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虚弱;全球行动的时候了:关于“75 岁及以上社区居住的老年人的虚弱及其与长期死亡率的关系”的评论。

Frailty; Time for Global Action : Commentary on "Frailty and its Association with Long-Term Mortality among Community-Dwelling older adults aged 75 years and Over".

机构信息

Division of Anesthesia, Intensive Care, and Pain Management, Tel-Aviv Medical Center, Tel- Aviv University, 6 Weizmann St, Tel-Aviv, 6423906, Israel.

出版信息

Isr J Health Policy Res. 2024 Oct 4;13(1):57. doi: 10.1186/s13584-024-00646-4.

Abstract

This commentary examines the study "Frailty and Its Association with Long-Term Mortality Among Community-Dwelling Older Adults Aged 75 Years and Over" by Lewis et al. The retrospective cohort study utilized data from a primary healthcare provider in Israel to investigate frailty using the Frailty Index (FI) and its correlation with long-term mortality. Nearly half of the older adult cohort was identified as frail, with a strong association between higher frailty levels and increased mortality risk. The commentary emphasizes the importance of routine frailty screening in clinical practice and health policy. Integrating FI calculations into electronic health records can facilitate timely care for high-risk individuals. However, presenting frailty data must be managed carefully and in conjunction with patients' preferences to avoid stigmatizing and negatively influencing clinical decisions. While the FI is a valuable tool, it should complement, not replace, other assessments that provide a more holistic view of the patient's health. Furthermore, the commentary strongly advocates for a more comprehensive approach to patient care, emphasizing that non-geriatricians must also be proficient in recognizing and managing frailty. Effectively addressing frailty can lead to significant cost savings for healthcare systems, reduced burden on healthcare facilities, and decreased need for long-term care.

摘要

这篇评论探讨了 Lewis 等人的研究“社区居住的 75 岁及以上老年人的虚弱及其与长期死亡率的关系”。这项回顾性队列研究利用以色列初级保健提供者的数据,使用虚弱指数 (FI) 及其与长期死亡率的相关性来研究虚弱。近一半的老年队列被确定为虚弱,较高的虚弱程度与更高的死亡率风险之间存在很强的关联。该评论强调了在临床实践和卫生政策中常规进行虚弱筛查的重要性。将 FI 计算纳入电子健康记录可以为高风险个体提供及时的护理。然而,必须谨慎处理和结合患者的偏好来呈现虚弱数据,以避免污名化和对临床决策产生负面影响。虽然 FI 是一种有价值的工具,但它应该补充而不是替代其他提供患者健康更全面视图的评估。此外,该评论强烈主张采取更全面的患者护理方法,强调非老年医学专家也必须熟练掌握识别和管理虚弱的能力。有效应对虚弱可以为医疗保健系统节省大量成本,减轻医疗设施的负担,并减少对长期护理的需求。

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本文引用的文献

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Preoperative Evaluation of the Frail Patient.虚弱患者的术前评估。
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