Euroclinic Hospital, Athens, Greece.
Internal Medicine, Department of Medicine and Surgery, University of Insubria, ASST-settelaghi, Via Guicciardini 5, 21100 Varese, Italy.
Eur J Prev Cardiol. 2022 Feb 19;29(1):216-227. doi: 10.1093/eurjpc/zwaa167.
Frailty is a health condition leading to many adverse clinical outcomes. The relationship between frailty and advanced age, multimorbidity and disability has a significant impact on healthcare systems. Frailty increases cardiovascular (CV) morbidity and mortality both in patients with or without known CV disease. Though the recognition of this additional risk factor has become increasingly clinically relevant in CV diseases, uncertainty remains about operative definitions, screening, assessment, and management of frailty. Since the burdens of frailty components and domains may vary in the various CV diseases and clinical settings, the relevance of specific frailty-related aspects may be different. Understanding these issues may allow general cardiologists a clearer focus on frailty in CV diseases and thereby make more tailored clinical decisions and therapeutic choices in outpatients. Guidance on identification and management of frailty are sparse and an international consensus document on frailty in general cardiology is lacking. Moreover, new options linked with eHealth are going to better define and manage frailty. This consensus document on definition, assessment, clinical implications, and management of frailty provides an input to integrate strategies pre- and post-acute CV events with a comprehensive view including out of hospital, office-based diagnostic and therapeutic choices, and based on a multidisciplinary team approach (general cardiologists, nurses, and general practitioners).
衰弱是一种导致许多不良临床结局的健康状况。衰弱与高龄、多种合并症和残疾之间的关系对医疗保健系统有重大影响。衰弱增加了心血管(CV)发病率和死亡率,无论患者是否患有已知的 CV 疾病。尽管在 CV 疾病中,认识到这一额外的风险因素在临床上变得越来越重要,但对于衰弱的操作性定义、筛查、评估和管理仍然存在不确定性。由于衰弱成分和领域的负担在各种 CV 疾病和临床环境中可能不同,因此特定与衰弱相关的方面的相关性可能不同。了解这些问题可以使普通心脏病专家更清楚地关注 CV 疾病中的衰弱问题,从而在门诊患者中做出更有针对性的临床决策和治疗选择。关于识别和管理衰弱的指南很少,也缺乏一般心脏病学中关于衰弱的国际共识文件。此外,与电子健康相关的新选择将更好地定义和管理衰弱。本共识文件提供了关于衰弱的定义、评估、临床意义和管理的输入,以整合与急性 CV 事件前后的策略,包括院外、基于办公室的诊断和治疗选择,并基于多学科团队方法(普通心脏病专家、护士和全科医生)。