基于GRADE的临床实践指南应急诊所 Delirium风险分层,查和脑成像在老年患者怀疑 Delirium
Sangil Lee1, Danya Khoujah2,3, Debra Eagles4,5
1University of Iowa, Iowa City, Iowa, USA.
概括
老年急诊室 (GED) 准则2.0提供了老年人痴呆症的有条件建议. 由于证据的确定性很低,进一步的研究对于改善护理至关重要.
科学领域:
- 老年急救医学的医学
- 妄想管理 妄想管理
- 基于证据的指导方针
背景情况:
- 痴呆症是老年人向急诊室 (ED) 提出的一个重大问题.
- 现有的指导方针需要根据老年人群的当前证据进行更新.
研究的目的:
- 制定基于证据的建议,用于老年人ED的妄想管理.
- 为了解决这一群体的风险分层,诊断和脑成像.
主要方法:
- 一个多学科的工作组采用了推评估,开发和评价 (GRADE) 的分级方法.
- 证据被评估为确定性,并制定了有条件的建议.
主要成果:
- 对于妄想风险分层,诊断和成像,得出了六项有条件的建议.
- 几个工具 (例如,狂妄症风险评分,Zucchelli's,REDEEM,4AT,bCAM,CAM-ICU,DTS) 的证据确定性非常低.
- 由于证据不足,在老年ED患者中对头部CT进行妄评估没有支持或反对的建议.
结论:
- 目前关于ED时痴呆症管理的证据基础的确定性非常低.
- 严格的,基于ED的研究对于加强建议和改善痴呆症老年人的护理至关重要.
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