老年外科患者发病率和死亡率预测风险评估工具的评价。
Review of risk assessment tools to predict morbidity and mortality in elderly surgical patients.
机构信息
Department of Surgery, University of Alberta, Edmonton, Canada.
Department of Community Health Sciences, University of Calgary, Calgary, Canada; Department of Medicine, University of Calgary, Calgary, Canada.
出版信息
Am J Surg. 2018 Sep;216(3):585-594. doi: 10.1016/j.amjsurg.2018.04.006. Epub 2018 Apr 18.
BACKGROUND
Informed surgical consent requires accurate estimation of risks and benefits. Multiple risk assessment tools are available; however, most are not widely used or are specific to certain interventions. Assessing surgical risk is especially challenging in elderly patients because of their range of comorbidities, level of frailty, or severity of illness and a number of available surgical interventions.
DATA SOURCES
We searched MEDLINE from January 2014 to July 2017 for studies that used risk assessment tools in studies on elderly surgical patients. We then sought the original articles describing each assessment tool and subsequent validation studies.
CONCLUSIONS
We identified risk assessment tools that can improve surgical risk assessment in elderly surgical patients. The majority of the identified tools are not commonly used for pre-operative risk assessment. NSQIP-PMP, mFI and SURPAS are promising tools. Age is commonly used to predict risk, but frailty may be a more appropriate measure.
背景
知情手术同意需要准确估计风险和收益。有多种风险评估工具可用；然而，大多数工具并未得到广泛应用或仅限于某些干预措施。由于老年患者的合并症范围、脆弱程度或疾病严重程度以及许多可用的手术干预措施，评估手术风险尤其具有挑战性。
资料来源
我们从 2014 年 1 月至 2017 年 7 月在 MEDLINE 上搜索了在老年外科患者研究中使用风险评估工具的研究。然后，我们寻找描述每个评估工具和后续验证研究的原始文章。
结论
我们确定了一些可以改善老年外科患者手术风险评估的风险评估工具。大多数确定的工具并不常用于术前风险评估。NSQIP-PMP、mFI 和 SURPAS 是很有前途的工具。年龄通常用于预测风险，但脆弱性可能是一个更合适的衡量标准。
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