晚期慢性瘤患者临床脆弱度,意外问题和一年死亡率
Imre Demirhan1,2, Micha Jongejan2, Mathijs van Oevelen2
1Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands.
Kidney360
|August 21, 2025
概括
使用临床虚弱度表 (CFS) 和惊喜问题 (SQ) 的虚弱度评估预测了晚期慢性病患者的死亡率. 结合CFS和SQ可提供最准确的一年死亡风险预测.
科学领域:
- 肝脏病学
- 老年病学
- 公共卫生
背景情况:
- 在晚期慢性病 (CKD) 中,脆弱性很普遍.
- 衰弱与慢性病的老年人死亡率增加有关.
- 目前对CKD死亡率的风险评估工具需要进一步调查.
研究的目的:
- 评估临床虚弱度 (CFS) 和惊喜问题 (SQ) 与晚年慢性病患者的一年死亡率的相关性.
- 确定结合CFS和SQ是否可以改善死亡风险预测.
- 在这个群体中制定治疗决策和预先计划护理.
主要方法:
- 预期观察队列研究 (DIALOGICA),包括65岁以上的患者,其eGFR为10 - 20毫升/分钟/1. 73米2.
- 使用CFS (分数≥5表示高风险) 和SQ (答案"不"表示高风险) 评估脆弱性.
- 用卡普兰- 梅尔曲线和调整后的考克斯模型分析了一年死亡率.
主要成果:
- 包括589名患者 (平均年龄为77岁,70%为男性,平均EGFR为15毫升/ 分钟/ 1. 73m2).
- 持续性衰竭评分≥5 (21%) 和SQ"没有" (19%) 独立地与更高的一年死亡率相关.
- 在CFS≥5和SQ"不"患者中,死亡风险最高 (调整HR3. 37).
结论:
- 在晚期慢性结核病患者中,慢性结核病和慢性结核病都是1年死亡率的重要预测因素.
- 结合CFS和SQ可以更准确地评估死亡风险.
- 这些经过验证的风险评估可以帮助临床医生和患者在治疗和护理规划方面做出明智的决定.
更多相关视频
05:53Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
16.7K
07:27Exergaming in Older People Living with HIV Improves Balance, Mobility and Ameliorates Some Aspects of Frailty
Published on: October 6, 2016
10.4K
相关概念视频
01:28Chronic Kidney Disease III: Interprofessional Care
78
Chronic kidney disease (CKD) requires collaborative and comprehensive management. CKD progresses through stages and can lead to end-stage kidney disease (ESKD) if untreated. Interprofessional collaboration and patient education are crucial, enabling patients to manage their health and improve their quality of life.Diagnostic approach for chronic kidney diseaseThe diagnosis of CKD primarily focuses on the glomerular filtration rate (GFR), which assesses kidney function by measuring how well...
78
01:24Chronic Kidney Disease II: Clinical Manifestations
87
Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...
87
01:17Factors Affecting Renal Clearance: Renal Impairment
157
Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
157
01:25Chronic Kidney Disease I: Introduction
67
Chronic Kidney Disease (CKD) arises when the kidneys progressively lose their ability to function, ultimately leading to end-stage renal disease. At this advanced stage, the kidneys can no longer filter waste or maintain essential body functions, requiring renal replacement therapy (RRT) through dialysis or a kidney transplant for survival.Early-stage chronic kidney disease and detection challengesIn CKD's early stages, symptoms often remain absent because healthy nephrons compensate for...
67
01:18Chronic Kidney Disease IV: Nursing Management
55
Nursing management is essential for preventing complications, maintaining stability, and improving patients' quality of life in chronic kidney disease (CKD). By using a structured approach, nurses help slow CKD progression and support effective patient care.1. Comprehensive patient assessmentEffective management begins with nurses reviewing the patient’s medical history, and identifying key risk factors like diabetes, hypertension, and nephrotoxic drug use. Nurses assess signs of...
55
01:22Acute Kidney Injury I: Introduction
72
Introduction:Acute Kidney Injury (AKI) describes a swift decrease in kidney function occurring over hours to days, characterized by the kidneys' failure to remove waste products from the bloodstream. This leads to dangerous complications like metabolic acidosis, fluid overload, and electrolyte imbalances, such as hyperkalemia, which can cause life-threatening arrhythmias. AKI is common in both hospital and outpatient settings, often triggered by dehydration, sepsis, or exposure to nephrotoxic...
72