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[腹主动脉瘤老年患者;术前衰弱筛查及多学科方法]

[Elderly patients with an abdominal aortic aneurysm; preoperative frailty-screening and a multidisciplinary approach].

作者信息

Smoor R M, Kropman R H J, van Dongen H P A, de Boer G A, Wille J, Noordzij P G

机构信息

St. Antonius Ziekenhuis, afd. Anesthesiologie en Intensive Care, Nieuwegein.

St. Antonius Ziekenhuis, afd. Vaatchirurgie, Nieuwegein.

出版信息

Ned Tijdschr Geneeskd. 2020 May 4;164:D4447.

Abstract

Aneurysm of the abdominal aorta is common and can be treated with endovascular repair, open surgical repair or conservative treatment. Risk-stratification and treatment decision-making can be complex in frail patients and depends largely on anatomy, life-expectancy and functional capacity. Currently, risk-stratification in the Netherlands is primarily based on comorbidities and age. Insight in a patient's resilience could provide important additional information. For this reason, St. Antonius hospital has implemented an Anaesthesia Geriatric Evaluation (AGE) to screen for frailty in high risk vascular surgery patients. Results of frailty-screening are discussed in a multi-disciplinary team (MDT) to assess perioperative risk and compose a personal treatment plan. This paper presents a case-series of three patients to illustrate the additional value of MDT care and frailty-screening in a high-risk vascular surgery population.

摘要

腹主动脉瘤很常见,可通过血管内修复、开放手术修复或保守治疗。对于身体虚弱的患者,风险分层和治疗决策可能很复杂,并且很大程度上取决于解剖结构、预期寿命和功能能力。目前,荷兰的风险分层主要基于合并症和年龄。了解患者的恢复力可以提供重要的额外信息。因此,圣安东尼乌斯医院实施了麻醉老年评估(AGE),以筛查高危血管手术患者的虚弱情况。在多学科团队(MDT)中讨论虚弱筛查的结果,以评估围手术期风险并制定个人治疗计划。本文介绍了一个包含三名患者的病例系列,以说明MDT护理和虚弱筛查在高危血管手术人群中的附加价值。

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