在预医院人群中使用验证的败血症查工具的证据:范围审查
Rae Denise Oanesa1,2, Tom Wen-Han Su2,3, Alexandra Weissman4
1Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Prehospital emergency care
|June 16, 2023
概括
早期预警分数 (EWS) 显示了识别医院前败血症的不一致结果. 建议将EWS与临床判断和教育相结合,以便在紧急情况下更好地检测败血症.
科学领域:
- 紧急医疗 紧急医疗
- 关键的护理关键的护理
- 传染性疾病 传染性疾病
背景情况:
- 败血症的诊断具有挑战性,特别是在资源有限的医院前环境中.
- 早期预警分数 (EWS) 为住院患者使用而开发,并适用于医院前败血症预测.
- 及时识别和治疗败血症显著提高了患者的生存率.
研究的目的:
- 评估验证的早期预警分数 (EWS) 在确定医院前败血症的证据.
- 评估当前在医院前环境中的EWS的有效性和局限性.
主要方法:
- 使用主要科学数据库 (CINAHL,Embase,Ovid-MEDLINE,PubMed) 进行了范围审查.
- 搜索于2022年9月1日进行,包括用于医院前毒症识别的EWS的文章.
- 包括和分析了23项研究 (验证,前性,系统性审查,回顾性).
主要成果:
- 包含的研究显示,用于医院前毒症检测的高度可变的分类统计数据.
- 灵敏度在0.02-1.00之间,特异性在0.07-1.00之间,PPV和NPV差异很大.
- 所有研究表明,在使用EWS用于医院前毒症识别方面存在不一致.
结论:
- 由于异质性,没有单一的EWS可能成为医院前败血症的黄金标准.
- 推的方法包括将标准化的医院前护理,临床判断和改善的败血症教育相结合.
- EWS可以作为辅助,但不应该是医院前败血症识别的唯一方法.
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