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衰弱老年住院患者的干预措施:随机对照试验中衰弱测量指标和报告结局的系统评价。

Interventions for frail older inpatients: A systematic review of frailty measures and reported outcomes in randomised controlled trials.

机构信息

Princess Alexandra Hospital, Woolloongabba, Qld, Australia.

Toowoomba Hospital, Toowoomba, Qld, Australia.

出版信息

Australas J Ageing. 2021 Jun;40(2):129-144. doi: 10.1111/ajag.12951. Epub 2021 Apr 20.

Abstract

OBJECTIVE

To summarise frailty measures and outcomes reported in trials involving frail older inpatients.

METHODS

Databases were searched for randomised controlled trials enrolling frail older inpatients.

RESULTS

Twenty-four articles describing twelve trials were included. Seven trials applied six tools to measure frailty, whilst five trials employed ad hoc measures. Eighty outcomes were examined with survival and functional status reported most commonly. Nine studies trialled multidisciplinary, geriatrician-led interventions. Statistically significant between-group differences were detected for at least one outcome in ten trials. All studies represented high risk of bias within at least one domain.

CONCLUSIONS

Heterogeneity of interventions, measurement of frailty and outcomes reported limit generalisability of findings. Many articles purport to study frail patients, yet do not enrol patients using any frailty measurement tool. Utilising validated instruments to measure frailty and a standard set of health outcomes relevant to older people would assist consistent reporting and evaluation of future studies.

摘要

目的

总结涉及虚弱老年住院患者的试验中报告的虚弱测量指标和结局。

方法

检索数据库,以纳入纳入虚弱老年住院患者的随机对照试验。

结果

共纳入 24 篇描述 12 项试验的文章。7 项试验应用 6 种工具来测量虚弱,而 5 项试验采用特定的措施。共检查了 80 个结局,最常报告的是生存和功能状态。9 项研究尝试了多学科、老年病医生主导的干预措施。10 项试验中有至少一项结局检测到组间存在统计学显著差异。所有研究在至少一个领域均存在高偏倚风险。

结论

干预措施、虚弱测量和报告的结局的异质性限制了研究结果的推广。许多文章声称研究虚弱的患者,但并未使用任何虚弱测量工具来招募患者。使用经过验证的工具来测量虚弱以及一套与老年人相关的标准健康结局,可以帮助更一致地报告和评估未来的研究。

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