Dewhurst Felicity, Stow Daniel, Paes Paul, Frew Katherine, Hanratty Barbara
Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
Palliative Medicine, St Oswald's Hospice, Newcastle upon Tyne, UK.
BMJ Support Palliat Care. 2022 Jun 1. doi: 10.1136/bmjspcare-2022-003658.
Frailty is associated with advancing age and increases the risk of adverse outcomes and death. Routine assessment of frailty is becoming more common in a number of healthcare settings, but not in palliative care, where performance scales (eg, the Australia-modified Karnofsky Performance Status Scale (AKPS)) are more commonly employed. A shared understanding of performance and frailty measures could aid interspecialty collaboration in both end-of-life care research and clinical practice.
To identify and synthesise evidence comparing measures of performance routinely collected in palliative care with the Clinical Frailty Scale (CFS), and create a conversion chart to support interspecialty communication.
A scoping literature review with comprehensive searches of PubMed, Web of Science, Ovid SP, the Cochrane Library and reference lists. Eligible articles compared the CFS with the AKPS, Palliative Performance Scale (PPS), Karnofsky Performance Scale or Eastern Cooperative Oncology Group Performance Status or compared these performance scales, in patients aged 18 in any setting.
Searches retrieved 3124 articles. Two articles directly compared CFS to the PPS. Thirteen studies translated between different performance scores, facilitating subsequent conversion to CFS, specifically: AKPS/PPS 10/20=very severe frailty, AKPS/PPS 30=severe frailty, AKPS/PPS 40/50=moderate frailty, AKPS/PPS60=mild frailty.
We present a tool for converting between the CFS and performance measures commonly used in palliative care. A small number of studies provided evidence for the direct translation between CFS and the PPS. Therefore, more primary evidence is needed from a wider range of population settings, and performance measures to support this conversion.
衰弱与年龄增长相关，会增加不良结局和死亡风险。在许多医疗环境中，衰弱的常规评估正变得越来越普遍，但在姑息治疗中并非如此，在姑息治疗中更常用的是功能量表（例如澳大利亚改良的卡氏功能状态量表（AKPS））。对功能和衰弱测量方法的共同理解有助于临终关怀研究和临床实践中的跨专业协作。
识别并综合比较姑息治疗中常规收集的功能测量指标与临床衰弱量表（CFS）的证据，并创建一个转换图表以支持跨专业交流。
进行一项范围综述，全面检索PubMed、科学网、Ovid SP、Cochrane图书馆及参考文献列表。纳入的文章将CFS与AKPS、姑息治疗功能量表（PPS）、卡氏功能状态量表或东部肿瘤协作组功能状态进行比较，或在任何环境下对18岁及以上患者的这些功能量表进行比较。
检索到3124篇文章。两篇文章直接将CFS与PPS进行比较。13项研究在不同的功能评分之间进行转换，便于随后转换为CFS，具体如下：AKPS/PPS 10/20 = 非常严重衰弱，AKPS/PPS 30 = 严重衰弱，AKPS/PPS 40/50 = 中度衰弱，AKPS/PPS 60 = 轻度衰弱。
我们提供了一种在CFS与姑息治疗中常用的功能测量指标之间进行转换的工具。少数研究为CFS与PPS之间的直接转换提供了证据。因此，需要从更广泛的人群背景和功能测量指标中获取更多的原始证据来支持这种转换。
