Uchmanowicz Izabella, Łoboz-Rudnicka Maria, Szeląg Przemysław, Jankowska-Polańska Beata, Łoboz-Grudzień Krystyna
Department of Clinical Nursing, Wroclaw Medical University, K. Bartla 5, 51-616, Wroclaw, Poland,
Curr Heart Fail Rep. 2014 Sep;11(3):266-73. doi: 10.1007/s11897-014-0198-4.
Considering the increasing age of individuals affected with heart failure (HF), a specific approach to their treatment is required, with more attention paid to geriatric conditions such as poor mobility, multiple disabilities, and cognitive impairment. Frailty is a distinct biological syndrome reflecting decreased physiologic reserve and resistance to stressors. It was shown to occur frequently in patients with heart failure, with the prevalence ranging from 15 to 74 %, depending on the studied population and the method of assessment. We reviewed literature data on the influence of frailty, skeletal abnormalities, comorbidities and geriatric condition on diagnosis, treatment, and outcomes in elderly patients with HF. Identification of frailty in patients with HF is important from the clinical point of view, as this condition exerts unfavorable effects on the course of heart failure. Frailty contributes to a higher frequency of visits to emergency departments, hospitalizations, and mortality in patients with HF. Exercise may improve mobility, and nursing support can be implemented to help the patients adhere to medications. Therefore, frail patients should be diagnosed and treated according to available guidelines, and successfully educated about their condition.
考虑到心力衰竭（HF）患者的年龄不断增加，需要一种针对他们的特殊治疗方法，更多地关注老年患者的状况，如行动不便、多种残疾和认知障碍。衰弱是一种独特的生物学综合征，反映了生理储备的减少和对应激源的抵抗力下降。研究表明，衰弱在心力衰竭患者中经常出现，患病率从15%到74%不等，这取决于所研究的人群和评估方法。我们回顾了关于衰弱、骨骼异常、合并症和老年状况对老年心力衰竭患者的诊断、治疗及预后影响的文献数据。从临床角度来看，识别心力衰竭患者的衰弱很重要，因为这种状况会对心力衰竭的病程产生不利影响。衰弱会导致心力衰竭患者更频繁地前往急诊科就诊、住院和死亡。运动可以改善行动能力，并且可以提供护理支持以帮助患者坚持服药。因此，应根据现有指南对衰弱患者进行诊断和治疗，并对他们的病情进行成功的宣教。
