
Tianjin Medical Journal ›› 2026, Vol. 54 ›› Issue (6): 663-667.doi: 10.11958/20253188
• Review • Previous Articles Next Articles
SHANG Gechu1(
), WANG Guan2,△(
)
Received:2025-10-20
Revised:2025-12-22
Published:2026-06-15
Online:2026-06-15
Contact:
△E-mail:neurocrown@163.com
SHANG Gechu, WANG Guan. Research progress on the risk management of frailty-oriented pneumonia after neurointervention in the elderly[J]. Tianjin Medical Journal, 2026, 54(6): 663-667.
CLC Number:
| 评估工具 | 核心评估维度 | 耗时 | 主要优点 | 主要局限性 | 适用场景 |
|---|---|---|---|---|---|
| CFS[ | 共病、功能依赖 | 1~2 min | 极快,操作简便,无需特殊设备 | 相对主观,依赖评估者经验 | 急诊、分诊、住院患者快速风险筛查 |
| FRAIL量表[ | 疲劳、阻力、活动能力、疾病数、体重 | 1~3 min | 简单快捷,患者可自评,预测死亡/跌倒风险佳 | 依赖患者主观陈述,在认知受损或沟通不畅者中准确性下降 | 门诊、社区及大型流行病学研究 |
| Fried表型[ | 握力、步速、体力活动、疲惫感、体重 | 10~15 min | 客观量化,标准化程度高 | 非快速筛查工具,需设备支持,耗时较长 | 科学研究、流行病学调查 |
| CGA[ | 疾病、功能、认知、心理、社会、营养 | >30 min | 最全面,直接指导个体化治疗 | 耗时,需多学科团队 | 制定复杂患者管理计划 |
Tab.1 Comparison of characteristics of commonly used frailty assessment tools
| 评估工具 | 核心评估维度 | 耗时 | 主要优点 | 主要局限性 | 适用场景 |
|---|---|---|---|---|---|
| CFS[ | 共病、功能依赖 | 1~2 min | 极快,操作简便,无需特殊设备 | 相对主观,依赖评估者经验 | 急诊、分诊、住院患者快速风险筛查 |
| FRAIL量表[ | 疲劳、阻力、活动能力、疾病数、体重 | 1~3 min | 简单快捷,患者可自评,预测死亡/跌倒风险佳 | 依赖患者主观陈述,在认知受损或沟通不畅者中准确性下降 | 门诊、社区及大型流行病学研究 |
| Fried表型[ | 握力、步速、体力活动、疲惫感、体重 | 10~15 min | 客观量化,标准化程度高 | 非快速筛查工具,需设备支持,耗时较长 | 科学研究、流行病学调查 |
| CGA[ | 疾病、功能、认知、心理、社会、营养 | >30 min | 最全面,直接指导个体化治疗 | 耗时,需多学科团队 | 制定复杂患者管理计划 |
| [1] | JIANG X, WANG J, HU Y, et al. Is endovascular treatment still good for acute ischemic stroke in the elderly? A meta-analysis of observational studies in the last decade[J]. Front Neurosci, 2023, 17:1308216. doi:10.3389/fnins.2023.1308216. |
| [2] | PREMAT K, DECHARTRES A, BAPTISTE A, et al. Comparison of rescue intracranial stenting versus best medical treatment alone in acute refractory large vessel occlusion:study protocol for the PISTAR multicenter randomized trial[J]. J Neurointerv Surg, 2025, 17(4):360-367. doi:10.1136/jnis-2024-021502. |
| [3] | WEBBER M, CASEY B, TUCKER L, et al. The conceptualisation and measurement of social frailty in older people:an umbrella review[J]. J Frailty Aging, 2025, 14(5):100078. doi:10.1016/j.tjfa.2025.100078. |
| [4] | GUO Z, HOU J, YU S, et al. Eosinophils,stroke-associated pneumonia,and outcome after mechanical thrombectomy for acute ischemic stroke[J]. Front Aging Neurosci, 2022, 14:830858. doi:10.3389/fnagi.2022.830858. |
| [5] | BAHAR A R, BAHAR Y, KIDESS G, et al. Association of frailty with outcomes in patients with large vessel occlusion stroke undergoing mechanical thrombectomy[J]. Neuroradiology, 2025, 67(4):845-854. doi:10.1007/s00234-025-03562-9. |
| [6] | BUSHNELL C, KERNAN W N, SHARRIEF A Z, et al. 2024 Guideline for the primary prevention of stroke:a guideline from the American Heart Association/American Stroke Association[J]. Stroke, 2024, 55(12):e344-e424. doi:10.1161/STR.0000000000000475. |
| [7] | GANESH K M, KRISHNA B. Utility of clinical frailty scale in intensive care unit[J]. Indian J Crit Care Med, 2025, 29(4):289-290. doi:10.5005/jp-journals-10071-24959. |
| [8] | GONG S, QIAN D, RIAZI S, et al. Association between the FRAIL scale and postoperative complications in older surgical patients:a systematic review and meta-analysis[J]. Anesth Analg, 2023, 136(2):251-261. doi:10.1213/ANE.0000000000006272. |
| [9] | WINDERMERE S A, MELNICK K, YAN S C, et al. Predictive power of the Fried phenotype in assessing postoperative outcomes in patients undergoing craniotomy for tumor resection[J]. Neurosurgery, 2025, 96(2):463-470. doi:10.1227/neu.0000000000003231. |
| [10] | ROLLER-WIRNSBERGER R, HERZOG C, LINDNER-RABL S, et al. Teaching comprehensive geriatric assessment(CGA) in medical education:a scoping review[J]. Eur Geriatr Med, 2025, 16(2):425-433. doi:10.1007/s41999-025-01157-4. |
| [11] | HAYES C, YIGEZU A, DILLON S, et al. Home-based comprehensive geriatric assessment for community-dwelling,at-risk,frail older adults:a systematic review and meta-analysis[J]. J Am Geriatr Soc, 2025, 73(6):1929-1939. doi:10.1111/jgs.19402. |
| [12] | LI Z, PANG M, ZHANG J, et al. Effect of ventilation modalities on the early prognosis of patients with poststroke sleep apnea[J]. Ann Clin Transl Neurol, 2024, 11(2):355-367. doi:10.1002/acn3.51956. |
| [13] | ST HILAIRE C, BURTON J, LUNKKADI K, et al. Frailty scores impact the outcomes of urgent carotid interventions in acute stroke patients:a comprehensive analysis of risk and prognosis[J]. J Vasc Surg, 2024, 80(6):1727-1735.e1. doi:10.1016/j.jvs.2024.07.096. |
| [14] | LUO O J, LEI W, ZHU G, et al. Multidimensional single-cell analysis of human peripheral blood reveals characteristic features of the immune system landscape in aging and frailty[J]. Nat Aging, 2022, 2(4):348-364. doi:10.1038/s43587-022-00198-9. |
| [15] | MEREUTA O M, ABBASI M, FITZGERALD S, et al. Histological evaluation of acute ischemic stroke thrombi may indicate the occurrence of vessel wall injury during mechanical thrombectomy[J]. J Neurointerv Surg, 2022, 14(4):356-361. doi:10.1136/neurintsurg-2021-017310. |
| [16] | SONG Z, LI W, HAN Y, et al. Investigating the shared genetic architecture between frailty and insomnia[J]. Front Aging Neurosci, 2024, 16:1358996. doi:10.3389/fnagi.2024.1358996. |
| [17] | BORIESOSDICK J, SUROV A, MICHAEL A, et al. Sarcopenia is a predictor of patient death in acute ischemic stroke[J]. J Stroke Cerebrovasc Dis, 2023, 32(12):107421. doi:10.1016/j.jstrokecerebrovasdis.2023.107421. |
| [18] | SHIRVANI O, FISCHBEIN P, BENDELLA Z, et al. Aetiology of acute respiratory insufficiency in patients with ischaemic stroke studied by chest CT scan[J]. Eur J Neurol, 2025, 32(3):e70125. doi:10.1111/ene.70125. |
| [19] | PINHO J, MEYER T, SCHUMANN-WERNER B, et al. Swallowing muscle mass contributes to post-stroke dysphagia in ischemic stroke patients undergoing mechanical thrombectomy[J]. J Cachexia Sarcopenia Muscle, 2024, 15(4):1539-1548. doi:10.1002/jcsm.13512. |
| [20] | HUANG M, WANG W, LI W L, et al. Construction and evaluation of a nomogram model for predicting the risk of hospital-acquired pneumonia in elderly patients with acute ischemic stroke[J]. BMC Geriatr, 2025, 25(1):340. doi:10.1186/s12877-025-05936-3. |
| [21] | SANTOS A C F F, COELHO L L S, CALDAS G C, et al. General anesthesia versus conscious sedation in mechanical thrombectomy for patients with acute ischemic stroke:systematic review and meta-analysis[J]. Arq Neuropsiquiatr, 2024, 82(4):1-7. doi:10.1055/s-0044-1785693. |
| [22] | SHAO Y R, KE X, LUO L H, et al. Application of early enteral nutrition nursing based on enhanced recovery after surgery theory in patients with digestive surgery[J]. World J Gastrointest Surg, 2023, 15(9):1910-1918. doi:10.4240/wjgs.v15.i9.1910. |
| [23] | MANCIN S, SGUANCI M, ANDREOLI D, et al. Nutritional assessment in acute stroke patients:A systematic review of guidelines and systematic reviews[J]. Int J Nurs Stud, 2024, 158:104859. doi:10.1016/j.ijnurstu.2024.104859. |
| [24] | WEIMANN A, BEZMAREVIC M, BRAGA M, et al. ESPEN guideline on clinical nutrition in surgery - Update 2025[J]. Clin Nutr, 2025, 53:222-261. doi:10.1016/j.clnu.2025.08.029. |
| [25] | BARBAGALLO M, ZAHN M, ZIMMERMANN J, et al. Reperfusion failure after successful thrombectomy of large vessel occlusion stroke:clinical and imaging evidence[J]. Front Neurol, 2025, 16:1639880. doi:10.3389/fneur.2025.1639880. |
| [26] | ARDELLIER F D, BALOGLU S, SOKOLSKA M, et al. Cerebral perfusion using ASL in patients with COVID-19 and neurological manifestations: A retrospective multicenter observational study[J]. J Neuroradiol, 2023, 50(5):470-481. doi:10.1016/j.neurad.2023.01.005. |
| [27] | STRBIAN D, TSIVGOULIS G, OSPEL J, et al. European Stroke Organisation(ESO)and European Society for Minimally Invasive Neurological Therapy (ESMINT) guideline on acute management of basilar artery occlusion[J]. J Neurointerv Surg, 2024, 16(9):e7. doi:10.1136/jnis-2024-022053. |
| [28] | OH T K, SONG I A. The impact of opioid prescription on the occurrence and outcome of pneumonia:a nationwide cohort study in South Korea[J]. Respir Care, 2024, 69(11):1424-1431. doi:10.4187/respcare.11870. |
| [29] | CHEN Q, QIN B, ZHANG M, et al. The safety and efficacy of remimazolam compared to dexmedetomidine for awake tracheal intubation by flexible bronchoscopy:a randomized,double-blind,controlled trial[J]. Drug Des Devel Ther, 2024, 18:967-978. doi:10.2147/DDDT.S446222. |
| [30] | NA TAKUATHUNG M, SAKULUDOMKAN W, KHATSRI R, et al. Adverse effects of angiotensin-converting enzyme inhibitors in humans:a systematic review and meta-analysis of 378 randomized controlled trials[J]. Int J Environ Res Public Health, 2022, 19(14):8373. doi:10.3390/ijerph19148373. |
| [31] | LIN Y Y, YU T Y, QUAN H, et al. Association between PSD95 gene 3'UTR single nucleotide polymorphism and risk of acute ischemic stroke in Chinese Han population[J]. J Mol Neurosci, 2020, 70(9):1389-1402. doi:10.1007/s12031-020-01559-y. |
| [32] | ZHANG H, MO X, WANG A, et al. Association of DNA methylation in blood pressure-related genes with ischemic stroke risk and prognosis[J]. Front Cardiovasc Med, 2022, 9:796245. doi:10.3389/fcvm.2022.796245. |
| [33] | SALMAN A T, SHAKER O, ELSHAER S S, et al. The expression profiling of serum miR-92a,miR-134 and miR-375 in acute ischemic stroke[J]. Future Sci OA, 2022, 8(10):FSO829. doi:10.2144/fsoa-2022-0074. |
| [34] | WANG Y, SHEN Y, LI Q, et al. Exploring the causal association between genetically determined circulating metabolome and hemorrhagic stroke[J]. Front Nutr, 2024, 11:1376889. doi:10.3389/fnut.2024.1376889. |
| [35] | RAMOS-VICENTE D, MONTEROSSO P, DE FàBREGUES O, et al. Single-cell transcriptomics for immune profiling of cerebrospinal fluid in neurological diseases[J]. Front Immunol, 2025, 16:1599303. doi:10.3389/fimmu.2025.1599303. |
| [36] | CHEN Q, WU M, TANG Q, et al. Age-related alterations in immune function and inflammation:focus on ischemic stroke[J]. Aging Dis, 2024, 15(3):1046-1074. doi:10.14336/AD.2023.0721-1. |
| [37] | ZHAO Z, ZHANG Y, SU J, et al. A comprehensive review for artificial intelligence on neuroimaging in rehabilitation of ischemic stroke[J]. Front Neurol, 2024, 15:1367854. doi:10.3389/fneur.2024.1367854. |
| [38] | ZHANG Z, DING Y, LIN K, et al. Development of an MRI based artificial intelligence model for the identification of underlying atrial fibrillation after ischemic stroke:a multicenter proof-of-concept analysis[J]. EClinicalMedicine, 2025, 81:103118. doi:10.1016/j.eclinm.2025.103118. |
| [39] | MARTIN-LOECHES I, TORRES A, NAGAVCI B, et al. ERS/ESICM/ESCMID/ALAT guidelines for the management of severe community-acquired pneumonia[J]. Intensive Care Med, 2023, 49(6):615-632. doi:10.1007/s00134-023-07033-8. |
| [40] | CINOTTI R, MIJANGOS J C, PELOSI P, et al. Extubation in neurocritical care patients:the ENIO international prospective study[J]. Intensive Care Med, 2022, 48(11):1539-1550. doi:10.1007/s00134-022-06825-8. |
| [41] | KLEINDORFER D O, TOWFIGHI A, CHATURVEDI S, et al. 2021 Guideline for the prevention of stroke in patients with stroke and transient ischemic attack:a guideline from the American Heart Association/American Stroke Association[J]. Stroke, 2021, 52(7):e364-e467. doi:10.1161/STR.0000000000000375. |
| [42] | SHU L, AZIZ Y N, DE HAVENON A, et al. Perioperative stroke:mechanisms,risk stratification,and management[J]. Stroke, 2025, 56(9):2798-2809. doi:10.1161/STROKEAHA.125.051673. |
| [43] | LIU J, HE H, SU H, et al. The predictive value of the ARC-HBR criteria for in-hospital bleeding risk following percutaneous coronary intervention in patients with acute coronary syndrome[J]. Int J Cardiol Heart Vasc, 2024, 55:101527. doi:10.1016/j.ijcha.2024.101527. |
| [44] | ZHOU Y, SU X, LIU P, et al. Clinical characteristics and outcomes of hospitalized patients with intracranial hemorrhage after percutaneous coronary intervention[J]. Front Cardiovasc Med, 2025, 12:1424598. doi:10.3389/fcvm.2025.1424598. |
| [45] | ZHOU Z, XIE H, FAN F, et al. Comparison of in-hospital net clinical outcomes of ticagrelor and clopidogrel in acute coronary syndrome patients stratified by CRUSADE score:findings from the CCC-ACS registry[J]. Platelets, 2025, 36(1):2570743. doi:10.1080/09537104.2025.2570743. |
| [46] | PARKER K J, MCDONAGH J, FERGUSON C, et al. Clinical outcomes of nurse-coordinated interventions for frail older adults discharged from hospital:a systematic review and meta-analysis[J]. J Clin Nurs, 2024, 33(11):4184-4206. doi:10.1111/jocn.17345. |
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