Introduction Comprehensive Geriatric Assessment (CGA) is a fundamental principle of geriatrics management aimed at limiting dysfunctions in the elderly. It is a multidirectional, integrated diagnostic process necessary for the biopsychological assessment of an elderly person in a home or institutional environment. Aim The aim of this study is to present the most commonly used standardized tools to facilitate the assessment of the functional, mental and social state of elderly patients, used in the overall diagnostic process, which is a comprehensive geriatric assessment. Overview The point scales used in the comprehensive geriatric assessment (CGA) can be divided into 4 large groups, i.e. scales assessing physical health (Clinical/Outcome Assessment), scales assessing functional status (Acti¬vities of Daily Living), scales assessing mental state (Cognitive and Mental Assessment) and scales assessing the socio-environmental situation (state) of the respondent (Global Assessment/Quality of Life). Conclusions The presented point scales can be successfully used both in inpatient care (hospital wards) and in long-term care facilities (care and treatment centers, rehabilitation departments, nursing homes for chronically ill pa¬tients, etc.) and in open care, as well as in the practice of a physician and family nurse.
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Wstęp Kompleksowa ocena geriatryczna – KOG (ang. Comprehensive Geriatric Assessment – CGA) jest fundamen¬talną zasadą postępowania w geriatrii zmierzającą do ograniczenia dysfunkcji u osób starszych. Jest to wie¬lokierunkowy, zintegrowany proces diagnostyczny niezbędny do oceny biopsychospołecznej osoby starszej przebywającej w środowisku domowym lub instytucjonalnym. Cel Celem pracy jest przedstawienie najczęściej stosowanych standaryzowanych narzędzi ułatwiających prze-prowadzenie oceny stanu funkcjonalnego, mentalnego i socjalnego pacjentów w wieku starszym, wykorzy¬stywanych w całościowym procesie diagnostycznym, jaki stanowi kompleksowa ocena geriatryczna. Przegląd Skale punktowe stosowane w całościowej ocenie geriatrycznej (CGA) można podzielić na 4 duże grupy tj. skale oceniające stan zdrowia fizycznego (Clinical/Outcome Assessment), skale oceniające stan czynnościo¬wy (Activities of Daily Living), skale oceniające stan umysłowy (Cognitive and Mental Assessment) oraz skale oceniające sytuację (stan) socjalno-środowiskową badanego (Global Assessment/Quality of Life). Wnioski Przedstawione skale punktowe można z powodzeniem zastosować zarówno w lecznictwie zamkniętym (od¬działy szpitalne) jak i w placówkach świadczących opiekę długoterminową (zakładach opiekuńczo-leczni¬czych, oddziałach rehabilitacyjnych, domach opieki nad osobami przewlekle chorymi itp.) oraz w lecznic¬twie otwartym, a również w praktyce lekarza i pielęgniarki rodzinnej.
The Vulnerable Elders Survey (VES-13) is a simple function based frailty screening tool that can be also administered by the nonclinical personnel within 5 minutes and has been validated in the out- and in patient clinic and acute medical care settings. The aim of the study was to validate theaccuracy of the VES-13 screening method for predicting the frailty syndrome based on a CGA in polish surgical patients. Material and methods. We included prospectively 106 consecutive patients ≥65, that qualify for abdominal surgery (both due to oncological and benign reasons), at the tertiary referral hospital.We evaluated the diagnostic performance of VES-13 score comparing to the results from the CGA, accepted as the gold standard for identifying at risk frail elderly patients. Results. The prevalence of frailty as diagnosed by CGA was 59.4%. There was significantly higher number of frail patients in the oncological group (78% vs. 31%; p<0.01). According to the frailty screening methods, the frailty prevalence was 45.3%. The VES-13 score had a 60% sensitivity and 78% specificity in detecting frailty syndrome. The positive and negative predictive value was 81% and 57%, respectively. The overall predictive capacity was intermediate (AUC=0.69) Conclusions. At present, the VES-13 screening tool for older patients cannot replace the comprehensive geriatric assessment; this is due to the insufficient discriminative power to select patients for further assessment. It might be helpful in a busy clinical practice and in facilities that do not have trained personal for geriatric assessment.
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