背景:本荟萃分析旨在评估支持干预性过渡护理与传统护理对卒中幸存者的影响。
方法:进行了系统的文献综述,招募了4,437例中风患者进行本研究;其中2,211例接受了过渡护理,2,226例接受了传统护理。当前研究的纳入标准仅招募了直到2023年11月的随机临床试验。随机分析模型用于分析连续模型和二分模型。
结果:卒中幸存者的支持干预过渡护理(早期支持出院)对患者的功能状态有显著影响(p=0.002),以Barthel指数表示(均差(MD)=0.57,95%置信区间(95%CI):0.20-0.94,I²=93.72%)。另一方面,在日常生活活动等其他结果方面没有相当大的差异(p>0.05),照顾者应变指数(CSI),改良的兰金量表(MRS),和死亡率(MD=0.29,95%CI:-0.12-0.69,I²=94.5%;MD=-0.13,95%CI:-0.40-0.14,I²=68.65%;MD=-0.13,95%CI:-0.49-0.23,I²=83.33%;MD=-0.19,95%CI:-0.58-0.17,I²,分别为0%。)
结论:与对照组相比,支持的过渡期护理使卒中幸存者能够成功提高其功能状态结局。而对死亡率没有显著影响.需要进一步的调查和多中心研究来加强证据。
BACKGROUND: This meta-analysis aims to assess the outcomes of supported intervention transitional care compared to traditional care for stroke survivors.
METHODS: A systematic literature review was accomplished and 4,437 stroke patients were recruited for the current study; 2,211 of them were treated with transitional care and 2,226 with traditional care. The inclusion criteria of the current study recruited only randomized clinical trials up until November 2023. A random analysis model was used to analyze the continuous and dichotomous models.
RESULTS: Supported intervention transitional care (early supported discharge) for stroke survivors showed a significant (p = 0.002) impact regarding the functional status of patients as expressed by the Barthel index (mean difference (MD) = 0.57, 95% confidence interval (95% CI): 0.20-0.94, I² = 93.72%). On the other hand, there were no considerable (p > 0.05) differences regarding other outcomes such as activities of daily living, the Caregiver Strain Index (CSI), the modified Rankin scale (mRS), and mortality (MD = 0.29, 95% CI: -0.12-0.69, I² = 94.5%; MD = -0.13, 95% CI: -0.40-0.14, I² = 68.65%; MD = -0.13, 95% CI: -0.49-0.23, I² = 83.33%; and MD = -0.19, 95% CI: -0.58-0.17, I² = 0%; respectively).
CONCLUSIONS: Supported transitional care allowed stroke survivors to succeed in enhancing their functional status outcomes compared with controls, while there was no significant impact regarding mortality rate. Further investigations and multicenter studies are required to enhance the evidence.