directions are underpinned by the hospital’s robust clinical foundation, multilayered academic collaboration networks, modern hospital governance, and a unified, committed healthcare workforce. This vision reflects the competence, dedication, and strategic foresight of a leading medical institution, contributing to the restructuring of Vietnam’s healthcare system towards a more proactive and humane adaptation to population aging.

Population Aging is a global trend characterized by an increasing proportion of people aged 65 and over in the total population. This article analyzes the phenomenon of PA through a demographic lens, clarifying that aging is not solely the result of increased life expectancy, but also due to a prolonged period of below-replacement total fertility rate (TFR). Evidence from South Korea illustrates this dynamic: within just 60 years, the country transitioned from a nonaged society (1960) to a super-aged society (projected in 2027), with the consequence of a steep population decline starting in 2020. Vietnam, projected to become an ‘aged’ society by 2036 and a ‘super-aged’ society around 2060, must recognize emerging trends and underlying causes early to develop appropriate adaptation policies. Population Aging is not merely the outcome of medical advances and improved living conditions; it also reflects national governance decisions related to fertility, elder care, and sustainable human development. This article emphasizes the importance of monitoring TFR, the proportion of older adults, and the labor force in order to formulate responsive population policies in the context of rapidly advancing aging

Musculoskeletal pain is highly prevalent among older adults, affecting 40–60% of this population and contributing significantly to disability and reduced quality of life. Chronic pain in the elderly is multifactorial and often underdiagnosed or undertreated due to complex clinical presentations, cognitive impairment, and misconceptions about pain as a normal part of aging. It is closely associated with geriatric syndromes such as falls, frailty, sleep disturbances, depression, and cognitive decline, and should be assessed in a comprehensive biopsychosocial context. Multimorbidity and polypharmacy further complicate treatment decisions. Non-pharmacologic strategies such as physical therapy, behavioral interventions, and mind-body therapies are strongly recommended. When medications are used, individualized dosing and careful monitoring are essential due to altered pharmacokinetics in older adults. Improving access to evidence-based non-drug therapies and strengthening clinical research are key strategies for enhancing pain care in this vulnerable population.

Hand surgery in Vietnam has evolved significantly, especially in cities like Ho Chi Minh City, Hanoi and Hue. Despite advancements, there remain challenges, including the lack of a unified national hand surgery society. This article highlights the contributions of key figures, advances and the future of the discipline in the country.

Contrast-induced nephropathy (CIN) is a common complication following percutaneous coronary intervention (PCI), particularly in older patients with chronic kidney disease (CKD) and acute coronary syndrome (ACS). CIN can lead to worsening renal function, increased mortality, and prolonged hospitalization. However, data on the incidence and associated factors of CIN in this high-risk population
remain limited. To determine the incidence and associated factors of CIN in patients aged ≥65 years with CKD and ACS undergoing percutaneous coronary intervention (PCI). A prospective descriptive study enrolled 225 patients aged ≥65 years with CKD and ACS admitted to Thong Nhat Hospital from May 2024 to May 2025. Serum creatinine and estimated glomerular filtration rate (eGFR) were monitored before and up to five days post-PCI. CIN is defined as an increase in creatinine ≥25% or ≥0.5 mg/dL from baseline. Risk factors analyzed include the Mehran risk score, cardiovascular history, hemodynamic status, anemia, and contrast volume. CIN occurs in 13.8% of patients, with significantly higher incidence in CKD stage 4–5 compared to stage 3 (23.3% vs. 9.2%; p = 0.004). The CKD 4–5 group has a higher mean Mehran score (15.4 vs. 7.31; p = 0.001) and lower post-PCI eGFR (16.8 vs. 46.6 mL/min/1.73 m²; p < 0.001). Two patients (0.9%) require emergency dialysis, and in-hospital mortality is 1.8%, mostly among those with advanced CKD. Significant predictors of CIN include Mehran score ≥10, heart failure, anemia, hypotension, and higher contrast volume. CIN remains a relevant complication in elderly patients with CKD and ACS undergoing PCI, especially in those with advanced CKD. Early risk stratification, hemodynamic optimization, and careful management of contrast use are essential to reducing CIN in this high-risk group.

We conducted this study to determine the prevalence of malnutrition and its associated factors among elderly hemodialysis patients at Thong Nhat Hospital, thereby providing evidence to guide nutritional support and dietary interventions. This cross-sectional, descriptive, retrospective, and comparative study included 158 hemodialysis patients at the Department of Nephrology and Dialysis, Thong Nhat Hospital, Ho Chi Minh City. Participants were divided into two groups: those aged ≥60 years and those aged <60 years. Nutritional status was assessed by using body mass index and serum albumin levels. The results showed that the prevalence of malnutrition among elderly hemodialysis patients varied depending on the assessment criteria: 39,82% based on serum albumin levels and 12,9% based on body mass index. Multivariate analysis revealed no statistically significant associations between hypoalbuminemia and diabetes mellitus (OR = 1,30; p = 0,516), hyperparathyroidism (OR = 0,54; p = 0,156), dyslipidemia (OR = 0,81; p = 0,665), hemoglobin levels (OR = 1,01; p = 0,935), duration of dialysis (OR = 1,00; p = 0,672), type of dialysis membrane (OR = 1,30; p = 0,542), or dialysis adequacy (Kt/V) (OR = 1,30; p = 0,355). Our study revealed the prevalence of malnutrition – particularly when defined by serum albumin – is high (39,82%) among hemodialysis patients, especially the elderly. These findings underscore the importance of investigating additional contributing factors to malnutrition in population.

To evaluate the impact of osteoporosis on bone union time. The study involved 405 fracture patients divided into two groups: Group A, consisting of 242 patients with fractures and osteoporosis; and Group B, consisting of 163 patients with corresponding fractures but without osteoporosis, from January 2020 to January 2024. The osteoporotic patient group was older, with a majority being female (p < 0.05). The most common fracture type was intertrochanteric, with 81 cases accounting for 20% of all fractures. Of these, the majority were in patients with osteoporosis (52 patients, 64.2%). Osteoporosis prolonged the bone union time in patients with intertrochanteric fractures and femoral shaft fractures. Bone healing time is affected by osteoporosis at intertrochanteric and femoral shaft fracture.

This article analyzes the clinical and paraclinical features of 47 elderly patients with colonic diverticulitis at Thong Nhat Hospital. The majority were male (68.1%) and aged 60–74 (72.3%). The most common symptom was dull persistent abdominal pain (70.2%), mainly in the right and left iliac fossae. Fever and digestive disorders were atypical, with low fever rates (10.6%) and watery stools accounting for 51%. Blood tests showed leukocytosis in 46.8% and increased CRP in 93.6%. CT imaging was crucial for diagnosis and severity assessment, with 25.5% requiring surgery. The findings highlight the importance of recognizing atypical symptoms and the role of paraclinical tests in diagnosis in the elderly.

To evaluate the prevalence of preoperative anemia in patients with gastrointestinal cancer and assess the rate of anemia treatment prior to surgery. A prospective cross-sectional descriptive study with analytical components was conducted on patients with gastrointestinal cancer scheduled for elective surgery at Thong Nhat Hospital from January to October 2024. Preoperative anemia was observed in 49.2% of patients, with 72.4% of these cases occurring in elderly individuals (≥60 years old). Among the 58 patients diagnosed with anemia, 20.7% received preoperative iron supplementation, while 15.5% required blood transfusions before surgery. The prevalence of preoperative anemia in patients with gastrointestinal cancer is high, yet the rate of preoperative iron supplementation remains low. Routine screening and early intervention are essential to optimize hemoglobin levels prior to surgery and improve clinical outcomes.

In Vietnam, kidney transplantation has been performed since 1992. However, the number of transplants remains limited, mainly due to reliance on living donors. Expanding the donor pool with brain-dead donors is considered a humane and sustainable solution to address the current organ shortage, particularly in kidney transplantation. Since May 2022, Thong Nhat Hospital has launched a kidney transplant program with technical support from Cho Ray Hospital. As of March 2025, we have successfully performed 21 kidney transplants, including 4 cases using kidneys from 2 brain-dead donors. This is a descriptive clinical study of the first 4 kidney transplants using organs from 2 brain-dead donors, performed on November 24, 2024, and March 19, 2025. There were two brain-dead donors: the first was a male, 18 years old, who died from traumatic brain injury, with 174 hours between injury and brain death diagnosis; the second was a male, 44 years old, who suffered a fatal occupational accident, with 45 hours from accident to brain death confirmation. Renal function in both donors was assessed before organ retrieval. Four recipients with end-stage chronic kidney disease undergoing regular hemodialysis were selected, including 3 males and 1 female, with a mean age of 33.25 years. Two kidneys were transplanted into the right iliac fossa and two into the left. All patients produced urine immediately on the operating table. The average operative time was 270 minutes, with arterial and venous anastomosis times averaging 15.5 and 12.5 minutes, respectively. Vascular anastomoses were performed in an end-to-side fashion. Ureteroneocystostomy was performed using the Lich-Grégoir technique with JJ stent placement. Renal function recovered rapidly within one week in the first two patients, while the other two experienced delayed recovery. One female patient underwent reoperation on postoperative day 13 due to perinephric fluid and hematoma; her condition stabilized after drainage and she was discharged one week later. Initial results suggest that kidney transplantation from brain-dead donors is feasible at Thong Nhat Hospital. Although technical support from Cho Ray Hospital is still necessary, the surgical team at Thong Nhat has gradually gained control over key steps of the transplant procedure. Compared to living-donor transplants, kidneys from brain-dead donors tend to have slower functional recovery. However, from a surgical standpoint, vascular anastomoses are more straightforward due to the presence of vascular patches, which facilitate safer and easier anastomosis. Kidney transplantation from brain-dead donors is a humane, safe, and effective solution that significantly improves the quality of life for end-stage renal disease patients and serves as a strategic direction for organ transplantation development at Thong Nhat Hospital.

This study was conducted to describe the clinical and paraclinical characteristics and evaluate early outcomes of laparoscopic surgery for common bile duct (CBD) stones in elderly patients. We performed a retrospective study of 95 patients over 60 years of age diagnosed with CBD stones who underwent laparoscopic surgery at the Hepatobiliary Surgery Department, Thong Nhat Hospital from January 2016 to December 2022. Among the 95 surgical cases, there were 49 male patients (51.58%) and 46 female patients (48.42%), with a mean age of 74.67 years (ranging from 60 to 95 years). Regarding clinical manifestations, abdominal pain was the most common symptom, present in 91.58% of patients, followed by cholangitis in 41.05% (39 cases). Post-surgery, the stone clearance rate reached 94.7%, demonstrating the high effectiveness of the laparoscopic approach. The mean operative time was 136.36 ± 23.26 minutes, and the average hospital stay was 13.4 ± 3.8 days. Postoperative complications were documented, including bile leakage (3.16%), bleeding (1.05%), and infection (2.11%). Notably, no mortality was recorded in this study. The findings indicate that laparoscopic surgery for CBD stones in elderly patients at Thong Nhat Hospital is a safe and feasible procedure, provided that patients are carefully selected preoperatively. This study contributes additional evidence supporting the efficacy and safety of laparoscopic surgery in treating CBD stones in elderly patients, who typically present with more comorbidities and higher risk of complications compared to younger patient groups. The low complication rates and absence of mortality in our series suggest that, with proper patient selection and surgical expertise, advanced age should not be considered a contraindication to laparoscopic CBD stone management.

The use of ambulatory blood pressure monitoring (ABPM) has been established in the evaluation of the 24-hour blood pressure (BP) pattern. Most studies have examined the nighttime blood pressure fall (NBPF) pattern in patients with chronic heart failure (CHF). However, little clinical information is available to understand the pattern of NBPF in patients with acute heart failure (AHF). Objective: to investigate the pattern of ABPM in patients with AHF. We included 69 patients with HFrEF who were hospitalised for AHF at Department of Cardiology, Thong Nhat Hospital from March 2020 to December 2021. After haemodynamic stabilisation, we monitored the patients ambulatory BP. The patients mean age was 66.2±14.77 years, with 71.0% of men, and a mean heart failure duration of 2.8±1.9 years. Coronary artery disease was the most common cause of heart failure (79.7%), while dilated cardiomyopathy accounted for 20.3%. The comorbidities were: hypertension, dyslipidemia, diabetes, stroke, and atrial fibrillation; 97.1%, 91.7%, 31.9%, 10.1%, and 31.9%, respectively. The New York Heart Association functional classification was: II, III, and IV; 17.4%, 63.8%, and 18.8%, respectively. The therapeutic regimens were as follows: angiotensin receptor neprilysin inhibitor, angiotensin converting enzyme inhibitor/angiotensin receptor antagonist, beta-blockers, spironolactone, and digoxin; 20.3%, 69.6%, 68.1%, 85.5%, and 34.8%, respectively. Four patients (5.8%) had normal BP dipping pattern (NBPF ≥10%), 35 (50.7%) had a non-dipping pattern (0% ≤NBPF <10%), and 30 (43.5%) had a riser pattern (NBPF <0%). Our findings highlight the haemodynamic pattern of patients with AHF with most of them showing an NBPF below 10%.

Describe the current situation and analyze some factors affecting participation in scientific research of nurses at Thong Nhat Hospital in the period 2021-2023. A cross-sectional descriptive study was conducted on 335 nurses in clinical departments and in-depth interviews with Hospital Leaders, Department/Office Leaders, Department Head Nurses and nurses. The rate of nurses participating in scientific research is 25.37% (n = 85). Of the 85 nurses participating in research, the rate of participation in 2 or more topics is 45.88%. Nurses are the project leaders of 16.4%. Scientific research activities of nurses are mainly data collection (85.9%), accounting for the highest rate compared to other activities. The number of scientific articles with the participation of nurses is low, accounting for 13.46% (21/156 articles in 3 years). Factors affecting nurses' participation in scientific research: professional qualifications, work position, knowledge, attitude, skills in scientific research, scientific research training activities participated. The proportion of nurses participating in scientific research is low, and their main activity is data collection. Professional qualifications, working position, knowledge, attitude, and skills in scientific research, funding, the role of hospital leaders/department leaders, reward policies for science and technology, and annual competition review activities are factors that influence nurses' participation in scientific research.

Exacerbations of Chronic Obstructive Pulmonary Disease (COPD) lead to decline in lung function, quality of life, and increased costs and mortality. Identifying trigger factors for exacerbations, especially in elderly patients with comorbidities, is crucial due to limited research in Vietnam. To investigate trigger factors for COPD exacerbations in patients admitted to the Emergency Department of Thong Nhat Hospital, HCMC. A prospective, cross-sectional descriptive study was conducted on 95 patients admitted to the Emergency Department of Thong Nhat Hospital for COPD exacerbation from January 2020 to July 2020. The mean age was 75.39 years; 91.6% were male, and 60% of patients had ≥2 exacerbations per year. Common cardiovascular comorbidities included hypertension (85.3%) and coronary artery disease (41.1%). Multiple factors (cardiovascular disease, bronchiectasis, Asthma-COPD Overlap (ACO), smoking, non-compliance with treatment) were associated with more frequent and severe exacerbations. Importantly, infection and eosinophilia (≥300 cells/µL or ≥2%) were statistically significantly associated with exacerbations (p < 0.05). Patients with COPD exacerbation were predominantly elderly males, often with cardiovascular comorbidities. Infection and eosinophilia were factors statistically significantly associated with exacerbations.

We conducted this study to assess the prevalance of pain and the efficacy of pain management for hospitalized elderly patient in Internal Medicine Department of Thong Nhat hospital from 4/2024 to 7/2024. Cross-sectional study at two time points 246 of eligible hospitalized elderly patients were assessed for pain by using the Vietnamese version of Brief Pain Inventory short form. Patients who experienced pain were then re-assessed again after 7 days by using the same measurement tool. Besides, data on demographic factors clinical characteristics and medication use were collected from medical records during the last days. The prevalance of pain among 246 hospitalized elderly patients was relatively high at 51.22% and significantly related to injuries (p < 0.001), musccular- skeletal disorder (p < 0.0001), surgical disease (p= 0.023). The common locations of pain were leg, head, abdomen and back. Among patient with pain, the median score of worst pain, the average pain and the interview pain was 7.3±1.86; 5.18 ± 1.83; 4.91± 2.27 ( on a scale from 0 to 10). Pain affected all daily activities of elderly patients, 65.9 % patients with pain experience serve pain related interference. 71.4% of hospitalized elderly patients with pain reported therapeutic efficacy (cut off as 50% of pain reduction). A large portion of patients were treated by using acetaminophen (69.8%), topical pain relief (33%), antiepileptic drugs (31.7%), NSAID (13.5%), morphin (0.8%). Pain is a common problem with high intensity and severe impairment of daily activities in hospitalized elderly patients, significantly related to injuries, musccular- skeletal disorder, surgical disease. Result of this study emphasizes the role of appropriate pain asessment and management to improve the treatment effectiveness and the quality of life of elderly patients.

The rate of insomnia is increasing in today’s life, finding effective non-pharmacological treatments for insomnia is very necessary. Intravascular low-level laser therapy is a new method in the treatment of insomnia disorders that needs to be exploited and evaluated for its therapeutic effectiveness when combined with manual acupuncture in Traditional Medicine. Determine the efficacy of low-level laser therapy combined with acupuncture versus acupuncture alone in the treatment of non-organic insomnia. Sixty patients diagnosed with non-organic insomnia at the Department of Traditional Medicine, Thong Nhat Hospital, from February 2024 to July 2024. The patients were randomly divided into two groups. The intervention group (n=30) received treatment with low-level laser therapy combined with manual acupuncture, while the control group (n=30) received manual acupuncture. The efficacy of the treatment was evaluated based on the Pittsburgh Sleep Quality Index (PSQI) and the number of awakenings before treatment, as well as at 5 and 10 days after treatment. After 10 days of treatment, the group receiving manual acupuncture combined with low-level laser therapy showed a significant and notable reduction in PSQI scores compared to the group receiving only manual acupuncture. The PSQI score decreased from 17.2 to 13.33, a total reduction of 3.87 points, reflecting a change in sleep disturbance from moderate to mild. The average sleep onset time reduced from 101.67 minutes to 41 minutes, corresponding to a decrease in the score from 2.63 to 1.43. The average number of hours of sleep per night increased from 3.23 hours to 5.27 hours, with a score reduction from 2.9 to 2.1. The average sleep efficiency improved from 40.59% to 59.91%, with a score decrease from 2.87 to 2.5. In terms of sleep quality, the score decreased from 2.9 to 1.87. The average daytime dysfunction score reduced from 1.77 to 1.1, and the number of awakenings decreased from 2.70 to 1.77. These improvements were statistically significant compared to the group receiving only manual acupuncture. The combined method of manual acupuncture with low-level laser therapy is more effective than manual acupuncture in the treatment of non-organic insomnia.

Non-variceal upper gastrointestinal bleeding (UGIB) is a common medical and surgical emergency,  and risk stratification upon patient admission is of great importance. Therefore, evaluating the predictive value of the Modified Glasgow Blatchford Score (mGBS) compared to the Full Glasgow Blatchford Score (GBS) and the Clinical Rockall Score (CRS) in patients with non-variceal UGIB upon hospital admission is essential. This study aimed to assess the value of the mGBS in predicting outcomes in non-variceal UGIB due to portal hypertension. A prospective cohort study was conducted on patients with non-variceal UGIB due to portal hypertension admitted to the Department of Gastroenterology, Thong Nhat Hospital, from January 2024 to July 2024. The mGBS, GBS, and CRS were calculated, and the area under the receiver operating characteristic curve (AUC) was compared to determine the predictive performance of these scores for interventions including blood transfusion, endoscopic hemostasis, and overall medical intervention. A total of 130 eligible patients with non-variceal UGIB due to portal hypertension were included. The mean age was 57.5 ± 19.8 years, with a male-to-female ratio of 3.1:1. The in-hospital rebleeding rate was 5.4%. Medical interventions were required in 59.2% of cases, including blood transfusion in 45.4%, endoscopic intervention in 28.5%, and surgery in 3.1%. In terms of predicting the need for medical intervention, the mGBS (AUC = 0.845) performed similarly to the GBS (AUC = 0.844; p = 0.37) and outperformed the CRS (AUC = 0.707; p < 0.001). The Modified Glasgow Blatchford Score demonstrated good predictive value for medical intervention in patients with non-variceal UGIB due to portal hypertension and may be widely applicable in clinical practice.

This study aimed to characterize the clinical and paraclinical features, treatment outcomes, and antibiotic resistance patterns of Acinetobacter baumannii-associated hospital-acquired pneumonia (HAP) in elderly patients. A cross-sectional descriptive study was carried out on 75 hospitalized patients aged 60 years and above who were diagnosed with A. baumannii-related HAP. The study took place at the Department of Respiratory Medicine, Thong Nhat Hospital, from April 2024 to April 2025. The majority of patients exhibited clinical manifestations including fever, productive cough, dyspnea, auscultatory crackles, leukocytosis, elevated C-reactive protein (CRP) levels, and chest radiographs revealing infiltrates in over 70% of cases. Altered mental status was notably prevalent among elderly patients, affecting 65.3%. The most frequently utilized empirical antibiotic regimens were ceftazidime plus gentamicin, piperacillin/tazobactam plus levofloxacin, and ceftazidime pus ciprofloxacin; however, only 21.3% of these empirical therapies aligned with antibiotic susceptibility testing results. Multidrug-resistant A. baumannii accounted for 84% of isolates, with 21.3% classified as multidrug-resistant (MDR), 50.7% as extensively drug-resistant (XDR), and 13.3% as pandrug-resistant (PDR). Resistance rates to β-lactam/β-lactamase inhibitor combinations and cephalosporins exceeded 85%, resistance to quinolones and aminoglycosides ranged between 60–70%, and carbapenem resistance was approximately 50%. Colistin was identified as the sole antibiotic demonstrating efficacy exceeding 70%. The treatment failure rate was 65.3%, which was significantly associated with age, duration of hospitalization, and inappropriate empirical antibiotic therapy. The clinical and paraclinical characteristics of hospital-acquired pneumonia (HAP) caused by A. baumannii in elderly patients are distinctive, with altered mental status being a prominent feature. A. baumannii exhibited resistance to the majority of antibiotics tested, leaving colistin as the only relatively effective therapeutic option. Nonetheless, managing HAP caused by A. baumannii in the elderly remains a formidable challenge, reflected in a notably high mortality rate. Factors such as advanced age, prolonged hospitalization, and inappropriate empirical antibiotic use were significantly correlated with treatment failure

To evaluate the motor function recovery in post-stroke patients using the motor assessment scale (MAS). A prospective, interventional, cross-sectional descriptive study without a control group, with assessments before and after treatment. The study was conducted on 92 post-stroke patients who received examination and treatment at the Rehabilitation Department, Emergency Cardiology Intervention Department, Neurology Department, and Traditional Medicine Department of Thong Nhat Hospital from May 2023 to May 2024. Motor function recovery was evaluated using the MAS scale, which includes 8 main activities: lying, sitting, standing, walking, and upper limb and hand movements. Motor function improved significantly after treatment, with an average increase of 5.58 ± 0.83 points (p<0.001). The position-shifting group showed greater improvement compared to the upper limb and hand movement group. The position-shifting score increased by 4.17 ± 0.5 points, while upper limb and hand activity scores increased by 0.86 ± 0.06 points. Activities that showed marked improvement included transitioning from supine to side-lying, from lying to sitting, achieving sitting balance, and standing up from a seated position. Upper limb and hand function requires more time to achieve full rehabilitation.