Der fraile Patient: fiktives Fallbeispiel

Bei Patienten mit Gebrechlichkeitssyndrom (Frailty) kann eine Prähabilitation vor Narkose und Operationen das Risiko von Komplikationen sowie das Outcome deutlich verbessern. Hierbei ist es wichtig, ein routinemäßiges Screening zu etablieren, um ein Gebrechlichkeitssyndrom im klinischen Alltag zu erfassen und Möglichkeiten für eine Prähabilitation zu schaffen. Diese Zusammenhänge sollen anhand eines fiktiven Fallbeispiels erläutert werden.

Abstract

Various limitations in everyday life can indicate a frailty syndrome. These limitations are not always directly visible and result from a wide variety of domains. Fried et al. described these limitations of different domains as frailty syndrome. This syndrome can be acutely worsened by different influencing factors. One major risk factor is an upcoming anesthesia and surgery. Frailty is associated with a significantly increased risk of peri- and postoperative complications. To avoid acute deterioration due to anesthesia and surgery, the concept of prehabilitation was developed. The aim is to specifically address the respective deficits and to develop an individual training concept together with the patient. Prehabilitation can significantly improve the risk of complications and the outcome of frail patients. In this context, it is important to establish routine screening in order to detect a frailty syndrome in everyday clinical practice and to create opportunities for prehabilitation.

Kernaussagen

• Es ist wichtig, ein Bewusstsein für das Frailty-Syndrom zu entwickeln.

• Ein Frailty-Screening sollte v. a. bei älteren Patienten Teil der täglichen Routine sein.

• Defizite im Frailty-Screening sollten erfasst und ein gemeinsames Konzept zusammen mit dem Patienten erarbeitet werden.

• Eine Prähabilitation ist eine Maßnahme, die den Patienten bereits präoperativ unterstützt und erfasste Defizite verbessern kann.

• Ein Frailty-Screening zusammen mit einer Prähabilitation senkt das Komplikationsrisiko des Patienten und verbessert insgesamt das Outcome.

Schlüsselwörter

Gebrechlichkeit - Prähabilitation - Anästhesiologie - Intensivmedizin

Keywords

frailty - prehabilitation - anaesthesia - intensive care

Publication History

Article published online:
29 November 2022

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