Ciara Harris, Agnieszka Ignatowicz, Thomas Knight, Brian Willis, Daniel Lasserson
{"title":"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。","authors":"Ciara Harris, Agnieszka Ignatowicz, Thomas Knight, Brian Willis, Daniel Lasserson","doi":"10.52964/AMJA.0990","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine whether front-door discharge decision tools operate at different mortality thresholds.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"23 3","pages":"152-165"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Do tools aimed at avoiding hospital admission operate at different mortality thresholds? A systematic review.\",\"authors\":\"Ciara Harris, Agnieszka Ignatowicz, Thomas Knight, Brian Willis, Daniel Lasserson\",\"doi\":\"10.52964/AMJA.0990\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To determine whether front-door discharge decision tools operate at different mortality thresholds.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>\",\"PeriodicalId\":39743,\"journal\":{\"name\":\"Acute Medicine\",\"volume\":\"23 3\",\"pages\":\"152-165\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acute Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.52964/AMJA.0990\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acute Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.52964/AMJA.0990","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
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.
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.