Ritt Martin, Gaßmann Karl-Günter, Sieber Cornel Christian
Department of Internal Medicine III (Medicine of Ageing), Geriatrics Centre Erlangen, Hospital of the Congregation of St. Francis Sisters of Vierzehnheiligen, Rathsberger Straße 57, 91054, Erlangen, Germany.
Institute for Biomedicine of Ageing (IBA), Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Kobergerstraße 60, 90408, Nürnberg, Germany.
Z Gerontol Geriatr. 2016 Oct;49(7):567-572. doi: 10.1007/s00391-016-1128-8. Epub 2016 Sep 14.
Frailty is a major health burden in an aging society. It constitutes a clinical state of reduced physiological reserves that is associated with a diminished ability to withstand internal and external stressors. Frail patients have an increased risk for adverse clinical outcomes, such as mortality, readmission to hospital, institutionalization and falls. Of further clinical interest, frailty might be at least in part reversible in some patients and subject to preventive strategies. In daily clinical practice older patients with a complex health status, who are mostly frail or at least at risk of developing frailty, are frequently cared for by geriatricians. Recently, clinicians and scientists from other medical disciplines, such as cardiology, pulmonology, gastroenterology, nephrology, endocrinology, rheumatology, surgery and critical care medicine also discovered frailty to be an interesting instrument for risk stratification of patients, including younger patients. In this review we highlight the results of recent studies that demonstrated the significance of frailty to predict adverse clinical outcomes in patients with specific medical conditions, such as cardiac, lung, liver and kidney diseases as well as diabetes mellitus, osteoarthritis, trauma patients, patients undergoing surgery and critically ill patients. Multiple studies in patients with the aforementioned specific medical conditions could be identified demonstrating a predictive role of frailty for several adverse clinical outcomes. The association between frailty and adverse clinical outcomes reported in these studies was in part independent of several major potential confounder factors, such as age, sex, race, comorbidities and disabilities and were also detected in younger patients.
在老龄化社会中，衰弱是一项重大的健康负担。它构成了一种生理储备减少的临床状态，与抵御内部和外部应激源的能力下降有关。衰弱的患者出现不良临床结局的风险增加，如死亡、再次入院、入住养老院和跌倒。更值得临床关注的是，衰弱在某些患者中可能至少部分是可逆的，并且可以采取预防策略。在日常临床实践中，健康状况复杂的老年患者（大多数体弱或至少有发展为衰弱的风险）通常由老年病科医生护理。最近，来自其他医学学科（如心脏病学、肺病学、胃肠病学、肾病学、内分泌学、风湿病学、外科学和重症医学）的临床医生和科学家也发现衰弱是对患者（包括年轻患者）进行风险分层的一个重要指标。在这篇综述中，我们重点介绍了最近的研究结果，这些研究表明衰弱对于预测患有特定疾病（如心脏、肺、肝和肾疾病以及糖尿病、骨关节炎、创伤患者、接受手术的患者和重症患者）的患者的不良临床结局具有重要意义。可以确定，针对上述特定疾病患者进行的多项研究表明衰弱对多种不良临床结局具有预测作用。这些研究报告的衰弱与不良临床结局之间的关联部分独立于几个主要的潜在混杂因素，如年龄、性别、种族、合并症和残疾，并且在年轻患者中也有发现。
