Vilas Boas Ana, Selby Kevin, Cornuz Jacques, Büla Christophe, Nguyen Sylvain
Centre universitaire de médecine générale et santé publique, Unisanté, 1011 Lausanne.
Service de gériatrie et réadaptation gériatrique, CHUV, 1011 Lausanne.
Rev Med Suisse. 2020 Nov 11;16(714):2156-2159.
The older population is heterogenous: at the same age, elderly patients can be robust, frail or dependent. Screening decisions must be individualized, taking into account the remaining life expectancy, the Time to Benefit (TTB: delay until preventive care gives a benefit), and patient preferences. Thus, robust patients, who have a longer life expectancy, can still benefit from some screening tests over age 75 that are inappropriate in vulnerable or dependent patients whose life expectancy is shorter than the TTB. Discussing life expectancy issues remains difficult outside of crises but medical encounters are unique opportunities to inquire about individual preferences and expectations, in order to define care objectives and discuss advanced care planning.
在相同年龄，老年患者可能身体强健、虚弱或需要他人照料。筛查决策必须个体化，要考虑剩余预期寿命、获益时间（TTB：直到预防性护理产生获益的延迟时间）以及患者偏好。因此，预期寿命较长的强健患者在75岁以上时仍可从某些筛查检查中获益，而这些检查对于预期寿命短于TTB的脆弱或需要他人照料的患者并不适用。在危机之外讨论预期寿命问题仍然困难，但医疗接触是询问个人偏好和期望的独特机会，以便确定护理目标并讨论高级护理计划。
