在急诊室患者中出现过敏症的严重结果:系统性审查
Hadi Mirfazaelian1,2, Ian Stiell3,4,5, Rasoul Masoomi6
1Emergency Medicine Department, Tehran University of Medical Sciences, Tehran, Iran.
概括
昏睡前期,是一种有昏睡症状但没有失去意识的情况,具有严重后果的显著风险,包括心律失常. 由于类似的风险,临 syncope 的急诊室管理应该反映 syncope 的管理.
科学领域:
- 心脏病学 心脏病学
- 紧急医疗 紧急医疗
- 临床研究 临床研究
背景情况:
- 昏迷是暂时失去意识; 昏迷前症涉及类似的症状而没有失去意识.
- 虽然昏迷的结果得到了很好的研究,但昏迷前的结果和急诊室 (ED) 的管理却不太了解.
- 这一系统性审查评估了ED患者经历前的短期 (30天) 严重结果.
研究的目的:
- 系统地审查和评估急诊室患者中出现的短期严重结果的发生和识别.
- 为了比较临床失眠的风险概况与ED环境中失眠的风险概况.
主要方法:
- 对ED研究进行系统审查,报告了前眼患者的短期严重结果.
- 纳入标准:英语出版物,临 syncope 患者,报告的严重结果. 排除标准:非鼻症状 (低血糖,,中风).
- 搜索了MEDLINE,Embase,Scopus,Web of Science (成立至2023年7月);使用SIGN 50工具评估了偏差风险.
主要成果:
- 包括5项研究 (4项前性,1项后性) 涉及2741名临床前患者.
- 总体而言,不良结果的患病率在成年人中为4.4%-26.8%,在老年人中为5.5%-18.7%.
- 心律失常是最常见的严重结局 (在一项研究中为17.4%),其次是贫血/出血;老年患者注意到心肌梗塞.
结论:
- 在ED前综合症患者中,短期的严重结果在4%至27%之间,心律失常是最常见的.
- 昏迷前期的风险概况与昏迷相似.
- 昏迷前期的ED管理需要与昏迷一样谨慎.
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