Khan Kashif T, Hemati Kaveh, Donovan Anne L
Department of Anesthesia and Perioperative Care, Division of Critical Care Medicine, University of California, San Francisco, 505 Parnassus Avenue, Room M-917, San Francisco, CA 94143, USA.
Department of Anesthesia and Perioperative Care, University of California, San Francisco, 513 Parnassus Avenue, San Francisco, CA 94143, USA.
Anesthesiol Clin. 2019 Sep;37(3):453-474. doi: 10.1016/j.anclin.2019.04.006. Epub 2019 Jun 18.
Understanding geriatric physiology is critical for successful perioperative management of older surgical patients. The frailty syndrome is evolving as an important, potentially modifiable process capturing a patient's biologic age and is more predictive of adverse perioperative outcomes than chronologic age. Use of frailty in risk stratification and perioperative decision-making allows providers to effectively diagnose, risk stratify, and treat patients in the perioperative setting. Further study is needed to develop a universal definition of frailty, to identify comprehensive yet feasible screening tools that allow for accurate detection of frailty in the perioperative setting, and to refine treatment programs for frail surgical patients.
了解老年生理学对于老年外科患者围手术期的成功管理至关重要。衰弱综合征正逐渐成为一个重要的、可能可改变的过程，它反映了患者的生物学年龄，并且比实际年龄更能预测围手术期不良结局。在风险分层和围手术期决策中使用衰弱评估，可使医疗人员在围手术期有效地诊断、进行风险分层并治疗患者。需要进一步研究以制定衰弱的通用定义，确定全面且可行的筛查工具，以便在围手术期准确检测衰弱，并完善针对衰弱外科患者的治疗方案。
