综合老年医学评估对老年人手术术术后后果的影响:系统性审查和元分析
Lin Chen1, Wei Zong2, Manyue Luo3
1Anesthesia and Surgery Department, Chengdu Second People's Hospital, Chengdu, Sichuan, China.
PloS one
|August 28, 2024
概括
综合老年医学评估显著减少了老年手术患者的术后妄想. 然而,它对逗留时间,再接收率和日常生活功能的影响仍然不确定,需要进一步研究.
科学领域:
- 老年医学 老年医学
- 手术结果研究研究.
- 基于证据的实践.
背景情况:
- 老年患者面临更高的术后并发症风险.
- 综合老年医学评估 (CGA) 是一种协调,多维的方法来减轻这些风险.
- 在改善老年人手术结果中,CGA的有效性需要进一步研究.
研究的目的:
- 评估综合老年医学评估 (CGA) 在减少老年手术患者手术后并发症方面的有效性.
- 综合来自随机试验的证据,比较CGA与通常的外科护理.
主要方法:
- 在多个数据库 (Medline,PubMed,Web of Science等) 中进行系统的文献搜索. 在2023年10月之前.
- 包括涉及65岁以上接受手术的个人随机试验.
- 聚合数据的元分析以计算术后结果的几率比率 (OR) 和平均差异 (MD).
主要成果:
- 分析包括了7项随机试验,共有1325名参与者.
- 综合老年医学评估显著降低了手术后妄的发生率 (OR:0.63;P = 0.003).
- 在停留时间,再接收率或日常生活活动 (ADL) 功能方面没有观察到显著的改善.
结论:
- 综合老年医学评估表明,在老年外科手术患者中减少术后狂妄症的有效性.
- 目前的证据不足以证实CGA对其他关键术后结果的益处.
- 需要更高质量的随机试验来确定CGA的更广泛影响.
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