Department of Internal Medicine and Geriatrics, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands.
Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Amsterdam, the Netherlands.
Eur J Emerg Med. 2021 Aug 1;28(4):266-276. doi: 10.1097/MEJ.0000000000000811.
Optimizing emergency care for the aging population is an important future challenge, as the proportion of older patients at the emergency department (ED) rapidly increases. Older patients, particularly those who are frail, have a high risk of adverse outcomes after an ED visit, such as functional decline, institutionalization, and death. The ED can have a key position in identifying frail older patients who benefit most from comprehensive geriatric care [including delirium preventive measures, early evaluation of after-discharge care, and a comprehensive geriatric assessment (CGA)]. However, performing extensive frailty assessment is not suitable at the ED. Therefore, quick and easy-to-use instruments are needed to identify older patients at risk for adverse outcomes. This narrative review outlines the importance and complexity of frailty assessment at the ED. It aligns the available screening instruments, including clinical judgment as frailty assessment, and summarizes arguments for and against frailty assessment at the ED.
优化老龄化人口的急救护理是未来的一项重要挑战，因为急诊科（ED）老年患者的比例迅速增加。老年患者，尤其是体弱患者，在 ED 就诊后发生不良后果的风险很高，如功能下降、住院和死亡。ED 在识别最需要全面老年护理（包括预防谵妄措施、出院后护理的早期评估和全面老年评估（CGA）的体弱老年患者方面可以发挥关键作用。然而，在 ED 进行广泛的虚弱评估并不合适。因此，需要快速易用的工具来识别有发生不良后果风险的老年患者。本综述概述了 ED 进行虚弱评估的重要性和复杂性。它列出了现有的筛查工具，包括作为虚弱评估的临床判断，并总结了 ED 进行虚弱评估的利弊。
