Hogan David B, Maxwell Colleen J, Afilalo Jonathan, Arora Rakesh C, Bagshaw Sean M, Basran Jenny, Bergman Howard, Bronskill Susan E, Carter Caitlin A, Dixon Elijah, Hemmelgarn Brenda, Madden Kenneth, Mitnitski Arnold, Rolfson Darryl, Stelfox Henry T, Tam-Tham Helen, Wunsch Hannah
Geriatric Medicine, University of Calgary, Calgary, AB, Canada.
Schools of Pharmacy and Public Health & Health Systems, University of Waterloo, Waterloo, ON, Canada.
Can Geriatr J. 2017 Mar 31;20(1):22-37. doi: 10.5770/cgj.20.240. eCollection 2017 Mar.
There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization. The examination of the available evidence highlighted a number of specific clinical and research topics requiring additional study. We conclude with a series of consensus recommendations regarding future research priorities in this important area.
人们普遍认为，衰弱是一种对多种系统功能受损所产生的应激源高度脆弱的状态，这种受损会导致体内稳态储备和恢复力下降，但在其检测、潜在病理生理学以及与衰老、残疾和多种疾病的关系方面，仍存在未解决的问题。一个特别具有挑战性的领域是衰弱与住院治疗之间的关系。基于2014年加拿大专家咨询会议的讨论以及对2005年至2015年相关文献的范围综述，本讨论文件对急性护理环境中衰弱的当前知识状态进行了综述，包括其患病率以及预测住院发生和结局的能力。对现有证据的审查突出了一些需要进一步研究的具体临床和研究主题。我们最后提出了一系列关于这一重要领域未来研究重点的共识建议。
