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住院老年患者衰弱与谵妄:系统评价与荟萃分析。

Frailty and delirium in hospitalized older adults: A systematic review with meta-analysis.

机构信息

Universidade Federal do Paraná, Curitiba, PR, Brazil.

Secretaria Municipal de Saúde, Hospital Municipal do Idoso Zilda Arns, Curitiba, PR, Brazil.

出版信息

Rev Lat Am Enfermagem. 2022 Oct 17;30:e3687. doi: 10.1590/1518-8345.6120.3687. eCollection 2022.

Abstract

OBJECTIVE

to estimate the prevalence and synthesize diverse evidence about the relationship between frailty and delirium in hospitalized older adults.

METHOD

a systematic review with meta-analysis in which observational studies conducted with older adults about frailty, delirium and hospitalization, were selected without time of language restrictions. The search was conducted in the MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and CENTRAL databases during August 2021. The precepts set forth by the Joanna Briggs Institute (JBI) - Evidence Synthesis Groups were followed. The meta-analysis model estimated the relative risk corresponding to the prevalence of frailty and delirium. The inverse variance method for proportions was used to estimate the prevalence values and relative risks for binary outcomes.

RESULTS

initially, 1,244 articles were identified, of which 26 were included in the meta-analysis (n=13,502 participants), with 34% prevalence of frailty (95% CI:0.26-0.42; I 2=99%; t 2=0.7618, p=0) and 21% for delirium (95% CI:0.17-0,25; I 2=95%; t 2=0.3454, p<0.01). The risk for hospitalized older adults to develop delirium was 66% (RR: 1.66; 95% CI:1.23-2.22; I2=92%; t2=0.4154; p<0.01).

CONCLUSION

34% prevalence of frailty and 21% of delirium in hospitalized older adults, with frailty being an independent risk factor for developing delirium, with an increased chance of 66% when compared to non-frail individuals.

摘要

目的

评估衰弱与住院老年患者谵妄的相关性,并对其进行综合分析。

方法

本研究为系统综述和荟萃分析,检索了 2021 年 8 月 MEDLINE、EMBASE、CINAHL、Scopus、Web of Science 和 CENTRAL 数据库中关于衰弱、谵妄和住院治疗的老年人群观察性研究,未设时间和语言限制。本研究遵循乔安娜·布里格斯研究所(JBI)证据综合组制定的原则。荟萃分析模型估计了衰弱和谵妄的流行率对应的相对风险。二分类结局采用逆方差法估计患病率和相对风险。

结果

最初共检索到 1244 篇文章,其中 26 篇文章纳入荟萃分析(n=13502 例),衰弱的患病率为 34%(95%CI:0.26-0.42;I 2=99%;t 2=0.7618,p=0),谵妄的患病率为 21%(95%CI:0.17-0.25;I 2=95%;t 2=0.3454,p<0.01)。与非衰弱患者相比,住院老年患者发生谵妄的风险增加了 66%(RR:1.66;95%CI:1.23-2.22;I 2=92%;t 2=0.4154;p<0.01)。

结论

住院老年患者衰弱的患病率为 34%,谵妄的患病率为 21%,衰弱是发生谵妄的独立危险因素,与非衰弱患者相比,发生谵妄的风险增加了 66%。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1db1/9580989/50a901c9ed18/1518-8345-rlae-30-e3687-gf1.jpg

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