Öz
Amaç: Kırılganlık,
nöromüsküler, metabolik ve immün sistemde ilerleyen yaşla birlikte fizyolojik
rezervlerin azalmasına bağlı olarak meydana gelen güçsüzlük halidir. Kırılgan
hastalar tüm sağlık çalışanları için takip ve tedavide en karmaşık ve en
zorlayıcı sorunlara neden olan hasta grubunu oluşturmaktadır. Bu çalışmanın amacı; üç farklı kırılganlık
ölçeği kullanılarak 65 yaş ve üstündeki hastanede yatan geriatrik hastalarda
kırılganlık prevalansının araştırılmasıdır.
Gereç-Yöntem: Bu çalışma iç
hastalıkları ve geriatri kliniklerinde yatan 65 yaş ve üstündeki hastalarda
yapılmıştır. Çalışmaya 399 hasta dahil edilmiştir. Hastalarda kırılganlık prevalansının
belirlenmesinde, Cardiovaskuler Health Study (CHS), Woman's Health and Aging Study
(WHAS) ve Gerontopole kırılganlık ölçekleri kullanılmıştır. CHS ve WHAS
ölçeklerinde beş kriterden üçü patolojik olanlar, Gerontopole ölçeğinde ise altı
kriterden biri patolojik olan hastalar kırılgan kabul edilmiştir.
Bulgular: Hastaların
ortalama yaşı 71,9 ± 6,3 ve %50,6‘sı erkekti. CHS ölçeğine göre, hastaların
%8,3’ü sağlam, %26,2’si prefrajil ve %65,5’i kırılgan,
WHAS ölçeğine göre %9,3’ü sağlam, % 27,6’sı prefrajil ve %63,1’i kırılgan iken
Gerontopole ölçeğine göre ise hastaların %8,8’ini sağlam ve %91,2’sini kırılgan
olarak bulduk.
Sonuç: Yaptığımız
çalışmada farklı kırılganlık ölçeklerine göre hastanede yatan geriatrik
hastalarda farklı kırılganlık ölçeklerine göre kırılganlık prevalansını %63.1 -
%91.2 gibi yüksek değerlerde saptadık. Kırılganlık tedavi edilebilen, geri
dönüşlü bir sendrom olup, erken fark edilmesi, düşme, kırık, bakımevine yatış
ve artmış mortalite gibi istenmeyen sonuçların önlenmesi için büyük önem
taşıdığından dolayı kliniklerde yatan geriatrik hastalarda %90’lara varan
oranlarda kırılgan hastalarla karşılaşabileceğimizi sağlık çalışanları olarak
unutmamamız gerekmektedir.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1. Kinsella K, Wan H. U.S. Census Bureau: International Population Reports. An Aging World, Washington:2008. U.S. Government Printing Office, DC. 2009:1-209.
- 2. Cherniack EP, Florez HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev. 2007;12:246-258.
- 3. Fairhall N, Aggar C, Kurrle SE, Sherrington C, Lord S, Lockwood K, et al. Frailty Intervention Trial (FIT). BMC Geriatr. 2008;8:27.
- 4. Ülger Z, Arıoğlu S. Kırılgan Yaşlı. Geriatri ve Gerontoloji, Medikal Nobel Kitabevleri, İstanbul. 2006;385-391.
- 5. Aras S. Varlı M, Atlı T. Yaşlılıkta Kırılganlığı Anlamak, Akad Geriatri,2011; 3(3): 130-137.
- 6. Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52:6-11.
- 7. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146-157.
- 8. Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women's health and aging studies. Journal of Gerontology: Medical Sciences,2006; 3: 262-266.
- 9. Tavassoli N, Guyonnet S, Abellan Van Kan G, Sourdet S, Krams T, Soto ME, et al. Description of 1,108 older patients referred by their physician to the "Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability" at the gerontopole. Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability Team. J Nutr Health Aging. 2014;18(5):457-464.
- 10. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R et al. Frailty in Older Adults: A Nationally Representative Profile in the United States. J Gerontol A Biol Sci Med Sci. 2015;70(11):1427-1434.
- 11. Bennett JA, Winters-Stone KM, Dobek J, Nail LM. Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum. 2013;40(3):126- 134.
- 12. Heppenstall, C. P. Maintaining Independence: Predicting and Preventing Residential Care Admission in Frail Older People Discharged from Hospital, A thesis for the degree of Doctor of Philosophy The University of Otago, Christchurch. 2011.
Öz
Objective: Frailty
syndrome is a weakness state characterized by age-associated decline in
physiological reserves across neuromuscular and immune systems and metabolism.
Frails are a group of patients that constitute probably the most complex and
drastic challenges in terms of follow-up and treatment for the healthcare
professionals. This study aimed to detect frailty prevalences by using three
discrete measures among inpatients aged 65 and older.
Methods: 399 patients aged 65 and older, hospitalized in internal
medicine and geriatrics wards were included in this study. Cardiovascular
Health Study (CHS), Women’s Health and Aging Study (WHAS) and Gerontopole
measures were used. Patients with three or more positive criteria out of five
in CHS or WHAS and one or more of those out of six in Gerontopole were
classified as frail.
Results: Mean age was 71.9 ± 6.3 and 50.6% of the subjects were male.
According to the CHS, 8.3% were robust, 26.2% were prefrail and 65.5% were
frail and 9.3% were diagnosed as robust, 27.6% were prefrail and 63.1% were
frail in conformity with the criteria of WHAS, wheras 8.8% were robust and
91.2% were frail in Gerontopole analysis.
Conclusion: The frailty
prevalences with discrete measures among hospitalized geriatric patients were
fairly high, ranged from 63.1% to 91.2% in this study. The frailty is a curable
and reversible syndrome and early recognition of frailty syndrome is priceless
to have reduced unfavourable outcomes like falls, fractures, admissions to
hospitals or nursing homes and decreased mortality risk therefore as health
care professionals, we shouldn’t forget that we may experience high frailty
prevalences, up to 90%, among geriatric patients in hospitals.
Anahtar Kelimeler
Kaynakça
- Kaynaklar 1. Kinsella K, Wan H. U.S. Census Bureau: International Population Reports. An Aging World, Washington:2008. U.S. Government Printing Office, DC. 2009:1-209.
- 2. Cherniack EP, Florez HJ, Troen BR. Emerging therapies to treat frailty syndrome in the elderly. Altern Med Rev. 2007;12:246-258.
- 3. Fairhall N, Aggar C, Kurrle SE, Sherrington C, Lord S, Lockwood K, et al. Frailty Intervention Trial (FIT). BMC Geriatr. 2008;8:27.
- 4. Ülger Z, Arıoğlu S. Kırılgan Yaşlı. Geriatri ve Gerontoloji, Medikal Nobel Kitabevleri, İstanbul. 2006;385-391.
- 5. Aras S. Varlı M, Atlı T. Yaşlılıkta Kırılganlığı Anlamak, Akad Geriatri,2011; 3(3): 130-137.
- 6. Topinková E. Aging, disability and frailty. Ann Nutr Metab. 2008;52:6-11.
- 7. Fried LP, Tangen CM, Walston J, Newman AB, Hirsch C, Gottdiener J, et al. Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):146-157.
- 8. Bandeen-Roche K, Xue QL, Ferrucci L, Walston J, Guralnik JM, Chaves P, et al. Phenotype of frailty: characterization in the women's health and aging studies. Journal of Gerontology: Medical Sciences,2006; 3: 262-266.
- 9. Tavassoli N, Guyonnet S, Abellan Van Kan G, Sourdet S, Krams T, Soto ME, et al. Description of 1,108 older patients referred by their physician to the "Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability" at the gerontopole. Geriatric Frailty Clinic (G.F.C) for Assessment of Frailty and Prevention of Disability Team. J Nutr Health Aging. 2014;18(5):457-464.
- 10. Bandeen-Roche K, Seplaki CL, Huang J, Buta B, Kalyani RR, Varadhan R et al. Frailty in Older Adults: A Nationally Representative Profile in the United States. J Gerontol A Biol Sci Med Sci. 2015;70(11):1427-1434.
- 11. Bennett JA, Winters-Stone KM, Dobek J, Nail LM. Frailty in older breast cancer survivors: age, prevalence, and associated factors. Oncol Nurs Forum. 2013;40(3):126- 134.
- 12. Heppenstall, C. P. Maintaining Independence: Predicting and Preventing Residential Care Admission in Frail Older People Discharged from Hospital, A thesis for the degree of Doctor of Philosophy The University of Otago, Christchurch. 2011.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | Makaleler |
| Yazarlar | |
| Yayımlanma Tarihi | 24 Kasım 2017 |
| Gönderilme Tarihi | 14 Eylül 2017 |
| Kabul Tarihi | 23 Kasım 2017 |
| Yayımlandığı Sayı | Yıl 2017 Cilt: 12 Sayı: 3 |
