术前评估门诊的效果：随机和非随机前瞻性对照研究的系统评价。
Effectiveness of pre-anaesthetic assessment clinic: a systematic review of randomised and non-randomised prospective controlled studies.
机构信息
Department of Health and Nursing Science, University of Agder, Kristiansand/Grimstad, Norway
Department of Anaesthesiology and Intensive Care, Sørlandet Hospital, Kristiansand, Norway.
出版信息
BMJ Open. 2022 May 11;12(5):e054206. doi: 10.1136/bmjopen-2021-054206.
OBJECTIVES
The aim of this systematic review was to examine the effectiveness of pre-anaesthesia assessment clinics (PACs) in improving the quality and safety of perioperative patient care.
DESIGN
Systematic review.
DATA SOURCES
The electronic databases CINAHL Plus with Full Text (EBSCOhost), Medline and Embase (OvidSP) were systematically searched on 11 September 2018 and updated on 3 February 2020 and 4 February 2021.
ELIGIBILITY CRITERIA
The inclusion criteria for this study were studies published in English or Scandinavian language and scientific original research that included randomised or non-randomised prospective controlled studies. Additionally, studies that reported the outcomes from a PAC consultation with the patient present were included.
DATA EXTRACTION AND SYNTHESIS
Titles, abstracts and full texts were screened by a team of three authors. Risk of bias was assessed using the Joanna Briggs Institute critical appraisal checklist for quasi-experimental studies. Data extraction was performed by one author and checked by four other authors. Results were synthesised narratively owing to the heterogeneity of the included studies.
RESULTS
Seven prospective controlled studies on the effectiveness of PACs were included. Three studies reported a significant reduction in the length of hospital stay and two studies reported a significant reduction in cancellation of surgery for medical reasons when patients were seen in the PAC. In addition, the included studies presented mixed results regarding anxiety in patients. Most studies had a high risk of bias.
CONCLUSION
This systematic review demonstrated a reduction in the length of hospital stay and cancellation of surgery when the patients had been assessed in the PAC. There is a need for high-quality prospective studies to gain a deeper understanding of the effectiveness of PACs.
PROSPERO REGISTRATION NUMBER
CRD42019137724.
目的
本系统评价旨在考察术前评估门诊（PAC）在提高围手术期患者护理质量和安全性方面的有效性。
设计
系统评价。
资料来源
2018 年 9 月 11 日，对 CINAHL Plus with Full Text（EBSCOhost）、Medline 和 Embase（OvidSP）电子数据库进行了系统检索，并分别于 2020 年 2 月 3 日和 2021 年 2 月 4 日进行了更新。
入选标准
本研究的纳入标准为发表于英语或斯堪的纳维亚语的研究，以及包括随机或非随机前瞻性对照研究的科学原始研究。此外，还纳入了报道有患者在场的 PAC 咨询结果的研究。
资料提取与综合
由三名作者组成的团队筛选标题、摘要和全文。使用 Joanna Briggs 研究所偏倚风险评估工具对类实验研究进行偏倚风险评估。由一名作者进行数据提取，由其他四名作者进行检查。由于纳入研究的异质性，结果以叙述性方式综合。
结果
纳入了 7 项关于 PAC 有效性的前瞻性对照研究。3 项研究报告称，患者在 PAC 就诊时，住院时间明显缩短，2 项研究报告称，因医疗原因取消手术的比例显著降低。此外，纳入的研究在患者焦虑方面呈现出混合的结果。大多数研究存在高偏倚风险。
结论
本系统评价显示，患者在 PAC 就诊时，住院时间和手术取消率均有所降低。需要高质量的前瞻性研究来更深入地了解 PAC 的有效性。
PROSPERO 注册号：CRD42019137724。
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