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Journal of Nursing ›› 2019, Vol. 26 ›› Issue (7): 34-39.doi: 10.16460/j.issn1008-9969.2019.07.034

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Evidence Summary of Preoperative Evaluation and Management of Older Patients with Frailty

YANG Ji-pinga, SHI Ze-yab, ZHOU Yi-fenga, CHEN Chengc, YIN Shu-huid, YUAN Haoe   

  1. a. Dept. of Operating Room; b. Dept. Nursing Administration; c. Dept. of Nephrology; d. Dept. of Pediatrics; e. Dept. of Laboratory Medicine, Hunan Provincial People’s Hospital, Hunan Normal University, Changsha 410005, China
  • Received:2019-02-25 Published:2020-07-14

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Abstract: Objective To search and obtain relevant evidences of preoperative evaluation and management of older patients with frailty, to provide references for their preoperative evaluation, and to reduce the surgical complication risk. Methods Operation risk for older frailty patients was assessed and guidelines, evidence summary (ES), best practice information sheet (BPIS), recommended practices (RP), system evaluation (SR) of preoperative evaluation on preoperative assessment of older patients with frailty were searched in medical databases at home and abroad. JBI evidence-based nursing practice model was used to screen the literatures, and 2 researchers evaluated the literatures quality and extracted the evidence independently. Results Fourteen articles including 7 guidelines,2 expert consensus and 5 systematic reviews were identified and 32 evidences of preoperative evaluation and management of older patients with frailty were summarized. Clinical experts made professional judgments on evidences by employing FAME principle, and developed review indicators to guide pre-operative assessment and management of older patients with frailty. Preoperative evaluation included frailty, consciousness, activity function and related complications for older patients with frailty. Patients' physiological function, condition disease management, exercise, medication, nutrition, and mobility should be improved according to the evaluation results. Conclusion Medical staff should update the latest best evidences for preoperative assessment of older frailty patient and evidences should be employed based on clinical context, existing medical environment, facilitating factors and obstacles of the applied evidence, patient's intention and preference. The preoperative evaluation of evidence-based scientific nursing methods is conducive to improving preoperative physical incapacity of patients with frailty, enhance their ability to cope with surgery and related injury stressors, and reduce related surgery risk.

Key words: geriatric, frailty, preoperative evaluation, surgery risk, postoperative complications

CLC Number: 

  • R473.59
[1] 韩斌如,李秋萍. 老年患者手术风险评估工具的应用进展[J].护理学报,2017,24(24):31-34.DOI:10.16460/j.issn1008-9969.2017.24.031.
[2] Eslami M H, Saadeddin Z, Rybin D V, et al.Association of Frailty Index with Perioperative Mortality and In-hospital Morbidity after Elective Lower Extremity Bypass[J]. J VASC SURG, 2018, 69(3):863-874.DOI: 10.1016/j.jvs.2018.07.050.
[3] Beckert A K,Huisingh-Scheetz M,Thompson K,et al.Screening for Frailty in Thoracic Surgical Patients[J]. Ann Thorac Surg, 2017, 103(3):956-961.DOI: 10.1016/j.athoracsur.2016.08.078.
[4] Madeleine L B, Thomas G C, Soroush T B, et al.Frailty as a Predictor of Complications after Radical Cystectomy: A Prospective Study of Various Preoperative Assessments[J]. Urol Oncol, 2018, 37(1):40-47. DOI: 10.1016/j.urolonc.2018.10.002.
[5] Bettelli G.Preoperative Evaluation of the Elderly Surgical Patient and Anesthesia Challenges in the XXI Century[J]. Aging Clin Exp Res,2018,30(3):229-235.DOI:10.1007/s40520-018-0896-y.
[6] 应巧燕,刘华平,郭欣颖,等. 老年人衰弱筛查和评估的证据总结[J]. 护理学杂志, 2017,32(1):95-98. DOI:10.3870/j.issn.1001-4152.2017.01.095.
[7] Bose S, Talmor D.Who Is a High-risk Surgical Patient?[J]. Curr Opin Crit Care, 2018, 24(6):547-553. DOI:10.1097/MCC.0000000000000556.
[8] Brennan M S, Barlotta R M, Simhan J.Frailty Assessments in Surgical Practice: What Is Frailty and How Can It Be Used in Prosthetic Health?[J]. Sex Med Rev,2017,6(2):302-309. DOI:10.1016/j.sxmr.2017.06.006.
[9] Huisingh-Scheetz M, Walston J.How Should Older Adults with Cancer Be Evaluated for Frailty?[J]. J Geriatr Oncol, 2016, 8(1):8-15. DOI:10.1016/j.jgo.2016.06.003.
[10] Dicenso A, Bayley L, Haynes R B.Accessing Pre-Appraised Evidence: Fine-tuning the 5s Model into a 6s Model[J]. Evid Based Nurs, 2009,12(4):99-101.DOI:10.1136/ebn.12.4.99-b.
[11] Brouwers M C, Kho M E, Browman G P, et al.AGREE II: Advancing Guideline Development, Reporting and Evaluation in Health Care[J]. J Clin Epidemiol, 2010,63(12):1308-1311.DOI:10.1016/j.ypmed.2010.08.005.
[12] 张方圆,沈傲梅,曾宪涛,等. 系统评价方法学质量评价工具AMSTAR 2解读[J]. 中国循证心血管医学杂志, 2018,10(1):14-18.DOI:1674-4055(2018)01-0014-05.
[13] 王春青,胡雁.JBI证据预分级及证据推荐级别系统(2014版)[J]. 护士进修杂志, 2015,30(11):964-967.DOI:1002-6975(2015)11-0964-04.
[14] Abdullahi Y S, Athanasopoulos L V, Casula R P, et al.Systematic Review on the Predictive Ability of Frailty Assessment Measures in Cardiac Surgery[J]. Interact Cardiovasc Thorac Surg, 2017, 24(4):619-624.DOI:10.1093/icvts/ivw374.
[15] Axley M S, Schenning K J.Preoperative Cognitive and Frailty Screening in the Geriatric Surgical Patient: A Narrative Review[J]. Clin Ther, 2015, 37(12):2666-2675. DOI:10.1016/j.clinthera.2015.10.022.
[16] Partridge J S, Harari D, Martin F C, et al.The Impact of Preoperative Comprehensive Geriatric Assessment on Postoperative Outcomes in Older Patients Undergoing Scheduled Surgery: A Systematic Review[J]. Anaesthesia, 2013, 69(s1):8-16.DOI:10.1111/anae.12494.
[17] Oresanya L B, Lyons W L, Finlayson E.Preoperative Assessment of the Older Patient: A Narrative Review[J]. JAMA, 2014,311(20):2110-2120.DOI:0.1001/jama.2014.4573.
[18] Shem T L, Matot I.Frailty and Anesthesia[J]. Curr Opin Anaesthesiol,2017,30(3):409.DOI:10.1097/ACO.0000000000000456.
[19] Mohanty S, Rosenthal R A, Russell M M, et al.Optimal Perioperative Management of the Geriatric Patient: A Best Practices Guideline from the American College of Surgeons Nsqip and the American Geriatrics Society[J]. J Am Coll Surg,2016,222(5):930-947.DOI:10.1016/j.jamcollsurg.2015.12.026.
[20] Kiselev J.Interventionen zur Präoperativen Unterstützung Geriatrischer Patienten Mit Frailty[J]. AINS, 2017, 52(11/12): 777-783.
[21] Audrey C.Medical and Preoperative Evaluation of the Older Adult[J]. Otolaryngol Clin North Am. 2018, 51(4):835-846. DOI: 10.1016/j.otc.2018.03.010.
[22] Olotu-Steffen C, Gurlit S, Kiefmann R.Präoperative Vorbereitung und Evaluation: Der Ältere Patient[J]. Anasthesiol Intensivmed Notfallmed Schmerzther, 2017, 52(5): 342-355. DOI: 10.1055/s-0042-109286.
[23] Sharon K.American Geriatrics Society Abstracted Clinical Practice Guideline for Postoperative Delirium in Older Adults[J]. J Am Geriatr Soc, 2015, 63(1):142-150.DOI: 10.1111/jgs.13281.
[24] Chow W B, Rosenthal R A, Merkow R P, et al.Optimal Preoperative Assessment of the Geriatric Surgical Patient: A Best Practices Guideline from the American College of Surgeons National Surgical Quality Improvement Program and the American Geriatrics Society[J]. J Am Coll Surg, 2012, 215(4):453-466.DOI: 10.1016/j.jamcollsurg.2012.06.017.
[25] Alvarez-Nebreda M L, Bentov N, Setia S, et al. Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI)[J]. J Clin Anesth, 2017,6(47):33-42.DOI: 10.1016/j.jclinane.2018.02.011.
[26] 中华医学会老年医学分会. 老年患者术前评估中国专家建议(2015)[J]. 中华老年医学杂志, 2015, 34(11):1273-1280.DOI: 10.3760/cma.j.issn.0254-9026.2015.11.033.
[27] 中华医学会老年医学分会. 老年患者衰弱评估与干预中国专家共识[J]. 中华老年医学杂志, 2017,36(3):251-256. DOI:10.3760/cma.j.issn.0254-9026.2017.03.007.
[28] 周英凤,胡雁,顾莺,等.基于证据的持续质量改进模式图的构建[J].中国循证医学杂志,2017,17(5):603-606.
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