在患有功能衰竭的老年患者中共享决策.
Mehmet Kanbay1, Carlo Basile2, Yuri Battaglia3,4
1Division of Nephrology, Department of Medicine, Koc University School of Medicine, Istanbul, Turkey.
概括
慢性年龄对于患有功能衰竭的老年患者来说是不充分的衡量标准. 个性化治疗决策,考虑到脆弱性和并发性疾病,对于这个不断增长的人口的最佳结果至关重要.
科学领域:
- 老年学是一门学科.
- 腎臟病學 (nephrology) 是一種醫學專業.
- 老年医学 老年医学
背景情况:
- "老年人" (≥65岁) 的定义忽略了老年人健康的显著异质性.
- 全球人口老龄化增加了慢性病 (CKD) 等慢性疾病,往往会导致功能衰竭.
- 在患有功能衰竭的老年患者中,虚弱是常见的,需要对治疗决策进行仔细评估.
研究的目的:
- 审查选择最佳治疗途径的复杂性,对于老年和脆弱的功能衰竭患者.
- 要突出伴随性疾病,生存率和生活质量在这个人口群体中所带来的挑战.
- 倡导修订的研究议程和改进的临床决策过程.
主要方法:
- 审查现有文献,承认回顾性和观察性研究的局限性.
- 讨论选择治疗的挑战 (血液透析,腹腔透析,保守管理).
- 强调需要采用多学科方法,涉及各种医疗保健专业人员.
主要成果:
- 目前的证据往往受到偏见和缺乏混因素调整的限制,阻碍了治疗指导.
- 一种适合所有人的方法对于患有功能衰竭的老年患者多样化的临床需求是不够的.
- 老年人口的多样性需要定制的管理策略.
结论:
- 专门的研究议程对于解决患有功能衰竭的老年患者管理的关键问题至关重要.
- 建议进行前性研究和系统审查,将观察和干预数据结合起来.
- 共享决策,将患者的偏好与证据整合起来,对于个性化治疗选择至关重要.
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