危急疾病的老年人脆弱性评估:一个叙事审查
L Moïsi1,2,3,4, J-C Mino5,6, B Guidet7,8
1Department of Geriatrics, Hopital Saint-Antoine, Assistance Publique Hôpitaux de Paris (AP-HP), Sorbonne Université, 75012, Paris, France. laura.moisi@aphp.fr.
脆弱性评估工具各不相同,导致老年人感到困惑. 本综述阐明了脆弱性概念和像临床脆弱性尺度 (CFS) 这样的尺度在重症监护中的使用,以确保公平的患者评估.
科学领域:
- 老年学是指老年学的学科.
- 关键护理医学 关键护理医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 虚弱是一种重要的老年综合征,具有不断发展的评估工具.
- 虚弱现象型和临床虚弱度量 (CFS) 是在不同的临床环境中使用的不同的测量标准.
- 关于脆弱性定义,评估工具及其偏见存在混,特别是在紧急情况下.
研究的目的:
- 为了澄清虚弱,功能自主和并发症的概念.
- 审查脆弱度量表在重症老年人中的应用和影响.
- 讨论在时间有限的环境中标准化脆弱性评估的好处,风险和潜在偏见.
主要方法:
- 文献综述和对脆弱性评估工具的概念澄清.
- 分析临床脆弱度量 (CFS) 在重症监护病房 (ICU) 的使用和影响.
- 讨论标准化尺度的使用与全面的患者评估.
主要成果:
- 虚弱影响了大约40%的75岁以上的ICU患者.
- 慢性疲劳症在ICU中广泛使用,与死亡率和长期结果有显著的相关性.
- 在COVID-19大流行期间,CFS被用于分拣,显示与住院死亡率有关.
结论:
- 标准化的脆弱度表虽然快速,但存在偏见或忙决策的风险.
- 意识到评估工具的偏见对于老年人公正的重症监护决策至关重要.
- 保持细微的,以患者为中心的评估是必不可少的,尽管临床时间压力.
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