Indications and risk assessment of endoscopic examinations in elderly or frail people. Position paper of the Societat Catalana de Digestologia, the Societat Catalana de Geriatria i Gerontologia and the Societat Catalana de Medicina de Família i Comunitària

Riba Porquet, Francesc; Guarner-Argente, Carles; Solanes Cabus, Mònica; Francia Santamaria, Esther; Garcia-Iglesias, Pilar; Machlab Machlab, Salvador; Mascort Roca, Juanjo; Mendive Arbeola, Juan Manuel; Ortiz Seuma, Jordi; Calvet Calvo, Xavier
doi:10.1016/j.gastre.2022.11.003
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        "titulo" => "Indicaciones y evaluaci&#243;n del riesgo de las exploraciones endosc&#243;picas en personas de edad avanzada o fr&#225;giles&#46; Documento de posicionamiento de la Societat Catalana de Digestologia&#44; la Societat Catalana de Geriatria i Gerontologia y la Societat Catalana de Medicina de Fam&#237;lia i Comunit&#224;ria"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Situational diagnosis and degree of reserve regarding the person&#58; How vulnerable is he or she&#63;&#59; Where is he or she in their life trajectory&#63;&#58; A&#44; B&#44; C&#44; D&#44; E or F&#63;</p> <p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Conceptual foundations and model of care for frail people&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p> <p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">CGA&#58; Comprehensive Geriatric Assessment&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Gastrointestinal endoscopy &#40;GE&#41; encompasses a broad group of invasive diagnostic and therapeutic examinations that are very important for the study of the gastrointestinal tract&#46; Despite being relatively safe and well-tolerated procedures&#44; in elderly and&#47;or frail people &#40;E&#47;F P&#41; they are associated with an increased risk of adverse events&#44; insufficient preparation and incomplete examinations&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">In Catalonia&#44; the population has aged considerably over the last few decades&#46; In 2020&#44; the percentage of people over the age of 65 in the population of Catalonia overall increased to 19&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> The population prevalence of frailty in people over 65 years of age approaches 10&#37;&#44; although there is no consensus in the data on prevalence rates of frailty in the population&#44; probably because of differences in the conceptualisation and measurement of frailty&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The prevalence of pathology - and therefore the performance of diagnostic tests - is usually higher in E&#47;F P&#46; Many times&#44; however&#44; the relevance of detecting a certain pathology is very low&#44; since the patient will gain little or no benefit&#44; either because there are no therapeutic options&#44; or because treatment is not expected to improve quality of life or survival&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> One example would be colorectal polyps&#46; The life expectancy of an E&#47;F P is often much shorter than the time the polyp needs to progress to symptomatic cancer&#46; However&#44; perforation or bleeding after a polypectomy in an E&#47;F P can be extremely serious&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Therefore&#44; the risk-benefit ratio of endoscopic treatments can be clearly negative in elderly or frail people&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Age itself is not a contraindication for the performance of any endoscopic procedure&#46; In contrast&#44; extreme frailty would contraindicate all endoscopic procedures&#44; as well as any other aggressive procedure&#46; However&#44; moderate degrees of frailty do not represent an absolute contraindication in symptomatic patients&#44; in whom GE may lead to a better quality of life&#46; In these situations&#44; the risk-benefit ratio of the test needs to be assessed on an individual basis&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">It should also be remembered that before an invasive procedure such as GE the indication should always be based on shared decision-making&#46; People have experiences&#44; beliefs&#44; and priorities that healthcare professionals do not know about which can influence their decisions&#46; Shared decision-making allows healthcare professionals to take these into account and adapt diagnostic and therapeutic options to each individual&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In conclusion&#44; E&#47;F P represent a heterogeneous population that requires a precise and individualised assessment of the indication for GE&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">The objective of this position paper by the <span class="elsevierStyleItalic">Societat Catalana de Digestologia</span> &#40;SCD&#41;&#44; the <span class="elsevierStyleItalic">Societat Catalana de Geriatria i Gerontologia</span> &#40;SCGiG&#41; and the <span class="elsevierStyleItalic">Societat Catalana de Medicina Familiar i Comunit&#224;ria</span> &#40;CAMFiC&#41; was to issue consensus recommendations&#44; whenever possible based on evidence&#44; risk assessment and the indications for GE in E&#47;F P &#40;<a class="elsevierStyleCrossRefs" href="#fig0005">Figs&#46; 1 and 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Methods</span><p id="par0040" class="elsevierStylePara elsevierViewall">This consensus document was produced by a group of experts appointed by the SCD&#44; the SCGiG and the CAMFiC in 2020 and 2021 &#40;<a class="elsevierStyleCrossRef" href="#fig0015">Fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">Each section was drafted by a multidisciplinary team that included a geriatrician&#44; a family doctor and a gastroenterologist&#46; The experts conducted a non-systematic review of the evidence and used the references retrieved and their bibliographic bases to write each section&#46; Finally&#44; the sections were collated in a document that was reviewed individually by each of the experts&#46; The controversial issues were discussed during several teleconferences in the course of 2021&#46; With the results of the discussions&#44; the final document was drafted and was revised again by each of the experts and by the boards of the respective societies&#46; The final version of the document was approved at a final consensus meeting&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Results</span><p id="par0050" class="elsevierStylePara elsevierViewall">The results were structured into four sections&#58; a&#41; an assessment of the risk-benefit ratio and indication for GE in E&#47;F P&#44; b&#41; for whom a situational diagnosis should be made before a GE&#44; c&#41; who should make the situational diagnosis&#44; and d&#41; how the relationship between Primary Care&#44; geriatrics and gastroenterology is articulated&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">The general recommendations made by the consensus group are summarised in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Assessment of indication and risk-benefit for GE in E&#47;F P</span><p id="par0060" class="elsevierStylePara elsevierViewall">The individualised adaptation of the intensity of treatment or of the diagnostic tests should always be carried out according to the risk-benefit balance&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">In elderly patients&#44; decision-making can be facilitated by establishing a situational diagnosis&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The concept of a situational diagnosis refers to the outcome of the multi-dimensional assessment process and patient needs that allows practitioners to determine the degree of reserve or frailty of the person cared for &#40;How vulnerable is he&#47;she&#63; Where is he&#47;she&#63; At what point in his&#47;her life span&#63;&#41; and identify the losses or dimensions affected and needs to be met&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">Ideally&#44; the situational diagnosis is conducted with a Comprehensive Geriatric Assessment &#40;CGA&#41; This requires time and an interdisciplinary team&#44; so as an alternative it is proposed that rapid multidimensional&#47;geriatric assessment tools be considered&#46; The two tools recommended in this document are described below&#58;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Clinical Frailty Scale &#40;Annex 1&#41;</span><p id="par0080" class="elsevierStylePara elsevierViewall">The Clinical Frailty Scale &#40;CFS&#41; is a very straightforward way to determine a person&#39;s degree of frailty&#44; ranging from 1 to 9&#44; and is based primarily on clinical trials&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> The CFS has been validated as a predictor of adverse effects in older people&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#44;9</span></a> This qualitative assessment of frailty can help us make decisions about health goals&#46; For example&#44; patients with frailty levels 7-8-9 &#40;living with severe frailty&#44; living with very severe frailty and&#47;or terminally ill&#41; are only candidates for non-invasive approaches and would not therefore be candidates for GE&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">The CFS is also available as an app&#44; which can be downloaded from <a href="https://www.acutefrailtynetwork.org.uk/Clinical-Frailty-Scale/Clinical-Frailty-Scale-App">https&#58;&#47;&#47;www&#46;acutefrailtynetwork&#46;org&#46;uk&#47;Clinical-Frailty-Scale&#47;Clinical-Frailty-Scale-App</a>&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a></p><p id="par0090" class="elsevierStylePara elsevierViewall">Dementia does not limit the use of the scale&#46; People with dementia follow a similar pattern to that of the CFS&#58; mild&#44; moderate&#44; and severe dementia would correspond to CFS levels 5&#44; 6&#44; and 7&#44; respectively&#46; If the degree of dementia is not known&#44; the standard CFS classification would need to be followed&#46; Recommendations for the correct use of the CFS are detailed in Appendix <a class="elsevierStyleCrossRef" href="#sec0075">B</a> Annex 1&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">The Frailty-CGA index &#40;Annex 2&#41;</span><p id="par0095" class="elsevierStylePara elsevierViewall">&#40;Appendix <a class="elsevierStyleCrossRef" href="#sec0075">B</a> Annex 2&#41; The Frailty-CGA &#40;Comprehensive Geriatric Assessment&#41; Index &#91;&#205;ndice Fr&#225;gil-VIG&#93; is a frailty index based on the Comprehensive Geriatric Assessment&#46; It has been shown to be simple &#40;with respect to content&#41;&#44; fast &#40;it can be administered in 5&#8722;10&#8239;min&#41;&#44; accurate &#40;it facilitates situational diagnosis through a continuous variable&#41; and highly predictive &#40;it has a high correlation with mortality&#41;&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">The Frailty-CGA Index facilitates the adaptation of therapeutic intensity &#40;providing actions according to the clinical situation and the patients&#39; desires&#41;&#44; advanced planning and optimisation of resource use based on healthcare objectives agreed on by patients&#44; family members and professionals&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a></p><p id="par0105" class="elsevierStylePara elsevierViewall">The Frailty-CGA Index can be determined with the help of an <span class="elsevierStyleItalic">online</span> calculator&#46; The Frailty-CGA Index calculator and a short instruction manual can be downloaded from&#58; <a href="https://www.c3rg.com/index-fragil-vig">https&#58;&#47;&#47;www&#46;c3rg&#46;com&#47;index-fragil-vig</a>&#46;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">13</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Who should have a situational diagnosis before a gastrointestinal endoscopy&#63;</span><p id="par0110" class="elsevierStylePara elsevierViewall">E&#47;F P benefit from an individualised&#44; person-centred approach&#46; This approach is useful for people with complex healthcare needs or a complex chronic disease &#40;complex chronic patient &#91;CCP&#93;&#41; such as those with palliative needs or advanced chronicity &#91;MACA modelo de atenci&#243;n a la cronicidad avanzada &#40;advanced chronicity model of healthcare&#41;&#93; &#40;Appendix <a class="elsevierStyleCrossRef" href="#sec0075">B</a> Annex 3 and 4&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6&#44;14&#44;15</span></a></p><p id="par0115" class="elsevierStylePara elsevierViewall">A comprehensive geriatric assessment should be conducted for anyone over 80 years of age and for all patients with multiple pathologies&#44; in this case regardless of age&#46; If no geriatric assessment has been made&#44; it should be conducted prior to any invasive intervention&#44; such as endoscopic procedures&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Who should make the situational diagnosis&#63;</span><p id="par0120" class="elsevierStylePara elsevierViewall">In clinically complex situations&#44; decision-making is an interdisciplinary collaborative process that sometimes requires collaboration between different care tiers&#46; That said&#44; assessment of the degree of frailty and the situational diagnosis will normally be performed by the patient&#39;s usual reference teams&#44; such as Primary Care physicians &#40;PCPs&#41; who&#44; because of their proximity and continuity of care&#44; understand the patient&#39;s overall situation and can determine the degree of frailty more easily&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">This pre-GE assessment should be recorded in the medical record&#46; If it is not there&#44; a geriatric assessment of the patient by the PCP teams prior to requesting GE is recommended&#46; An initial assessment by Primary Care is recommended using CFS as screening and the Frailty-CGA Index if there is any doubt&#46; It is also advisable to request a specialised geriatric assessment in the most complex cases&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Geriatric teams specialise in assessments of the highest clinical complexity and should act if necessary&#46; However&#44; other hospital teams can make a quality situational diagnosis&#46; The ultimate goal will be that all teams that normally care for the patient always adopt an overall perspective&#44; not one exclusively focused on a specific disease&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">If the geriatric assessment is not available in the shared medical record &#40;SMR&#41;&#44; the gastroenterologist evaluating the GE request may perform an interim evaluation based on SMR data&#46; Since the gastroenterologist&#39;s assessment will be based on indirect data and without knowing the patient personally&#44; it is considered to be less accurate&#46; Therefore&#44; it is proposed only if there is no recent Primary Care or geriatrics assessment or if there is a very obvious discrepancy between the available geriatric assessment and SMR data&#46; If in doubt&#44; the assessment by the gastroenterologist should be confirmed or validated together with the appropriate Primary Care or geriatric teams before a final decision is made&#46;</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Indications for GE according to degree of frailty</span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Indications in advanced frailty &#40;Frailty-CGA Index&#8239;&#62;&#8239;0&#46;5 or CFS&#8239;&#8805;&#8239;7&#41;</span><p id="par0140" class="elsevierStylePara elsevierViewall">As mentioned above&#44; in patients with advanced frailty&#44; diagnostic-therapeutic objectives are usually based on guaranteeing well-being and symptomatic control&#46; In general&#44; invasive measures&#44; including endoscopic examinations&#44; do not play a role&#44; due to patients&#39; shorter life expectancy and the high risk of complications&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Indications in mild-moderate frailty &#40;Frailty-CGA Index 0&#46;2&#8211;0&#46;5 or CFS 5&#8211;6&#41;</span><p id="par0145" class="elsevierStylePara elsevierViewall">In patients with mild or moderate frailty&#44; the diagnostic-therapeutic objectives are intended to obtain a clinical benefit to promote and maintain autonomy and quality of life&#44; but not survival&#46; Therefore&#44; the indication for the test must be assessed and a decision taken as to whether the outcome could lead to measures that would improve the patient&#39;s functional status or quality of life&#46;</p></span><span id="sec0060" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">No frailty or pre-frailty &#40;Frailty-CGA Index&#8239;&#60;&#8239;0&#46;2 or CFS 1&#8211;4&#41;</span><p id="par0150" class="elsevierStylePara elsevierViewall">In patients with no frailty or pre-frailty Frailty-CGA Index&#8239;&#60;&#8239;0&#46;2 or CFS 1&#8211;4&#44; the diagnostic-therapeutic objectives are similar to those of the general population&#44; and preventive measures to improve survival should also be considered appropriate&#46;</p></span><span id="sec0065" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">What is the relationship between primary care&#44; geriatrics and gastroenterology&#63;</span><p id="par0155" class="elsevierStylePara elsevierViewall">There are currently different systems of relationship between Primary Care physicians &#40;PCPs&#41;&#44; geriatricians and gastroenterologists&#46; The idiosyncrasy of organisations and the resources available define the systems established in each case&#46; Telemedicine is increasingly relevant and enabling&#44; which should have an impact on improved user care&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Therefore&#44; in this guide&#44; we do not intend to make concrete recommendations&#44; knowing that they will be obsolete and that they are subject to the specificities of each territory&#46; We would like to emphasise the importance of establishing and strengthening connection systems that facilitate the interrelationship in a streamlined and two-way manner&#46; We will only suggest a few tools that may be useful&#46; Thus&#44; certain existing communication experiences that have proven useful are&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0165" class="elsevierStylePara elsevierViewall">Development of protocols shared with multidisciplinary teams in a given territory&#46; These protocols can be developed nationally or locally&#44; and general recommendations can also be applied locally&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0170" class="elsevierStylePara elsevierViewall">Virtual interconsultations between Primary Care and Gastroenterology or Geriatrics&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">-</span><p id="par0175" class="elsevierStylePara elsevierViewall">Use of specific social networking or instant messaging groups &#40;XatSalut&#41;<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a> preserving patient confidentiality&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">-</span><p id="par0180" class="elsevierStylePara elsevierViewall">Periodic virtual or face-to-face meetings between the Primary Care&#44; Gastroenterology&#44; and Geriatrics medical teams and meetings to review complex clinical cases&#46; This makes a joint agreement on the management of clinical cases possible&#46; In especially complex cases that require it&#44; meetings of more than one speciality may be held&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">-</span><p id="par0185" class="elsevierStylePara elsevierViewall">Creation of the figure of the primary care referee&#46; A primary care physician with a special interest in a specific pathology&#44; in this case gastroenterology and geriatrics&#46; This referee would be responsible for training activities and communication with hospital specialists&#46; In addition&#44; Primary Care&#44; Gastroenterology or Geriatrics nursing teams would play a very important role in the comprehensive geriatric assessment and use of the Frailty-CGA Index&#46;</p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">-</span><p id="par0190" class="elsevierStylePara elsevierViewall">Creation of a referee-specialist for primary care&#58; a hospital specialist who supports one or more primary care centres&#46; This person would coordinate activity with Primary Care teams in their reference area for non-patient consultations&#44; case discussion meetings&#44; and teaching activities&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">-</span><p id="par0195" class="elsevierStylePara elsevierViewall">In the case of elderly patients&#44; geriatric services can offer support both through the resolution of specific inter-consultations and through the direct management of complex patients and&#47;or patients with advanced disabilities&#46;</p></li></ul></p></span></span></span>"
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                  \t\t\t\t">Before any invasive intervention&#8212;and specifically a GE&#8212;in patients of advanced age and&#47;or with frailty and&#47;or with multiple pathologies&#44; it is advisable to carry out a comprehensive geriatric assessment&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">It is recommended that the CFS index be used as a rapid detection tool&#46; A score of 1&#8722;4 does not limit explorations&#46; With scores from 7 to 9&#44; it is proposed that any invasive intervention be avoided&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">In E&#47;F P with CFS 5&#8722;6&#44; a comprehensive geriatric assessment is warranted&#46; If this is not possible&#44; an assessment with the Frailty-CGA Index can be made&#44; to decide on the appropriateness of GE&#44; inform the patient and&#47;or family of the prognosis and establish a consensual care plan&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Assessment of frailty in the first instance is the responsibility of Primary Care teams&#46;&nbsp;\t\t\t\t\t\t\n
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                  "referenciaCompleta" => "Estructura per sexe i edat&#46; Catalunya&#46; S&#232;rie temporal&#46; Banc d&#8217;estad&#237;stiques de municipis i comarques&#46; Idescat&#46; 2020 &#91;accessed Jan 2022&#93;&#46; Available from&#58; <a target="_blank" href="https://www.idescat.cat/pub/?id=aec&amp;n=253">https&#58;&#47;&#47;www&#46;idescat&#46;cat&#47;pub&#47;&#63;id&#61;aec&#38;n&#61;253</a>&#46;"
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                    0 => array:2 [
                      "titulo" => "Fragilidad&#58; de la epidemiolog&#237;a a la cl&#237;nica"
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                            2 => "C&#46;J&#46; Rees"
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                        ]
                      ]
                    ]
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                        "paginaInicial" => "33"
                        "paginaFinal" => "41"
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                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0025"
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                  "referenciaCompleta" => "Raons per compartir les decisions&#46; Gencat&#46; 2014 &#91;accessed May 2021&#93;&#46; Available from&#58; <a target="_blank" href="http://decisionscompartides.gencat.cat/ca/que-es/raons-per-compartir-la-decisio">http&#58;&#47;&#47;decisionscompartides&#46;gencat&#46;cat&#47;ca&#47;que-es&#47;raons-per-compartir-la-decisio</a>&#46;"
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                  "referenciaCompleta" => "Ambl&#224;s J&#44; Amil P&#44; Bocanegra I&#44; Bullich &#205;&#44; Contel JC&#44; Gil E&#44; et al&#46; Bases conceptuals i model d&#8217;atenci&#243; per a les persones fr&#224;gils&#44; amb cronicitat complexa &#40;PCC&#41; o avan&#231;ada &#40;MACA&#41;&#46; Generalitat de Catalunya&#59; 2020 &#91;accessed May 2021&#93;&#46; Available from&#58; <a target="_blank" href="https://salutweb.gencat.cat/web/.content/_ambits-actuacio/Linies-dactuacio/Estrategies-de-salut/Cronicitat/Documentacio-cronicitat/arxius/Model-de-Bases-de-Cronicitat.pdf">https&#58;&#47;&#47;salutweb&#46;gencat&#46;cat&#47;web&#47;&#46;content&#47;&#95;ambits-actuacio&#47;Linies-dactuacio&#47;Estrategies-de-salut&#47;Cronicitat&#47;Documentacio-cronicitat&#47;arxius&#47;Model-de-Bases-de-Cronicitat&#46;pdf</a>&#46;"
                ]
              ]
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "A global clinical measure of fitness and frailty in elderly people"
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                            3 => "H&#46; Bergman"
                            4 => "D&#46;B&#46; Hogan"
                            5 => "I&#46; McDowell"
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                      "titulo" => "Using the clinical frailty scale in allocating scarce health care resources"
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                          "autores" => array:2 [
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                      "doi" => "10.5770/cgj.23.463"
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                        "tituloSerie" => "Can Geriatr J&#46;"
                        "fecha" => "2020"
                        "volumen" => "23"
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                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/32904824"
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                    0 => array:2 [
                      "titulo" => "Frail-VIG index&#58; a concise frailty evaluation tool for rapid geriatric assessment"
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                            5 => "M&#46; Inzitari"
                          ]
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                  "referenciaCompleta" => "Index-Fragil-VIG&#44; calculadora&#46; Grup de Recerca en Cronicitat de la Catalunya Central &#40;C3RG&#41; &#91;accessed May 2021&#93;&#46; Available from&#58; <a target="_blank" href="https://www.c3rg.com/index-fragil-vig">https&#58;&#47;&#47;www&#46;c3rg&#46;com&#47;index-fragil-vig</a>&#46;"
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                    ]
                  ]
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                  ]
                ]
              ]
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