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老年患者衰弱的定义与评估:外科、麻醉学及肿瘤学视角

Definition and assessment of frailty in older patients: the surgical, anaesthesiological and oncological perspective.

作者信息

Dottorini Lorenzo, Turati Luca, Mattei Luca, Formenti Paolo

机构信息

Oncology Unit, Medical Sciences Department, ASST Bergamo Est, Alzano Lombardo (BG), 24022, Italy.

Surgical Oncology Unit, Treviglio Hospital, Treviglio (BG), 24047, Italy.

出版信息

Ecancermedicalscience. 2020 Sep 15;14:1105. doi: 10.3332/ecancer.2020.1105. eCollection 2020.

Abstract

The number of oncology, surgery and anaesthesia procedures in older patients has greatly increased in recent years due to ageing populations. Older patients are typically characterised by physical changes such as comorbidities, decline in physiological activities and cognitive impairment. All these factors, together with polypharmacological therapies, may substantially impact perioperative outcome, quality of recovery and, more in general, quality of life. A comprehensive multidisciplinary approach to perioperative care is thus needed. The assessment of frailty has a central role in the pre-operative evaluation of older patients and, with a multidisciplinary approach. The best surgical procedures and oncologic therapies can be accurately discussed in the pre- and post-operative periods. All clinicians involved in this scenario should be proactive in multidisciplinary care to achieve better outcomes.

摘要

近年来,由于人口老龄化,老年患者的肿瘤学、外科手术和麻醉程序数量大幅增加。老年患者通常具有身体变化的特征,如合并症、生理活动下降和认知障碍。所有这些因素,加上多种药物治疗,可能会对围手术期结果、恢复质量以及总体生活质量产生重大影响。因此,需要一种全面的多学科围手术期护理方法。衰弱评估在老年患者的术前评估中起着核心作用,采用多学科方法,可以在术前和术后准确讨论最佳的手术程序和肿瘤治疗方法。参与这种情况的所有临床医生都应积极参与多学科护理,以取得更好的结果。

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