预测精神科住院患者住院时间的因素：系统评价和荟萃分析方案。
Predictors of the length of stay of psychiatric inpatients: protocol for a systematic review and meta-analysis.
机构信息
Department of Psychiatry, Hospital Universitario "Dr. José E. González", Av. Francisco I. Madero & Av. Gonzalitos, Mitras Centro, 64460, Monterrey, Mexico.
Plataforma INVEST KER Medicina UANL KER Unit Mayo Clinic (KER Unit Mexico), Universidad Autónoma de Nuevo León, Av. Francisco I. Madero & Av. Gonzalitos, Mitras Centro, Monterrey, Mexico.
出版信息
Syst Rev. 2021 Mar 2;10(1):65. doi: 10.1186/s13643-021-01616-6.
BACKGROUND
Length of stay (LOS) for inpatient psychiatric services is an important factor with serious drawbacks when it is extended more than needed. Impacts on economy, social functioning, and stigma can hamper improvement and affect the patients' experiences on future mental healthcare. Predictions of which patients have a higher chance for prolonged LOS have been extensively researched. Previous systematic reviews found consistent predictors of both longer and shorter LOS. However, they do not provide an estimate from the pooled effect sizes. Furthermore, to our knowledge, there is no meta-analysis on the influence of these factors. The primary objective of this study will be to provide point estimates on the effect sizes of all studied predictors of the LOS of psychiatric inpatients.
METHODS
We will conduct a systematic search in PubMed, MEDLINE, EMBASE, and PsycINFO for observational studies evaluating the effect size of independent factors on the length of stay of psychiatric inpatients. Prospective and retrospective cohorts that assess the influence of predictors through the reporting of standardized regression coefficients will be included. We will provide a qualitative synthesis of the findings from each study and perform a meta-analysis from pooled regression coefficients that were adjusted for other variables or confounders in order to obtain a point estimate and confidence interval for all factors extracted from the included studies.
DISCUSSION
The results from this study may provide more accurate predictions for mental health institutions, psychiatrists, mental health service providers, patients, and families on the prognosis regarding the length of stay for needed inpatient care. This information may be used to anticipate individuals with a higher chance for prolonged hospitalization to plan the necessary interventions for these specific situations. Considering both the benefits and disadvantages of longer and shorter stays, the pooled estimates for independent factors may be used by mental healthcare providers and patients for informed decision-making. The results from this study will also update results presented in previous studies and identify the strengths and limitations from the current available evidence.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO ID CRD42020172840.
背景
住院精神科服务的住院时间（LOS）是一个重要的因素，如果延长超过必要的时间，会带来严重的缺点。对经济、社会功能和耻辱感的影响会阻碍改善，并影响患者未来精神卫生保健的体验。预测哪些患者有更长 LOS 的更高机会已经得到了广泛的研究。以前的系统评价发现了更长和更短 LOS 的一致预测因素。然而，它们并没有提供汇总效应大小的估计。此外，据我们所知，没有关于这些因素影响的荟萃分析。本研究的主要目的将是提供所有研究的 LOS 预测因素的效应大小的点估计。
方法
我们将在 PubMed、MEDLINE、EMBASE 和 PsycINFO 中进行系统搜索，以评估评估独立因素对精神科住院患者 LOS 影响的观察性研究。将纳入评估通过报告标准化回归系数来评估预测因子影响的前瞻性和回顾性队列。我们将对每项研究的结果进行定性综合，并对经过调整其他变量或混杂因素的汇总回归系数进行荟萃分析，以获得从纳入研究中提取的所有因素的点估计值和置信区间。
讨论
这项研究的结果可能为精神卫生机构、精神科医生、精神卫生服务提供者、患者和家属提供更准确的预测，了解需要住院治疗的患者的 LOS 预后。这些信息可用于预测住院时间延长的可能性较高的个体，为这些特定情况计划必要的干预措施。考虑到 LOS 延长和缩短的利弊，独立因素的汇总估计值可由精神卫生保健提供者和患者用于知情决策。本研究的结果还将更新以前研究中提出的结果，并确定当前可用证据的优势和局限性。
系统评价注册
PROSPERO ID CRD42020172840。
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