Ottawa Hospital, Civic Campus, 1053 Carling Ave, Ottawa, ON K1Y 4E9.
Can Fam Physician. 2010 Nov;56(11):1123-9.
To help physicians become more comfortable assessing the fitness to drive of patients with complex cardiac and cognitive conditions.
The approach described is based on the authors' clinical practices, recommendations from the Third Canadian Consensus Conference on Diagnosis and Treatment of Dementia, and guidelines from the 2003 Canadian Cardiovascular Society Consensus Conference.
When assessing fitness to drive in patients with multiple, complex health problems, physicians should divide conditions that might affect driving into acute intermittent (ie, not usually present on examination) and chronic persistent (ie, always present on examination) medical conditions. Physicians should address acute intermittent conditions first, to allow time for recovery from chronic persistent features that might be reversible. Decisions regarding fitness to drive in acute intermittent disorders are based on probability of recurrence; decisions in chronic persistent disorders are based on functional assessment.
Assessing fitness to drive is challenging at the best of times. When patients have multiple comorbidities, assessment becomes even more difficult. This article provides clinicians with systematic approaches to work through such complex cases.
帮助医生更轻松地评估患有复杂心脏和认知状况的患者的驾驶适宜性。
所描述的方法基于作者的临床实践、第三届加拿大痴呆症诊断和治疗共识会议的建议，以及 2003 年加拿大心血管学会共识会议的指南。
在评估患有多种复杂健康问题的患者的驾驶适宜性时，医生应将可能影响驾驶的情况分为急性间歇性（即检查时通常不出现）和慢性持续性（即检查时始终存在）医疗状况。医生应首先解决急性间歇性疾病，以便有时间从可能可逆的慢性持续性特征中恢复。急性间歇性疾病的驾驶适宜性决策基于复发的可能性；慢性持续性疾病的决策基于功能评估。
在最好的情况下评估驾驶适宜性都具有挑战性。当患者有多种合并症时，评估就变得更加困难。本文为临床医生提供了系统的方法来处理此类复杂病例。
