Division of Health and Social Care Research, Kings College London, 7th Floor Capital House, 42 Weston Street, London SE1 3QD, UK.
Age Ageing. 2012 Mar;41(2):142-7. doi: 10.1093/ageing/afr182.
The rate of surgical procedures in the older population is rising. Despite surgical, anaesthetic and medical advances, older surgical patients continue to suffer from adverse postoperative outcomes. Comorbidities and reduction in physiological reserve are consistently identified as major predictors of poor postoperative outcome in this population. Frailty can be defined as a lack of physiological reserve seen across multiple organ systems and is an independent predictor of mortality, morbidity and institutionalisation after surgery. Despite this identification of frailty as a significant predictor of adverse postoperative outcome, there is not yet a consensus on the definition of frailty or how best to assess and diagnose it. This review describes our current definitions of frailty and discusses the available methods of assessing frailty, the impact on the older surgical population and the emerging potential for modification of this important syndrome.
老年人群中的手术数量正在增加。尽管在外科、麻醉和医学方面取得了进步，但老年手术患者仍继续遭受不良术后结果的困扰。合并症和生理储备能力下降一直被认为是该人群术后不良结果的主要预测因素。衰弱可以被定义为多个器官系统中生理储备不足的现象，并且是手术后死亡率、发病率和住院率的独立预测因素。尽管已经认识到衰弱是不良术后结果的一个重要预测因素，但目前对于衰弱的定义以及如何最好地评估和诊断衰弱尚未达成共识。这篇综述描述了我们目前对衰弱的定义，并讨论了现有的评估衰弱的方法、对老年手术人群的影响以及对这种重要综合征进行修正的潜力。
