University of New South Wales (SWS Clinical School), Research: Ingham Institute of Applied Medical Research, Australia; Simpson Centre for Health Services Research, Ingham Institute of Applied Medical Research, PO Box 3151, Liverpool NSW 2170, Sydney, Australia; Intensive Care Department of Liverpool Hospital, NSW 2170, Sydney, Australia.
University of New South Wales (SWS Clinical School), Research: Ingham Institute of Applied Medical Research, Australia; Intensive Care Department of Liverpool Hospital, NSW 2170, Sydney, Australia.
Aust Crit Care. 2019 Mar;32(2):175-178. doi: 10.1016/j.aucc.2017.11.005. Epub 2017 Dec 9.
Our population is ageing, and this is also reflected in the ageing of the hospital and intensive care population. Along with ageing, there is also an increase in age-related chronic health conditions or comorbidities, which in turn affects the patient's functional state. There is an increasing need to describe a patient's clinical condition in terms of their functional capacity, such as frailty. Frailty is an age-related syndrome which reduces physiological and cognitive reserves. As a result, frailty increases people's vulnerability to insults such as infection and trauma. The concept of frailty also indicates prognosis and levels of health from a patient's perspective rather than simply from the acute reason for admission to the intensive care unit. Understanding the concept of frailty may facilitate our awareness of long-term outcomes after intensive care and being a trigger for considering its prognostic implications and the need to honestly and empathetically begin discussions with patients and their carers and how the patient's own goals of care could be established around this information.
我们的人口正在老龄化，这也反映在医院和重症监护病房人口的老龄化上。随着年龄的增长，与年龄相关的慢性健康状况或合并症也在增加，这反过来又影响了患者的功能状态。越来越需要根据患者的功能能力来描述其临床状况，例如虚弱。虚弱是一种与年龄相关的综合征，会降低生理和认知储备。因此，虚弱会增加人们对感染和创伤等刺激的脆弱性。虚弱的概念还从患者的角度而非仅仅从重症监护病房入院的急性原因来表示预后和健康水平。了解虚弱的概念可以帮助我们认识到重症监护后的长期结果，并成为考虑其预后意义以及诚实地、富有同理心地与患者及其护理人员展开讨论的触发因素，以及如何围绕这些信息来确定患者自身的护理目标。
