Frailty in the critically ill: a novel concept.
Frailty in the critically ill: a novel concept.
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DOI：
10.1186/cc9297
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发表时间：
2011
期刊：
影响因子：
--
通讯作者：
Bagshaw SM
中科院分区：
文献类型：
--
作者：
McDermid RC;Stelfox HT;Bagshaw SM
虚弱的概念已被定义为一个多方面的综合征，其特征是身体和认知储备的损失，易于积累赤字和增加对不良事件的脆弱性。虚弱与年龄密切相关，并与患者的残疾状态（即，功能限制）和/或共病负担的方面重叠和扩展。虚弱的表型更具体地表征为患者的活动性、肌肉质量、营养状态、力量和耐力的不利变化。我们认为，在特定的情况下，危重病人可能类似于虚弱的老年病人。目前尚不清楚危重患者中虚弱的患病率;然而，根据数据显示老年人对重症监护室（ICU）资源的利用率正在上升，虚弱的患病率可能正在上升。由于老年患者和危重患者之间在虚弱方面的理论相似性，这一概念可能具有临床相关性，并可能预测结局，沿着显示出与疾病严重程度、共病以及社会和结构环境等几个因素的重要相互作用。我们认为需要对危重患者的虚弱进行研究，以评估其与生存和生活质量等结局的相关性，以及与资源利用的相关性，如机械通气时间，ICU住院时间和住院时间。我们假设，虚弱的客观测量可能会提供额外的支持和加强面临临终决策的ICU支持和/或暂停生命维持治疗的适当性的临床医生。
The concept of frailty has been defined as a multidimensional syndrome characterized by the loss of physical and cognitive reserve that predisposes to the accumulation of deficits and increased vulnerability to adverse events. Frailty is strongly correlated with age, and overlaps with and extends aspects of a patient's disability status (that is, functional limitation) and/or burden of comorbid disease. The frail phenotype has more specifically been characterized by adverse changes to a patient's mobility, muscle mass, nutritional status, strength and endurance. We contend that, in selected circumstances, the critically ill patient may be analogous to the frail geriatric patient. The prevalence of frailty amongst critically ill patients is currently unknown; however, it is probably increasing, based on data showing that the utilization of intensive care unit (ICU) resources by older people is rising. Owing to the theoretical similarities in frailty between geriatric and critically ill patients, this concept may have clinical relevance and may be predictive of outcomes, along with showing important interaction with several factors including illness severity, comorbid disease, and the social and structural environment. We believe studies of frailty in critically ill patients are needed to evaluate how it correlates with outcomes such as survival and quality of life, and how it relates to resource utilization, such as length of mechanical ventilation, ICU stay and duration of hospitalization. We hypothesize that the objective measurement of frailty may provide additional support and reinforcement to clinicians confronted with end-of-life decisions on the appropriateness of ICU support and/or withholding of life-sustaining therapies.
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影响因子：
10.7
作者：
Ho, K. M.;Finn, J.;Webb, S. A. R.
通讯作者：
Webb, S. A. R.
影响因子：
168.9
作者：
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DOI：
10.1186/cc8967
发表时间：
2010
期刊：
Critical care (London, England)
影响因子：
--
作者：
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通讯作者：
Sjöberg F
影响因子：
120.7
作者：
LEGALL, JR;LEMESHOW, S;SAULNIER, F
通讯作者：
SAULNIER, F
影响因子：
8.8
作者：
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通讯作者：
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