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急诊科肌肉骨骼性胸痛的患病率:一项系统评价与荟萃分析

Prevalence of musculoskeletal chest pain in the emergency department: a systematic review and meta-analysis.

作者信息

Mandrekar Shivani, Venkatesan Prem, Nagaraja Ravishankar

机构信息

Department of Physiotherapy, Manipal College of Health Professions, Manipal Academy of Higher Education, Bengaluru, Karnataka, India.

Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi, India.

出版信息

Scand J Pain. 2021 Apr 12;21(3):434-444. doi: 10.1515/sjpain-2020-0168. Print 2021 Jul 27.

Abstract

OBJECTIVES

Our objective was to systematically review and meta-analyse relevant studies to determine the prevalence of musculoskeletal chest pain in the emergency department.

METHODS

This review was constructed while confirming to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. PubMed, Cochrane Library, SCOPUS, Science Direct, and OVID were systematically searched from their inception to January 19, 2020, to identify observational studies, where the prevalence of musculoskeletal causes of chest pain was reported in isolation or in combination with other causes or could be calculated from the available data.

RESULTS

A meta-analysis of the nine included studies, having a total of 14,743 participants, showed the global pooled prevalence of musculoskeletal chest pain in the emergency department to be 16% (10-22%) [=99.24%]. The pooled prevalence for the European continent was 17% (9-25%) [=99.51%] and that for the urban areas was 13% (7-19%) [=99.00%].

CONCLUSIONS

This review provides a reliable estimate of the prevalence of musculoskeletal chest pain in the emergency department. More studies providing age and gender-specific data for the prevalence of musculoskeletal chest pain in the emergency department should be carried out. A paucity of such data from rural areas also needs to be addressed in future research work. The prevalence values from this study will be useful in the application of Bayesian reasoning utilised in diagnosing patients, where the process of Bayesian arguing begins by knowing pre-test probabilities of different differential diagnosis, in this case that of musculoskeletal chest pain in the emergency department.

摘要

目的

我们的目的是系统回顾和荟萃分析相关研究,以确定急诊科肌肉骨骼性胸痛的患病率。

方法

本综述是按照系统评价和荟萃分析的首选报告项目(PRISMA)指南进行构建的。对PubMed、Cochrane图书馆、SCOPUS、Science Direct和OVID从创建到2020年1月19日进行系统检索,以识别观察性研究,这些研究单独报告或与其他原因结合报告了胸痛的肌肉骨骼原因患病率,或者可以从现有数据中计算得出。

结果

对纳入的9项研究进行荟萃分析,共有14743名参与者,结果显示急诊科肌肉骨骼性胸痛的全球合并患病率为16%(10%-22%)[=99.24%]。欧洲大陆的合并患病率为17%(9%-25%)[=99.51%],城市地区的合并患病率为13%(7%-19%)[=99.00%]。

结论

本综述提供了急诊科肌肉骨骼性胸痛患病率的可靠估计。应开展更多研究,提供急诊科肌肉骨骼性胸痛患病率的年龄和性别特异性数据。未来的研究工作也需要解决农村地区此类数据匮乏的问题。本研究的患病率值将有助于在诊断患者时应用贝叶斯推理,在贝叶斯推理过程中,首先要了解不同鉴别诊断的检验前概率,在这种情况下是急诊科肌肉骨骼性胸痛的概率。

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