与术后妄想研究中的有效性相关的特征:随机对照试验的系统性审查与元回归和元分析
Lingzhong Meng1, Xu Zhao2, Yanhua Sun3
1Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA.
British journal of anaesthesia
|July 5, 2024
概括
术后妄想试验的有效性因地区,妄想发病率和偏差风险而异. 全球研究质量必须提高,以获得可靠的关于预防妄想的研究结果.
科学领域:
- 老年医学 老年医学
- 麻醉学 麻醉学
- 关键护理医学 关键护理医学
- 临床研究方法论 临床研究方法论
背景情况:
- 术后妄想 (POD) 是一种常见的并发症,尽管进行了广泛的研究.
- 随机试验旨在减少POD发病率,但它们的有效性各不相同.
- 了解影响试验有效性的因素对于解释结果至关重要.
研究的目的:
- 调查与旨在减少术后妄想的干预措施的有效性相关的试验特征.
- 确定影响试验结果的区域,方法和发病率相关因素.
主要方法:
- 系统的文献搜索确定了201个符合条件的随机试验.
- 多变量元回归分析了试验特征和有效性 (odds比率).
- 分析评估了干预措施的综合有效性.
主要成果:
- 美国/加拿大和欧洲/澳大利亚/新西兰的试验显示,与中国相比,疗效降低.
- 更高的 Delirium 发病率和干预偏差与更高的有效性相关.
- 某些干预措施在低风险试验中显示出潜在的益处,但由于异质性和研究规模较小,研究结果往往是不确定的.
结论:
- 手术后妄想干预的有效性受到试验起源,妄想发病率和偏差风险的影响.
- 诸如异质性,小型研究和潜在偏见等局限性,在解释研究结果时需要谨慎.
- 提高全球手术后妄想研究的质量是必不可少的.
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