住院老年患者中跌倒风险预测模型:系统性审查和元分析
Anli Mao1, Jie Su1, Mingzhu Ren1
1Department of Nursing, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, China.
BMC geriatrics
|January 14, 2025
概括
这次审查发现,住院老年人的跌倒风险预测模型往往具有高偏差风险. 未来的研究必须使用严格的方法来准确地预测这一群体的下降.
科学领域:
- 老年学是指老年学的学科.
- 临床流行病学 临床流行病学
- 医疗信息学 医疗信息学
背景情况:
- 目前用于评估老年人落风险的临床工具缺乏准确性.
- 对于住院的老年人来说,已经出现了许多跌倒风险预测模型,但它们的临床实用性是不确定的.
- 本系统性审查解决了评估这些模型在实践和研究中的有用性的需要.
研究的目的:
- 系统地审查和评估已公布的跌倒风险预测模型,专门针对住院的老年人.
- 评估现有模型的方法质量,偏差风险和适用性.
主要方法:
- 在主要数据库 (Web of Science,PubMed,Embase等) 进行了全面的文献搜索. 在2024年1月之前.
- 包括的研究被评估为数据来源,预测因素,模型性能和偏差风险,使用PROBAST检查清单.
- 数据提取的重点是模型开发,验证和报告的性能指标,如AUC.
主要成果:
- 从8086个检索的文章中,包括了13个风险预测模型的13项研究.
- 发现的常见预测因素是移动性,跌倒史,药物和精神疾病.
- 所有纳入的研究都表现出高偏差风险,主要是由于设计缺陷和缺乏外部验证;AUC值在0.630到0.851之间.
结论:
- 对住院老年人的所有审查的跌倒风险预测模型都表明存在偏差的高风险.
- 缺陷包括缺乏前性设计,不适当的分析和不足的外部验证.
- 未来的研究应该优先考虑可靠的方法和外部验证,以可靠地预测跌倒风险.
相关概念视频
01:15Drug Dosing: Geriatric Patients
Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism
Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Excretion
In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...