老年人的临床预后因素:系统性审查和元分析
Nicola Veronese1, Anna Fazzari1, Maria Armata1
1Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy.
Ageing research reviews
|May 22, 2024
概括
多维预测工具准确地预测老年人的死亡率,住院和养老院入院情况. 这些工具,特别是多维预测指数 (MPI),在各种医疗保健环境中显示出精度.
科学领域:
- 老年医学 老年医学
- 医疗保健服务研究 医疗服务研究
- 生物统计学 生物统计学
背景情况:
- 预测工具对于预测老年人群的健康结果至关重要.
- 现有的工具在不同的设置和时间框架中在准确性和精度上有所不同.
- 需要对这些工具进行全面评估.
研究的目的:
- 系统地审查和元分析用于预测老年人死亡率,住院和养老院入院的预后工具的准确性和精度.
- 在不同的环境 (社区,急诊室,医院病房,养老院) 和时间框架 (短期,长期) 中比较工具性能.
主要方法:
- 对前性和后性研究进行系统审查和元分析.
- 在Medline,Embase,Cinhal和Cochrane图书馆进行了搜索,直到2023年2月.
- 提取精度 (AUC) 和精度 (C指数) 数据;使用随机效应模型进行聚合;使用QUIPS工具评估偏差风险.
主要成果:
- 包括159项研究,涉及2,398,856名老年人 (平均年龄为78岁).
- 多维预后指数 (MPI) 对社区的长期死亡率具有很好的准确性,对医疗病房的短期死亡率具有中等的确定性 (AUC=0.79,C指数=0.82).
- 巴特尔指数在急诊室的短期死亡率方面表现出极好的准确性. 对于养老院和外科病房的文献是有限的.
结论:
- 多维预后工具在预测老年患者的不良结果方面表现出卓越的精度和准确性.
- 多维预后指数 (MPI) 是老年预后的一个有前途的工具.
- 对于在养老院和手术场所的预后工具验证,需要进一步的研究.
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