目的:确定长期护理机构的老年(≥60岁)居民入院和/或急诊就诊的原因和/或危险因素。
背景:老年人使用急性服务与巨大的财务和社会成本相关。对使用急症服务的原因的全球了解可能有助于早期识别和干预,避免临床恶化,减少对卫生服务的需求,提高生活质量。
方法:在PROSPERO(CRD42022326964)中注册并按照PRISMA指南报告的系统评价。
方法:搜索策略是在与学术图书馆员协商后制定的。该策略使用MeSH术语和相关关键字。自2017年以来以英文发表的文章有资格被收录。CINAHL,MEDLINE,搜索了Scopus和WebofScience核心合集(11/08/22)。Title,abstract,并根据纳入/排除标准筛选全文;数据提取由两名盲检人员进行.使用NewCastle渥太华量表(NOS)评估证据质量。
结果:有39篇文章符合条件并纳入本综述;纳入的研究被评估为高质量和低偏倚风险。据报道,住院最有可能发生在长期护理的第一年。呼吸和心血管诊断经常与急性服务使用相关。虚弱,降压药,跌倒和营养不足与计划外服务使用有关.
结论:已经确定了可改变的风险,这些风险可以作为评估的触发因素,并且可以进行早期干预。协调干预可能有重要的个体,经济效益和社会效益。
结论:本综述确定了老年人使用急性服务的几个可改变的原因。早期和协调的干预可以降低住院和/或急诊科的风险。
■本系统评价是按照系统评价和荟萃分析(PRISMA)方法的首选报告项目进行和报告的。
■没有患者或公众捐款。
OBJECTIVE: To identify the reasons and/or risk factors for hospital admission and/or emergency department attendance for older (≥60 years) residents of long-term care facilities.
BACKGROUND: Older adults\' use of acute services is associated with significant financial and social costs. A global understanding of the reasons for the use of acute services may allow for early identification and intervention, avoid clinical deterioration, reduce the demand for health services and improve quality of life.
METHODS: Systematic
review registered in PROSPERO (CRD42022326964) and reported following PRISMA guidelines.
METHODS: The search strategy was developed in consultation with an academic librarian. The strategy used MeSH terms and relevant keywords. Articles published since 2017 in English were eligible for inclusion. CINAHL, MEDLINE, Scopus and Web of Science Core Collection were searched (11/08/22). Title, abstract, and full texts were screened against the inclusion/exclusion criteria; data extraction was performed two blinded reviewers. Quality of evidence was assessed using the NewCastle Ottawa Scale (NOS).
RESULTS: Thirty-nine articles were eligible and included in this
review; included research was assessed as high-quality with a low risk of bias. Hospital admission was reported as most likely to occur during the first year of residence in long-term care. Respiratory and cardiovascular diagnoses were frequently associated with acute services use. Frailty, hypotensive medications, falls and inadequate nutrition were associated with unplanned service use.
CONCLUSIONS: Modifiable risks have been identified that may act as a trigger for assessment and be amenable to early intervention. Coordinated intervention may have significant individual, social and economic benefits.
CONCLUSIONS: This
review has identified several modifiable reasons for acute service use by older adults. Early and coordinated intervention may reduce the risk of hospital admission and/or emergency department.
UNASSIGNED: This systematic
review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.
UNASSIGNED: No patient or public contribution.