旨在避免入院的工具在不同的死亡率阈值下是否有效?系统回顾。

Q3 Medicine Acute Medicine Pub Date : 2024-01-01 DOI:10.52964/AMJA.0990
Ciara Harris, Agnieszka Ignatowicz, Thomas Knight, Brian Willis, Daniel Lasserson
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引用次数: 0

摘要

目的确定前门出院决策工具是否在不同的死亡率阈值下运行:在三个数据库中搜索了测试、推导或验证前门风险预测工具或出院决策辅助工具的研究,这些工具都有明确的出院 "临界值",并报告了死亡率或再入院率。还包括支持将工具纳入国家指南的研究:结果:共纳入 24 项研究,主要针对急性胸痛。根据工具得出的出院死亡率为 0-1.7%。八项研究报告了再入院率,其中提前出院或被视为低风险者的再入院率为 0-8%:虽然决策辅助工具认为低风险患者的死亡率低于入院患者或对照组,但低风险患者或出院患者的再入院率往往高于对照组或入院患者。
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Do tools aimed at avoiding hospital admission operate at different mortality thresholds? A systematic review.

Objective: To determine whether front-door discharge decision tools operate at different mortality thresholds.

Methods: Three databases  searched, for studies testing, deriving or validating front-door risk prediction tools or discharge decision aids, with  defined discharge 'cut-off', reporting mortality or readmission rates. Studies supporting tools' inclusion in national guidelines were also included.

Results: Twenty-four studies were included, frequently for acute chest pain. Mortality rates among those discharged based on tools 0-1.7%. Eight studies reported readmission rates, 0-8% among those discharged early or deemed low-risk.

Conclusion: Although mortality rates were lower for those deemed low-risk by decision aids than those admitted or control groups, readmission rates tended to be higher among low-risk or discharged patients, than among control group or admitted patients.

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来源期刊
Acute Medicine
Acute Medicine Medicine-Emergency Medicine
CiteScore
1.50
自引率
0.00%
发文量
32
期刊介绍: These are usually commissioned by the editorial team in accordance with a cycle running over several years. Authors wishing to submit a review relevant to Acute Medicine are advised to contact the editor before writing this. Unsolicited review articles received for consideration may be included if the subject matter is considered of interest to the readership, provided the topic has not already been covered in a recent edition. Review articles are usually 3000-5000 words and may include tables, pictures and other figures as required for the text. Include 3 or 4 ‘key points’ summarising the main teaching messages.
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