应用衰弱评估预测老年病人围手术期风险研究进展

Advances in research on application of frailty assessment to predict perioperative risk of elderly surgical patients

老年病人随着生理储备能力下降即自身衰弱程度加重,围手术期并发症的发生风险增高。当前的手术病人风险分级方法均无法准确的评估老年病人的生理储备能力,需要衰弱评估作为补充。现有的衰弱评估方法多来自国外,主要包括衰弱表型量表(FP)、5项改良衰弱指数量表(5-mFI)、衰弱筛查量表(the"FRAIL"scale),每种方法各有其优点,如指标可量化、注重手术风险因素、适于快速筛查等,其中以5-mFI最适合应用于外科术前评估。但这些方法应用于外科术前评估时,又各有其不足,如需要工具辅助、项目定义不明确、未评估生活自理能力等。在未来的研究中,需要外科医生予以衰弱评估更多关注。

Elderly patients become more frailty as their physical reserve capacity decreases,and the risk of perioperative complications increases.The current risk classification methods for surgical patients cannot accurately assess the physiological reserve capacity of elderly patients,and need to be supplemented by the assessment of frailty.Most of the existing methods for assessment of frailty come from abroad,mainly including FP,5-mFI,The"FRAIL"Scale,each method has its own advantages,such as quantifiable indicators,focus on surgical risk factors,suitable for rapid screening,etc.5-mFI is the most suitable for preoperative evaluation of surgery.However,the methods have their own deficiencies when applied to preoperative evaluation of surgery,such as the need for tool assistance,unclear project definition,and failure to assess self-care ability.In the future research,surgeons need to pay more attention to frailty.