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肺栓塞反应小组 - - 有益的证据? 一个系统的审查和元分析
Amelia Bryan1, Quincy K Tran2,3, Jalil Ahari4
1Department of Emergency Medicine, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20037, USA.
Journal of clinical medicine
|January 8, 2025
概括
肺栓塞反应小组 (PERT) 在此元分析中没有显著影响患者的死亡率或住院时间. 需要进一步的研究,以了解为什么一些机构报告PERT计划的好处.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 静脉血栓塞栓症,包括肺栓塞 (PE),是死亡的重要原因.
- 对于PE的临床表现和治疗有所不同,往往导致提供者特定的策略.
- 肺栓塞反应小组 (PERT) 提供了一种多学科的方法来管理高风险的肺栓塞,但它们对结果的影响尚未确立.
研究的目的:
- 评估肺栓塞反应小组 (PERT) 计划对临床结果的影响.
- 为了在PERT前和PERT期间之间比较全因死亡率,外科血栓切除率,导管血栓溶解,住院时间 (HLOS) 和重症监护室停留时间 (ICULOS).
主要方法:
- 在PubMed,Scopus,Web of Science和Cochrane数据库中进行了系统的搜索,直到2024年3月.
- 包括13项观察性研究,包括12586名患者 (PERT前:60%;PERT前:40%).
- 使用随机效应模型进行元分析和纽卡斯尔-太华尺度进行质量评估.
主要成果:
- 在PERT前和PERT期间之间,所有原因的死亡率没有显著差异 (OR:1.52;95%CI:0.80-2.89;p = 0.20).
- 在ICU停留时间没有显著差异 (平均差异:0.08;95%CI: -0.32至0.49;p = 0.68).
- 住院时间没有统计学意义上的差异 (平均差异: -0.82; 95% CI: -2.86至1.23; p = 0.43).
结论:
- 这次元分析没有发现与PERT实施相关的死亡率或停留时间的显著差异.
- 对机构PERT系统细节的进一步调查可能会澄清结果差异,并优化实施.
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