Conneely Mairéad, Robinson Katie, Leahy Siobhán, Trépel Dominic, Jordan Fionnuala, Galvin Rose
School of Allied Health, Faculty of Education and Health Sciences, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland, V94 TPPX, Ireland.
Trinity Institute of Neurosciences, School of Medicine, Trinity College Dublin, Dublin, Ireland, DO2 PN40, Ireland.
HRB Open Res. 2021 Apr 6;3:27. doi: 10.12688/hrbopenres.13027.2. eCollection 2020.
Older adults are frequent users of Emergency departments (ED) and this trend will continue due to population ageing and the associated increase in healthcare needs. Older adults are vulnerable to adverse outcomes following ED discharge. A number of heterogeneous interventions have been developed and implemented to improve clinical outcomes among this cohort. A growing number of systematic reviews have synthesised evidence regarding ED interventions using varying methodologies. This overview aims to synthesise the totality of evidence in order to evaluate the effectiveness of interventions to reduce adverse outcomes in older adults discharged from the ED. To identify relevant reviews, the following databases will be searched: Cochrane Database of Systematic reviews, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, Databases of Abstracts of Reviews of Effects, PubMed, MEDLINE, Epistemonikos, Ageline, Embase, PEDro, Scopus, CINAHL and the PROSPERO register. The search for grey literature will include Open Grey and Grey Literature Reports. Systematic reviews of randomised controlled trials will be analysed to assess the effect of ED interventions on clinical and process outcomes in older adults. Methodological quality of the reviews will be assessed using the Assessment of Multiple Systematic Reviews 2 tool. The review will be reported in accordance to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Summary of findings will include a hierarchical rank of interventions based on estimates of effects and the quality of evidence. This overview is required given the number of systematic reviews published regarding the effectiveness of various ED interventions for older adults at risk of adverse outcomes following discharge from the ED. There is a need to examine the totality of evidence using rigorous analytic techniques to inform best care and potentially develop a hierarchy of treatment options. : CRD42020145315 (28/04/2020).
老年人是急诊科的频繁使用者，由于人口老龄化以及相关的医疗保健需求增加，这一趋势将持续下去。老年人在急诊科出院后容易出现不良后果。已经开发并实施了一些不同类型的干预措施，以改善这一人群的临床结局。越来越多的系统评价使用不同的方法综合了有关急诊科干预措施的证据。本综述旨在综合全部证据，以评估干预措施对减少急诊科出院的老年人不良结局的有效性。为了识别相关综述，将检索以下数据库：Cochrane系统评价数据库、乔安娜·布里格斯循证卫生保健中心系统评价与实施报告数据库、效果综述文摘数据库、PubMed、MEDLINE、Epistemonikos、老年医学数据库、Embase、PEDro、Scopus、CINAHL和PROSPERO注册库。对灰色文献的检索将包括Open Grey和灰色文献报告。将对随机对照试验的系统评价进行分析，以评估急诊科干预措施对老年人临床和过程结局的影响。将使用多重系统评价评估工具2评估综述的方法学质量。本综述将按照系统评价和Meta分析的首选报告项目声明进行报告。结果总结将包括根据效应估计和证据质量对干预措施进行的分层排序。鉴于已发表了大量关于急诊科各种干预措施对出院后有不良结局风险的老年人有效性的系统评价，因此需要进行本综述。有必要使用严格的分析技术来审查全部证据，以为最佳护理提供信息，并可能制定治疗选择的层次结构。：CRD42020145315（2020年4月28日）
