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在急诊室的种族差异身体限制使用:系统性审查和元分析

Vidya Eswaran^1,2,3, Melanie F Molina^3,4,5, Alison R Hwong^4,6,7

¹Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas.

JAMA internal medicine

|September 25, 2023

概括

与白人患者相比,黑人患者在急诊室 (ED) 面临更高的身体克制风险. 本系统性审查综合了成人ED环境中各种种族和种族群体对限制使用的数据.

科学领域:

医学研究医学研究
公共卫生公共卫生
卫生公平性健康公平性

背景情况:

之前的研究表明,在急诊室 (ED) 中,有色人种的身体克制率更高.
现有的研究往往局限于单个机构,影响了概括性.
了解ED控制器使用的种族和民族差异对于患者安全和公平护理至关重要.

研究的目的:

系统地审查和综合现有关于成人EDS体力限制使用风险的文献.
根据患者的种族和种族背景,专门研究限制使用的差异.
提供关于这一关键问题的当前证据的全面概述.

主要方法:

在主要数据库 (PubMed,Embase,Web of Science,CINAHL) 进行了系统的文献搜索,截至2022年2月.
包括的研究是同行评审的,专注于成年EDS,根据种族/种族报告了身体克制的使用情况,并以英语出版.
使用随机效应模型对10项符合条件的研究的数据进行了元分析,涵盖了超过250万例患者接触.

主要成果:

分析包括10项研究,代表了2,557,983例患者接触和24,030例限制事件 (总体为0.94%).
与白人患者 (RR, 1.31) 和所有非黑人患者 (RR, 1.27) 相比,黑人患者的身体克制风险明显更高.
与非西班牙裔患者相比,西班牙裔患者的克制风险较低 (RR,0.85),尽管这可能受到非西班牙裔患者中包括黑人患者的影响.

结论:

虽然身体克制在ED患者中不常见 (<1%),但黑人患者面临不成比例的更高风险.
对西班牙裔患者观察到的较低的克制风险需要进一步调查,因为可能存在混因素.
进一步的研究,包括定性研究,对于解决导致这些差异的个人间,机构和结构性种族主义至关重要.

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