Danesh Valerie, McDonald Anthony D, Hansmann Kellia J, Boehm Leanne M, Su Han, Eaton Tammy L, Toth Kelly M, Arroliga Alejandro C, Work Brittany D, McPeake Joanne
Center for Applied Health Research, Baylor Scott and White Health, Dallas, TX, USA; Baylor College of Medicine, Houston, TX, USA.
Industrial and Systems Engineering, School of Engineering, University of Wisconsin, Madison, WI, USA.
Int J Nurs Stud. 2025 Aug;168:105105. doi: 10.1016/j.ijnurstu.2025.105105. Epub 2025 Apr 30.
Adults recovering from hospitalization for acute or critical illnesses often face new or worsening physical and cognitive impairments, which can impact their driving abilities and safety. The purpose of this review is to synthesize evidence on driving behaviors and outcomes in the six months following hospitalization for acute or critical illness to guide patient care, provider recommendations, and future research.
A comprehensive search was conducted on PubMed, CINAHL, PsycINFO, and Cochrane databases from 1997 to October 20, 2023 with forward and backward searches. Primary empirical research involving vehicle drivers was included. Studies were excluded if they involved fewer than five participants, or if they focused on acute medical conditions with established driving rehabilitation programs. Two reviewers screened abstracts and full texts, resolving discrepancies through discussion.
Nineteen studies met the inclusion criteria. Driving behavior and safety data from these studies were derived from simulators (n = 10), self-reports (n = 8) and administrative/regulatory datasets (n = 1). Simulation studies primarily focused on post-surgical populations, and brake reaction times. Self-report studies highlighted driving suspension, cessation, and perceived safety issues. The heterogeneity of study designs and populations limited formal meta-analyses.
The evidence on driving safety and behavior post-hospitalization is heterogeneous and sparse, with some studies indicating no significant change in collision rates and others showing increased risks. Consequently, clinicians face challenges in recommendations on return to driving. There is a need for robust study designs and naturalistic driving studies to examine the specific impacts of hospitalization on driving safety and to develop evidence-based guidelines to address discharge planning to answer questions of "when should I return to driving?"
PROSPERO identifier CRD42023464876.
因急性或危重症住院康复的成年人常常面临新的或恶化的身体及认知障碍，这可能会影响他们的驾驶能力和安全性。本综述的目的是综合关于急性或危重症住院后六个月内驾驶行为及结果的证据，以指导患者护理、医生建议及未来研究。
对1997年至2023年10月20日期间的PubMed、CINAHL、PsycINFO和Cochrane数据库进行了全面检索，并进行了前后检索。纳入涉及车辆驾驶员的主要实证研究。如果研究参与者少于五人，或者聚焦于已有驾驶康复项目的急性医疗状况，则将其排除。两名评审员筛选摘要和全文，通过讨论解决分歧。
19项研究符合纳入标准。这些研究中的驾驶行为和安全数据来自模拟器（n = 10）、自我报告（n = 8）和行政/监管数据集（n = 1）。模拟研究主要关注术后人群和制动反应时间。自我报告研究强调了驾驶暂停、停止及感知到的安全问题。研究设计和人群的异质性限制了正式的荟萃分析。
关于住院后驾驶安全性和行为的证据异质性大且稀少，一些研究表明碰撞率无显著变化，而另一些研究则显示风险增加。因此，临床医生在关于恢复驾驶的建议方面面临挑战。需要强有力的研究设计和自然驾驶研究，以检查住院对驾驶安全的具体影响，并制定基于证据的指南来解决出院计划问题，以回答“我何时可以恢复驾驶？”的问题。
PROSPERO标识符CRD42023464876。
