错觉查的风险因素和风险分层方法:老年急诊室指南2.0系统审查
Justine Seidenfeld1,2,3, Sangil Lee4, Luna Ragsdale2,3
1Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham VA Health Care System, Durham, North Carolina, USA.
概括
识别处于急诊室妄想高风险的老年人至关重要. 关键因素包括痴呆症,75岁以上的年龄和功能障碍,指导有针对性的查工作.
科学领域:
- 老年医学 老年医学
- 紧急医疗 紧急医疗
- 神经科学是一个神经科学.
背景情况:
- 狂妄症是老年人向急诊室 (ED) 提出的常见和严重的疾病.
- 有效识别高风险个体对于及时干预和改善结果至关重要.
- 对于ED妄想查的现有指南和风险分层工具需要进行系统的评估.
研究的目的:
- 进行系统审查,以确定风险因素和分层方法,以针对ED中老年人 Delirium 查.
- 通过综合这些人群妄风险的证据,为老年急诊部 (ED) 准则2.0项目提供信息.
主要方法:
- 在2021年4月和2022年11月进行的系统电子搜索.
- 包括65岁及以上的患者的全文研究,这些患者在ED时被评估患有流行的妄想.
- 使用麦克马斯特大学明确性小组工具进行偏差风险评估;由于异质性,没有进行元分析.
主要成果:
- 从1878个唯一的引用中,包括了13项研究.
- 痴呆病史是最常见的危险因素 (OR 3.3-18.33).
- 其他重大风险因素包括年龄,特定药物和功能障碍. 新的风险评分显示AUC从0.77到0.90.
结论:
- 痴呆症,75岁以上的年龄和功能障碍是ED痴呆症高风险老年人的关键指标.
- 需要在ED环境中对妄风险分层工具的实施和面向患者的结果进行进一步的研究.
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