衰弱筛查工具在急诊科老年护理中的应用进展

doi:10.3761/j.issn.1672-9234.2020.10.005

摘要/Abstract

摘要：

目的总结不同衰弱筛查工具在急诊科老年护理中应用价值,找出衰弱筛查实施过程中的障碍及相应的对策。方法检索PubMed、The Cochrane Library、Web of Science、Embase、中国生物医学文献数据库（CBM）、中国知网（CNKI）和万方数据库关于衰弱筛查工具在急诊老年护理中应用的文献,进行整合性综述。结果共纳入19项研究,包含10种筛查工具,13项研究报告了工具的有效性,3项研究报告了可靠性,4项研究报告了衰弱筛查实施过程中的障碍和采取的策略,实施障碍包括急诊科工作量过大、工作人员短缺、缺乏激励措施和资源（设备、多学科小组）、患者和照顾者因素、意识薄弱。应尽早将衰弱筛查纳入护理常规评估,选择可靠和快速的筛查工具。结论衰弱筛查工具的准确性需要进一步提高。建议根据实际情况,使用有效和可靠的衰弱筛查工具,并在急诊护理环境中进行早期衰弱筛查,给予提前干预以优化患者的健康结局。

关键词: 老年人, 急症护理, 衰弱, 筛查, 准确性, 实施障碍, 整合性综述

Key words: Elderly, Emergency Nursing, Frailty, Screening, Accuracy, Implementation, Integrative review

迟俊婷,陶红霞,张静,牛晓丹,阮海慧,王艳红. 衰弱筛查工具在急诊科老年护理中的应用进展[J]. 中华护理教育, 2020, 17(10): 891-896.

图/表 2

参考文献 30

[1]	Samaras N, Chevalley T, Samaras D, et al. Older patients in the emergency department:a review[J]. Ann Emerg Med, 2010,56(3):261-269. doi: 10.1016/j.annemergmed.2010.04.015
[2]	De Saint-Hubert M, Schoevaerdts D, Cornette P, et al. Predicting functional adverse outcomes in hospitalized older patients:a systematic review of screening tools[J]. J Nutr Health Aging, 2010,14(5):394-399. doi: 10.1007/s12603-010-0086-x
[3]	Cheung A, Haas B, Ringer TJ, et al. Canadian study of health and aging clinical frailty scale:does it predict adverse outcomes among geriatric trauma patients?[J]. J Am Coll Surg, 2017,225(5):658-665. pmid: 28888692
[4]	Clegg A, Young J, Iliffe S, et al. Frailty in elderly people[J]. Lancet, 2013,381(9868):752-762. doi: 10.1016/S0140-6736(12)62167-9
[5]	李小鹰. 中华老年医学[M]. 北京: 人民卫生出版社, 2016: 98-103.
[6]	Apóstolo J, Cooke R, Bobrowicz-Campos E, et al. Predicting risk and outcomes for frail older adults:an umbrella review of frailty screening tools[J]. JBI Database System Rev Implement Rep, 2017,15(4):1154-1208. doi: 10.11124/JBISRIR-2016-003018 pmid: 28398987
[7]	Anaya JB, Peña ED, Bedore LM. Conceptual scoring and classification accuracy of vocabulary testing in bilingual children[J]. Lang Speech Hear Serv Sch, 2018,49(1):85-97. doi: 10.1044/2017_LSHSS-16-0081 pmid: 29209728
[8]	Gladman JR, Conroy SP, Ranhoff AH, et al. New horizons in the implementation and research of comprehensive geriatric assessment:knowing,doing and the‘know-do’ gap[J]. Age Ageing, 2016,45(2):194-200. doi: 10.1093/ageing/afw012 pmid: 26941353
[9]	Wells G. The Newcastle-Ottawa Scale(NOS) for assessing the quality of non-randomised studies in meta-analyses[EB/OL]. [2020-08-26]. http://www.ohri.ca/programs/clinicalepidemiology/oxford.asp, 2001.
[10]	Rostom A, Dube C, Cranney A, et al. Appendix D. Quality assessment forms[EB/OL].[2020-08-26]. http://www.ncbi.nlm.nih.gov/books/NBK35156.
[11]	Lalkhen AG, McCluskey A. Clinical tests:sensitivity and specificity[J]. Continuing Educ Anaesth Crit Care Pain, 2008,8(6):221-223. doi: 10.1093/bjaceaccp/mkn041
[12]	Hoppe FM, Hoppe DJ, Walter SD. Explaining odds ratios as conditional risk ratios[J]. J Clin Epidemiol, 2018,97:123-124. doi: 10.1016/j.jclinepi.2017.10.009 pmid: 29100823
[13]	Warnier RMJ, van Rossum E, van Kuijk SMJ, et al. The maastricht frailty screening tool for hospitalised patients（MFST-HP） to identify non-frail patients[J]. Int J Clin Pract, 2017. DOI: 10.1111/ijcp.13003. doi: 10.1111/ijcp.13758 pmid: 33098613
[14]	Sattar S, Alibhai SM, Wildiers H, et al. How to implement a geriatric assessment in your clinical practice[J]. Oncologist, 2014,19(10):1056-1068. pmid: 25187477
[15]	De Brauwer I, Cornette P, Boland B, et al. Can we predict functional decline in hospitalized older people admitted through the emergency department? Reanalysis of a predictive tool ten years after its conception[J]. BMC Geriatr, 2017,17(1):105. doi: 10.1186/s12877-017-0498-0 pmid: 28499358
[16]	Warnier RM, van Rossum E, van Leendert JA, et al. Screening for frailty in hospitalized older adults:reliability and feasibility of the maastricht frailty screening tool for hospitalized patients(MFST-HP)[J]. Res Gerontol Nurs, 2016,9(5):243-251. doi: 10.3928/19404921-20160906-01 pmid: 27637112
[17]	Heim N, van Fenema EM, Weverling-Rijnsburger AW, et al. Optimal screening for increased risk for adverse outcomes in hospitalised older adults[J]. Age Ageing, 2015,44(2):239-244. doi: 10.1093/ageing/afu187 pmid: 25432981
[18]	Volpato S, Bazzano S, Fontana A, et al. Multidimensional Prognostic Index predicts mortality and length of stay during hospitalization in the older patients:a multicenter prospective study[J]. J Gerontol A Biol Sci Med Sci, 2015,70(3):325-331. doi: 10.1093/gerona/glu167 pmid: 25209253
[19]	Evans SJ, Sayers M, Mitnitski A, et al. The risk of adverse outcomes in hospitalized older patients in relation to a frailty index based on a comprehensive geriatric assessment[J]. Age Ageing, 2014,43(1):127-132. doi: 10.1093/ageing/aft156 pmid: 24171946
[20]	Salvi F, Morichi V, Grilli A, et al. Screening for frailty in elderly emergency department patients by using the Identification of Seniors At Risk(ISAR)[J]. J Nutr Health Aging, 2012,16(4):313-318. doi: 10.1007/s12603-011-0155-9 pmid: 22499448
[21]	Hoogerduijn JG, Buurman BM, Korevaar JC, et al. The prediction of functional decline in older hospitalised patients[J]. Age Ageing, 2012,41(3):381-387. doi: 10.1093/ageing/afs015
[22]	Sancarlo D, D’Onofrio G, Franceschi M, et al. Validation of a Modified-Multidimensional Prognostic Index(m-MPI)including the Mini Nutritional Assessment Short-Form(MNA-SF)for the prediction of one-year mortality in hospitalized elderly patients[J]. J Nutr Health Aging, 2011,15(3):169-173. doi: 10.1007/s12603-010-0293-5 pmid: 21369662
[23]	Hoogerduijn JG, Schuurmans MJ, Korevaar JC, et al. Identification of older hospitalised patients at risk for functional decline,a study to compare the predictive values of three screening instruments[J]. J Clin Nurs, 2010,19(9/10):1219-1225. doi: 10.1111/jcn.2010.19.issue-9-10
[24]	Salvi F, Morichi V, Grilli A, et al. Predictive validity of the Identification of Seniors At Risk(ISAR) screening tool in elderly patients presenting to two Italian emergency departments[J]. Aging Clin Exp Res, 2009,21(1):69-75. doi: 10.1007/BF03324901 pmid: 19225272
[25]	Hilmer SN, Perera V, Mitchell S, et al. The assessment of frailty in older people in acute care[J]. Australas J Ageing, 2009,28(4):182-188. doi: 10.1111/j.1741-6612.2009.00367.x pmid: 19951339
[26]	Pilotto A, Ferrucci L, Franceschi M, et al. Development and validation of a multidimensional prognostic index for one-year mortality from comprehensive geriatric assessment in hospitalized older patients[J]. Rejuvenation Res, 2008,11(1):151-161. doi: 10.1089/rej.2007.0569 pmid: 18173367
[27]	Cornette P, Swine C, Malhomme B, et al. Early evaluation of the risk of functional decline following hospitalization of older patients：development of a predictive tool[J]. Eur J Public Health, 2006,16(2):203-208. doi: 10.1093/eurpub/cki054 pmid: 16076854
[28]	McCusker J, Bellavance F, Cardin S, et al. Detection of older people at increased risk of adverse health outcomes after an emergency visit:the ISAR screening tool[J]. J Am Geriatr Soc, 1999,47(10):1229-1237. doi: 10.1111/j.1532-5415.1999.tb05204.x pmid: 10522957
[29]	Sager MA, Rudberg MA, Jalaluddin M, et al. Hospital admission risk profile(HARP):identifying older patients at risk for functional decline following acute medical illness and hospitalization[J]. J Am Geriatr Soc, 1996,44(3):251-257. doi: 10.1111/j.1532-5415.1996.tb00910.x pmid: 8600192
[30]	Eamer G, Gibson JA, Gillis C, et al. Surgical frailty assessment:a missed opportunity[J]. BMC Anesthesiol, 2017,17(1):99. doi: 10.1186/s12871-017-0390-7 pmid: 28738809

衰弱筛查工具在急诊科老年护理中的应用进展

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