败血性休克临床试验中的死亡率时间框架变化:系统性审查
Andres Laserna1, John A Cuenca2, Peyton Martin3
1Department of Critical Care Medicine, Division of Anesthesiology, Critical Care, and Pain Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, United States.
Medicina intensiva
|March 16, 2025
概括
败血栓休克随机对照试验 (RCT) 显示死亡报告时间有所变化,阻碍了准确的比较. 为了更好的临床洞察力,迫切需要一种标准化的方法来报告败血性休克研究中的死亡时间框架.
科学领域:
- 关键护理医学 关键护理医学
- 临床试验方法论 临床试验方法论
- 流行病学 流行病学
背景情况:
- 感染性休克是一种危及生命的疾病,需要有效的干预措施.
- 随机对照试验 (RCT) 对于评估新疗法至关重要.
- 结果报告中的变化可能会影响试验结果的解释.
研究的目的:
- 系统地审查和划分报道的死亡结果时间框架在败血性休克RCT.
- 确定常见和独特的死亡时间框架,用于败血性休克研究.
- 分析报告死亡时间框架中的地理差异和时间趋势.
主要方法:
- 主要医学数据库 (PubMed,EMBASE,Cochrane) 的系统审查.
- 包括涉及成年患有败血性休克患者和任何干预的RCT.
- 提取和分析研究特征,患者群体,干预措施和死亡时间框架.
主要成果:
- 132项符合条件的研究报告了234个死亡时间框架,其中28天死亡率是最常见的 (74%).
- 其他常见的时间框架包括医院死亡率 (27%),ICU死亡率 (23%) 和90天死亡率 (22%).
- 除非洲外,28天死亡率在全球普遍存在,医院/ICU联合死亡率的报告随着时间的推移而下降.
结论:
- 报道的死亡时间框架存在显著的变化,用于败血性休克RCT.
- 这种不一致可能导致对治疗有效性的偏见估计,并限制元分析.
- 在败血性休克试验中关于标准化死亡时间框架报告的共识是必不可少的.
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