McDonagh Julee, Ferguson Caleb, Newton Phillip J
ImPACCT, Faculty of Health, University of Technology Sydney, PO Box 123, Ultimo, NSW, 2007, Australia.
Western Sydney Nursing & Midwifery Research Centre, Blacktown Clinical & Research School, Blacktown Hospital, Western Sydney University & Western Sydney Local Health District, Marcel Crescent, Blacktown, NSW, 2148, Australia.
Curr Heart Fail Rep. 2018 Feb;15(1):17-23. doi: 10.1007/s11897-018-0373-0.
The study aims (1) to provide a contemporary description of frailty assessment in heart failure and (2) to provide an overview of multi-domain frailty assessment in heart failure.
Frailty assessment is an important predictive measure for mortality and hospitalisation in individuals with heart failure. To date, there are no frailty assessment instruments validated for use in heart failure. This has resulted in significant heterogeneity between studies regarding the assessment of frailty. The most common frailty assessment instrument used in heart failure is the Frailty Phenotype which focuses on five physical domains of frailty; the appropriateness a purely physical measure of frailty in individuals with heart failure who frequently experience decreased exercise tolerance and shortness of breath is yet to be determined. A limited number of studies have approached frailty assessment using a multi-domain view which may be more clinically relevant in heart failure. There remains a lack of consensus regarding frailty assessment and an absence of a validated instrument in heart failure. Despite this, frailty continues to be assessed frequently, primarily for research purposes, using predominantly physical frailty measures. A more multidimensional view of frailty assessment using a multi-domain approach will likely be more sensitive to identifying at risk patients.
本研究旨在(1)对心力衰竭患者的衰弱评估进行当代描述,(2)概述心力衰竭患者的多领域衰弱评估。
衰弱评估是心力衰竭患者死亡率和住院率的重要预测指标。迄今为止,尚无经证实可用于心力衰竭的衰弱评估工具。这导致了不同研究在衰弱评估方面存在显著异质性。心力衰竭中最常用的衰弱评估工具是衰弱表型,它侧重于衰弱的五个身体领域;对于经常出现运动耐量下降和呼吸急促的心力衰竭患者,单纯采用身体衰弱测量方法的适用性尚待确定。少数研究采用多领域视角进行衰弱评估,这在心力衰竭中可能更具临床相关性。关于衰弱评估仍缺乏共识,且在心力衰竭中尚无经证实的评估工具。尽管如此,衰弱评估仍经常进行,主要用于研究目的,主要采用身体衰弱测量方法。采用多领域方法对衰弱评估进行更全面的考量可能对识别高危患者更为敏感。