Zusammenfassung
Der stetig zu beobachtende demografische Wandel geht mit veränderten Anforderungen
an die Patientenbetreuung einher. Ältere Patienten weisen häufig einen erhöhten Behandlungsbedarf
und eine höhere Komplexität des klinischen Gesamtbildes auf. Dieser Umstand ist –
abgesehen von der Routineversorgung – besonders dann zu beachten, wenn eine angedachte
Intervention zu schweren und potenziell lebensbedrohlichen Komplikationen führen kann.
Abstract
Frailty is a complex syndrome leading to a higher vulnerability in elderly patients,
especially during and after surgery. It is characterized by the simultaneous presence
of at least three of five phenotypical symptoms: unintentional weight loss, exhaustion,
muscle weakness, slow walking speed, and low activity levels. The presence of two
of these symptoms is often labelled as pre-frailty.
By identifying these symptoms of frailty, medical teams can plan and perform suitable
interventions prior to a planned surgery in order to lower these risk factors and
to avoid complications, such as delir, hospital re-admission, loss of independence,
and increased mortality. Examples for these interventions are pre-surgery rehabilitation
and Delirium Management Units (DMU).
This article describes the frailty syndrome and its associated consequences for complications
during and after surgery. Additionally, clinical assessments for identifying frailty
symptoms as well as pre- and post-surgical interventions to reduce these risk factors
are presented.
Schlüsselwörter
Frailty - Gebrechlichkeit - perioperatives Management - präoperatives Management -
geriatrische Patienten
Key words
frailty - perioperative management - preoperative management - geriatric patients
