衰弱对急性普通外科患者的影响：系统评价。
The impact of frailty on acute care general surgery patients: A systematic review.
机构信息
From the Department of Surgery, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada.
出版信息
J Trauma Acute Care Surg. 2019 Jan;86(1):148-154. doi: 10.1097/TA.0000000000002084.
BACKGROUND
Frailty may predict negative health outcomes more accurately than chronological age alone. This review examines evidence for the impact of frailty on adverse outcomes in patients admitted with an acute care general surgery (ACS) diagnosis.
METHODS
A systematic literature search for studies reporting frailty and outcomes after admission with an ACS diagnosis was performed. We searched PubMed and SCOPUS from inception until September 2017.
RESULTS
A total of 8,668 records were screened, of which seven studies examined the relationship between frailty and outcomes in ACS patients. Frailty was associated with higher 30-day mortality patients (odds ratio, 3.04; 95% confidence interval, 2.67-3.46; p < 0.01), postoperative complications, length of stay, institutional discharge, and critical care admission.
CONCLUSIONS
There is emerging evidence that frailty is associated with worse outcomes in patients with an unplanned admission due to an ACS diagnosis. Further investigation is warranted with regard to how frailty may impact patients with an acute illness more severely.
LEVEL OF EVIDENCE
Systematic review, level III.
背景
衰弱可能比单纯的年龄更能准确预测健康不良结局。本综述检查了衰弱对急性普通外科（ACS）诊断入院患者不良结局的影响的证据。
方法
系统检索了从开始到 2017 年 9 月发表的报告 ACS 诊断入院后衰弱和结局的研究。我们在 PubMed 和 SCOPUS 上进行了搜索。
结果
共筛选出 8668 条记录，其中 7 项研究检查了衰弱与 ACS 患者结局之间的关系。衰弱与 30 天死亡率更高的患者相关（优势比，3.04；95%置信区间，2.67-3.46；p < 0.01）、术后并发症、住院时间、机构出院和重症监护入院。
结论
有越来越多的证据表明，衰弱与 ACS 诊断导致的非计划入院患者的不良结局相关。需要进一步研究衰弱如何更严重地影响急性疾病患者。
证据水平
系统评价，III 级。
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