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快速反应团队对患者结局的影响:系统评价。

Effects of a Rapid Response Team on Patient Outcomes: A Systematic Review.

机构信息

Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia; Nursing Department, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China.

Department of Nursing, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia.

出版信息

Heart Lung. 2024 Jan-Feb;63:51-64. doi: 10.1016/j.hrtlng.2023.09.007. Epub 2023 Sep 27.

Abstract

BACKGROUND

Despite the widespread adoption of the rapid response team (RRT) by many hospitals, questions remain regarding their effectiveness in improving several aspects of patient outcomes, such as hospital mortality, cardiopulmonary arrests, unplanned intensive care unit (ICU) admissions, and length of stay (LOS).

OBJECTIVES

To conduct a systematic review to understand the rapid response team's (RRT) effect on patient outcomes.

METHODS

A systematic search was conducted using PubMed, Cochrane, Embase, CINAHL, Web of Science, and two trial registers. The studies published up to May 6, 2022, from the inception date of the databases were included. Two researchers filtered the title, abstract and full text. The Version 2 of the Cochrane Risk of Bias tool and Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool were used separately for randomized and non-randomized controlled trials for quality appraisal.

RESULTS

Sixty-one eligible studies were identified, four randomized controlled trials(RCTs), four non-randomized controlled trials, six interrupted time-series(ITS) design , and 47 pretest-posttest studies. A total of 52 studies reported hospital mortality, 51 studies reported cardiopulmonary arrests, 18 studies reported unplanned ICU admissions and ten studies reported LOS.

CONCLUSION

This systematic review found the variation in context and the type of RRT interventions restricts direct comparisons. The evidence for improving several aspects of patient outcomes was inconsistent, with most studies demonstrating that RRT positively impacts patient outcomes.

摘要

背景

尽管许多医院广泛采用了快速反应团队(RRT),但其在改善患者预后的多个方面(如医院死亡率、心肺骤停、非计划性重症监护病房(ICU)入院和住院时间(LOS))的效果仍存在疑问。

目的

进行系统评价以了解快速反应团队(RRT)对患者预后的影响。

方法

使用 PubMed、Cochrane、Embase、CINAHL、Web of Science 和两个试验登记处进行系统搜索。纳入截至 2022 年 5 月 6 日数据库创建日期发表的研究。两名研究人员筛选标题、摘要和全文。使用 Cochrane 风险偏倚工具第 2 版和干预非随机研究的偏倚(ROBINS-I)工具分别对随机对照试验和非随机对照试验进行质量评估。

结果

确定了 61 项符合条件的研究,其中 4 项为随机对照试验(RCT),4 项为非随机对照试验,6 项为中断时间序列(ITS)设计,47 项为前后测试研究。共有 52 项研究报告了医院死亡率,51 项研究报告了心肺骤停,18 项研究报告了非计划性 ICU 入院,10 项研究报告了 LOS。

结论

本系统评价发现,背景和 RRT 干预类型的差异限制了直接比较。改善患者预后多个方面的证据不一致,大多数研究表明 RRT 对患者预后有积极影响。

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