Vanderbilt University School of Nursing, 461 21st Avenue South, GH 420, Nashville, TN 37240, USA.
Division of Trauma and Surgical Critical Care, Vanderbilt University Medical Center, 1211 21st Avenue South, Nashville, TN 37212-1750, USA.
Clin Geriatr Med. 2019 Feb;35(1):13-26. doi: 10.1016/j.cger.2018.08.002. Epub 2018 Oct 3.
Frailty is a predominant predictor of poor outcomes in older populations. This article presents a review of the concept of frailty and its role for prognostication among geriatric trauma and surgery patients. We discuss models of frailty defined in the scientific literature, emphasizing that frailty is a process of biologic aging. We emphasize the importance of screening, assessment, and inclusion of frailty indices for the development and use of prognostication instruments/tools in the population of interest. Finally, we discuss best practices for the delivery of prognostic information in acute care settings and specific recommendations for trauma and surgical care settings.
衰弱是老年人群不良结局的主要预测因素。本文回顾了衰弱的概念及其在老年创伤和手术患者预后中的作用。我们讨论了科学文献中定义的衰弱模型，强调衰弱是生物衰老的过程。我们强调了在目标人群中筛选、评估和纳入衰弱指数对预后工具/指标的开发和使用的重要性。最后，我们讨论了在急性护理环境中提供预后信息的最佳实践以及创伤和外科护理环境的具体建议。
