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快速反应系统对死亡率和心脏骤停的影响——文献综述。

The impact of rapid response systems on mortality and cardiac arrests - A literature review.

机构信息

Intensive Therapy Unit, Mater Dei Hospital, Msida, MSD 2090, Malta.

Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, MSD 2080, Malta.

出版信息

Intensive Crit Care Nurs. 2020 Aug;59:102848. doi: 10.1016/j.iccn.2020.102848. Epub 2020 Apr 3.

DOI:10.1016/j.iccn.2020.102848
PMID:32253121
Abstract

BACKGROUND

Rapid response systems were created to improve recognition of and response to deterioration of general ward patients.

AIM

This literature review aimed to evaluate the evidence on whether rapid response systems decrease in-hospital mortality and non-intensive care unit cardiac arrests.

METHOD

Six databases (MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index of Nursing and Allied Health Literature, SCOPUS, Web of Science and PubMed) were systematically searched for primary studies published between 1st January 2014 and 31st October 2017, recruiting general ward patients, where the intervention involved introducing/maintaining a rapid response system, the comparison referred to a hospital setting without a rapid response system and the outcomes included mortality and cardiac arrests.

RESULTS

Fifteen studies met eligibility criteria: one stepped wedge cluster randomised controlled trial, one concurrent cohort controlled study and thirteen historically controlled studies. Thirteen studies investigated mortality of which seven reported statistically significant findings in favour of rapid response systems. Thirteen studies investigated cardiac arrests, of which eight reported statistically significant findings in favour of rapid response systems.

CONCLUSION

Evidence suggests that when the process of introducing/maintaining a rapid response system is successful and under certain favourable conditions, rapid response systems significantly decrease mortality and cardiac arrests.

摘要

背景

快速反应系统的创建是为了提高对普通病房患者病情恶化的识别和反应能力。

目的

本文献综述旨在评估快速反应系统是否能降低院内死亡率和非 ICU 心脏骤停的证据。

方法

系统检索了六个数据库(MEDLINE、Cochrane 对照试验中心注册库、护理和联合健康文献累积索引、SCOPUS、Web of Science 和 PubMed),检索时间为 2014 年 1 月 1 日至 2017 年 10 月 31 日,纳入普通病房患者的研究,干预措施涉及引入/维持快速反应系统,对照组为没有快速反应系统的医院环境,结局包括死亡率和心脏骤停。

结果

符合入选标准的研究有 15 项:一项阶梯式楔形集群随机对照试验、一项同期队列对照研究和 13 项历史对照研究。13 项研究调查了死亡率,其中 7 项研究的结果支持快速反应系统。13 项研究调查了心脏骤停,其中 8 项研究的结果支持快速反应系统。

结论

有证据表明,当引入/维持快速反应系统的过程取得成功并在某些有利条件下,快速反应系统能显著降低死亡率和心脏骤停。

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