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卒中后口咽吞咽困难的成本:系统评价方案。

Cost of oropharyngeal dysphagia after stroke: protocol for a systematic review.

机构信息

Pharmacy Department, Consorci Sanitari del Maresme. Hospital de Mataró., Mataro, Spain.

Research Unit, Consorci Sanitari del Maresme, Barcelona, Spain.

出版信息

BMJ Open. 2018 Dec 14;8(12):e022775. doi: 10.1136/bmjopen-2018-022775.

Abstract

INTRODUCTION

Oropharyngeal dysphagia (OD) is a major disorder following stroke. OD can produce alterations in both the efficacy and safety of deglutition and may result in malnutrition, dehydration, frailty, respiratory infections and pneumonia. These complications can be avoided by early detection and treatment of OD in poststroke patients, and hospital stays, medication and mortality rates can be reduced. In addition to acute in-hospital costs from OD complications, there are other costs related to poststroke OD such as direct non-healthcare costs or indirect costs. The objective of this systematic review is to assess and summarise literature on the costs related to OD in poststroke patients.

METHODS AND ANALYSIS

A systematic review of studies on the cost of OD and its complications (aspiration, malnutrition, dehydration, aspiration pneumonia and death) in patients who had a stroke will be performed from the perspectives of the hospital, the healthcare system and/or the society. The main outcomes of interest are the costs related to poststroke OD. We will search MEDLINE, Embase and the National Health Service Economic Evaluation Database. Studies will be included if they are partial economic evaluation studies, studies that provide information on costs in adult (>17 years) poststroke patients with OD and/or its complications (malnutrition, dehydration, frailty, respiratory infections and pneumonia) or economic evaluation studies in which the cost of this condition has been estimated. Studies will be excluded if they refer to oesophageal dysphagia or OD caused by causes other than stroke. Main study information will be presented and summarised in tables, separately for studies that provide incremental costs attributable to OD or its complications and studies that report the effect of OD or its complications on total costs of stroke, and according to the perspective from which costs were measured.

ETHICS AND DISSEMINATION

The results of this systematic review will be published in a peer-reviewed journal.

PROSPERO REGISTRATION NUMBER

CRD42018099977.

摘要

简介

口咽吞咽困难(OD)是中风后的主要障碍。OD 可导致吞咽的疗效和安全性发生改变,并可能导致营养不良、脱水、虚弱、呼吸道感染和肺炎。通过对中风后患者的 OD 进行早期检测和治疗,可以避免这些并发症,同时可以降低住院时间、药物治疗和死亡率。除了 OD 并发症的急性住院费用外,还存在与中风后 OD 相关的其他费用,如直接非医疗保健费用或间接费用。本系统评价的目的是评估和总结中风后患者 OD 相关费用的文献。

方法和分析

将从医院、医疗保健系统和/或社会的角度对中风患者 OD 及其并发症(误吸、营养不良、脱水、吸入性肺炎和死亡)的成本进行系统评价。主要观察结果是与中风后 OD 相关的成本。我们将检索 MEDLINE、Embase 和英国国家卫生服务经济评价数据库。如果研究是部分经济评估研究、提供有关成年(>17 岁)中风后 OD 患者及其并发症(营养不良、脱水、虚弱、呼吸道感染和肺炎)成本信息的研究,或已估算该疾病成本的经济评估研究,则将纳入研究。如果研究涉及食管吞咽困难或由中风以外的其他原因引起的 OD,则将排除研究。将根据归因于 OD 或其并发症的增量成本和报告 OD 或其并发症对中风总费用的影响的研究,分别以表格形式呈现和总结主要研究信息,并根据测量成本的角度进行分类。

伦理和传播

本系统评价的结果将发表在同行评议期刊上。

PROSPERO 注册号:CRD42018099977。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/673b/6303570/c0fb329bbf45/bmjopen-2018-022775f01.jpg

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