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老年人住院相关残疾的风险因素:系统评价和荟萃分析。

Risk factors for hospitalization-associated disability among older patients: A systematic review and meta-analysis.

机构信息

School of Nursing, Jilin University, 965 Xinjiang street, Changchun 130021, China.

出版信息

Ageing Res Rev. 2024 Nov;101:102516. doi: 10.1016/j.arr.2024.102516. Epub 2024 Sep 26.

Abstract

BACKGROUND

The outcomes of older patients are significantly limited by hospitalization-associated disability (HAD), and there are currently few available management options for HAD. This review aimed to identify and quantify the risk factors for HAD, to provide reliable evidence for developing a HAD prevention program centered on risk factor management among older patients.

METHODS

The MEDLINE, Embase, PsycINFO, CINAHL, and PubMed databases were searched in March 2024 to identify cross-sectional and cohort studies that used multivariable analysis to examine risk factors for HAD among older patients.

RESULTS

We screened 883 studies, 21 of which met our inclusion criteria. Our findings revealed a substantial association between various risk factors and HAD among older patients. Specifically, advanced age, female sex, Caucasian ethnicity, comorbidity burden, better activities of daily living at admission, dementia diagnosis, and longer lengths of stay were significant risk factors for HAD. Furthermore, frailty, poor physical function, immobility, and delirium were identified as confirmed risk factors for HAD among older patients.

CONCLUSIONS

This review provided a comprehensive synthesis of available evidence on risk factors for HAD among older patients, serving as a valuable guide for the development of HAD prevention strategies both prior to and during hospitalization.

摘要

背景

住院相关失能(HAD)显著限制了老年患者的预后,目前针对 HAD 尚无有效的治疗方法。本研究旨在确定和量化 HAD 的风险因素,为制定以 HAD 风险因素管理为中心的老年患者 HAD 预防计划提供可靠证据。

方法

检索了 2024 年 3 月的 MEDLINE、Embase、PsycINFO、CINAHL 和 PubMed 数据库,以识别使用多变量分析探讨老年患者 HAD 风险因素的横断面和队列研究。

结果

我们筛选了 883 项研究,其中 21 项符合纳入标准。我们的研究结果表明,各种风险因素与老年患者 HAD 显著相关。具体而言,高龄、女性、白种人、合并症负担、入院时日常生活活动能力较好、痴呆诊断以及住院时间较长是 HAD 的显著风险因素。此外,衰弱、身体功能较差、活动受限和谵妄被确定为老年患者 HAD 的明确风险因素。

结论

本研究全面综合了现有老年患者 HAD 风险因素的证据,为制定住院前和住院期间 HAD 预防策略提供了重要指导。

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