Naess Hanne Langseth, Vikane Eirik, Wehling Eike Ines, Skouen Jan Sture, Bell Rae Frances, Johnsen Lars Gunnar
Regional Trauma Center, Haukeland University Hospital, Bergen, Norway.
Department of Physical Medicine and Rehabilitation, Haukeland University Hospital, Bergen, Norway.
Arch Rehabil Res Clin Transl. 2020 Jun 25;2(4):100070. doi: 10.1016/j.arrct.2020.100070. eCollection 2020 Dec.
To perform a systematic review to assess the current scientific evidence concerning the effect of EIR for trauma patients with or without an associated traumatic brain injury.
We performed a systematic search of several electronic (Ovid MEDLINE, Embase, Cochrane Library Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health, and SveMed+) and 2 clinical trial registers (clinicaltrials.gov and International Clinical Trials Registry Platform). In addition, we handsearched reference lists from relevant studies.
Two review authors independently identified studies that were eligible for inclusion. The primary outcome measures were functional-related outcomes and return to work. The secondary outcome measures were length of stay in hospital, number of days on respirator, complication rate, physical and mental health measures, quality of life, and socioeconomic costs.
Four studies with a total number of 409 subjects, all with traumatic brain-associated injuries, were included in this review. The included trials varied considerably in study design, inclusion and exclusion criteria, and had small numbers of participants. All studies were judged to have at least 1 high risk of bias. We found the quality of evidence, for both our primary and secondary outcomes, low.
No studies that matched our inclusion criteria for EIR for trauma patients without traumatic brain injuries could be found. For traumatic brain injuries, there are a limited number of studies demonstrating that EIR has a positive effect on functional outcomes and socioeconomic costs. This review highlights the need for further research in trauma care regarding early phase interdisciplinary rehabilitation.
进行一项系统评价,以评估有关早期综合康复(EIR)对伴有或不伴有创伤性脑损伤的创伤患者影响的当前科学证据。
我们对多个电子数据库(Ovid MEDLINE、Embase、Cochrane图书馆临床试验中央注册库、护理及相关健康累积索引和SveMed+)以及2个临床试验注册库(clinicaltrials.gov和国际临床试验注册平台)进行了系统检索。此外,我们还手工检索了相关研究的参考文献列表。
两位综述作者独立识别符合纳入标准的研究。主要结局指标为功能相关结局和重返工作情况。次要结局指标为住院时间、使用呼吸机天数、并发症发生率、身心健康指标、生活质量和社会经济成本。
本综述纳入了4项研究,共409名受试者,均伴有创伤性脑损伤。纳入的试验在研究设计、纳入和排除标准方面差异很大,且参与者数量较少。所有研究均被判定至少存在1项高偏倚风险。我们发现,无论是主要结局还是次要结局,证据质量都很低。
未找到符合我们对无创伤性脑损伤的创伤患者进行早期综合康复纳入标准的研究。对于创伤性脑损伤,仅有少数研究表明早期综合康复对功能结局和社会经济成本有积极影响。本综述强调了在创伤护理中进行早期跨学科康复进一步研究的必要性。