旨在避免入院的工具是否在不同的死亡率值上起作用? 一个系统的审查
Ciara Harris1, Agnieszka Ignatowicz2, Thomas Knight2
1Warwick Applied Health, Warwick Medical School, University of Warwick, Institute of Applied Health Research, University of Birmingham.
Acute medicine
|November 8, 2024
概括
前门出院决策工具显示,低风险患者的死亡率低 (0-1.7%),但与对照组相比,再入院率更高 (0-8%). 这些工具可能需要改进,以实现全面的患者管理.
科学领域:
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
- 医疗决策的制定 医疗决策的制定
背景情况:
- 医疗保健中越来越多地使用前门放电决策工具.
- 评估这些工具的性能,特别是关于死亡率和再接收值,对于患者安全和资源分配至关重要.
研究的目的:
- 评估前门排放决策工具运行的死亡率值.
- 用这些工具和对照组,比较使用这些工具出院的患者之间的死亡率和再入院率.
主要方法:
- 在三个数据库中进行了系统的文献搜索,寻找有关前门风险预测工具或出院决策辅助工具的研究.
- 包括报告定义出院截止日期和相关死亡率或再接收率的研究,以及支持指导方针的研究.
主要成果:
- 分析了24项研究,其中许多研究集中在急性胸痛上.
- 使用这些工具出院的患者的死亡率在0%至1.7%之间.
- 在八项研究中报告的再入院率在早期或低风险出院时从0%到8%不等.
结论:
- 虽然与入院或对照组相比,决策辅助器与低风险患者的死亡率较低有关,但它们可能导致再入院率更高.
- 这些发现表明,在减少住院死亡率和管理出院后再入院之间存在潜在的权衡.
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