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| 衰弱对老年患者外科手术结局影响的研究进展 |
| Research progress in the effect of frailty on the elderly patients' outcomes after surgery |
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| DOI：10.12089/jca.2022.01.018 |
| 中文关键词: 衰弱 外科手术结局 术前衰弱评估 老年 干预方式 |
| 英文关键词: Frailty Surgical outcome Preoperative frailty assessment Aged Intervention modalities |
| 基金项目:北京大学人民医院研究与发展基金（RDY2019-17） |
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| 中文摘要: |
随着人口的老龄化，老年手术患者越来越多。常用的术前评估工具如ASA分级、纽约心脏协会分级、Charlson共病指数和代谢当量，并没有得到令人满意的预测外科手术结局的效果。最近的研究表明，衰弱会增加老年患者的术后并发症和死亡率，延长住院时间，增加医疗费用。衰弱是一种多维综合征，其特征是与年龄或疾病相关的缺陷累积、储备减少和对应激源抵抗力的降低，接受重大手术的老年患者中有50%处于衰弱状态。衰弱评估工具有很多，他们的评估内容、耗时和对术后并发症的预测能力不同。衰弱的病理机制是当前的研究热点，研究者试图通过分子水平的治疗改善衰弱。对于老年患者，推荐术前常规进行衰弱评估，有助于提高预测术后不良事件发生率的准确性，协助制定围术期个性化治疗方案，达到优化术后结局的
目的 。 |
| 英文摘要: |
| With the aging of the population, more and more elderly patients present as surgical candidates. Those commonly used preoperative assessment tools such as American Society of Anesthesiologists (ASA) classification, New York Heart Association (NYHA) classification, Charlson comorbidity index (CCI) and metabolic equivalent (MET) do not yield satisfactory prediction for morbidity and mortality. Most recently, frailty status is found to be associated with adverse clinical outcomes for elderly patients after surgery. Frailty is a multidimensional syndrome characterized by the decrease of reserve and reduction of resistance to stressor, due to age or disease related deficits. Up to 50% of elderly patients having major surgeries are frail or prefrail. There are many frailty assessment tools, with different contents and different abilities to predict postoperative complications. The underlying mechanisms of how frailty affects surgical outcomes remains a research focus because targeting at frailty might have an implication of improving surgical outcomes. In conclusion, frailty assessment should be included in routine preoperative evaluation in order to better predict the incidence of postoperative adverse events, tailoring individualized perioperative management, and optimizing clinical outcomes. |
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