From the Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, Sydney, New South Wales, Australia.
Department of Aged Care, Prince of Wales Hospital, Randwick, Sydney, New South Wales, Australia.
Anesth Analg. 2020 Jun;130(6):1524-1533. doi: 10.1213/ANE.0000000000004785.
Anesthetists are increasingly faced with the challenge of delivering perioperative care to frail older people. Patients with frailty undergoing surgical intervention are at a significantly increased risk of perioperative complications, mortality, and longer length of stay. Moreover, frailty is often associated with multimorbidity and a range of geriatric syndromes including functional dependency, cognitive impairment, and malnutrition which further increases risk and complexity of care. There is a growing body of evidence that prehabilitation-intervention delivered during the preoperative period to improve overall health and function-can improve postoperative outcomes for patients undergoing surgery. However, whether this vulnerable population stand to benefit from prehabilitation is less clear. We review the evidence for prehabilitation for patients with frailty including whether the risks associated with and outcomes from surgery can be modified through comprehensive geriatric assessment.
麻醉师越来越面临为体弱老年人提供围手术期护理的挑战。接受手术干预的虚弱患者在围手术期并发症、死亡率和住院时间延长方面的风险显著增加。此外，虚弱通常与多种疾病和一系列老年综合征有关，包括功能依赖性、认知障碍和营养不良，这进一步增加了护理的风险和复杂性。越来越多的证据表明，术前进行的康复干预措施可以改善整体健康和功能，从而改善手术患者的术后结果。然而，这种脆弱的人群是否能从康复中受益还不太清楚。我们回顾了虚弱患者康复的证据，包括通过全面老年评估是否可以改变与手术相关的风险和结果。
