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感染作为卒中患者再入院的关键决定因素:一项系统评价与荟萃分析

Infection as a Key Determinant of Readmission in Stroke Patients: A Systematic Review and Meta-Analysis.

作者信息

Heydari Abbas, Mirhaghi Amir, Ghandehari Kavian, Rajabpour Mohammad

机构信息

Department of Medical Surgical Nursing, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

Department of Medical Emergencies, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

Iran J Public Health. 2025 Jul;54(7):1389-1398. doi: 10.18502/ijph.v54i7.19145.

Abstract

BACKGROUND

Accurately identifying the relationship between infection and the readmission of stroke patients leads to emphasis more the corresponding strategies. We aimed to determine the relationship between infection and readmission in stroke patients.

METHODS

This systematic review and meta-analysis was based on PRISMA 2020 guidelines. A comprehensive search was performed across multiple databases, including PubMed, Web of Science, CINAHL, Scopus, and Google Scholar, using keywords such as "stroke," "readmission," "recurrence," "re-hospitalization," and "infection" up to 2024. The rate of readmissions due to infection, along with the Odds Ratio (OR) for infection, was calculated using a random effects model via Comprehensive Meta-Analysis V.2 software.

RESULTS

Based on the reviewed studies, the 30-day readmission rate of stroke patients due to infection ranged from 6.5% to 30.0% and the one-year readmission rate ranged from 5.1% to 24.5%. Also, infection is an important risk factor in the readmission of stroke patients based on cohort studies (RR 1.38, 95% CI: 1.16-1.65, <0.001), case-control (OR 1.68, 95% CI: 1.16-2.42, = 0.006) and descriptive-analytical (OR 1.31, 95% CI: 1.07-1.59, = 0.008).

CONCLUSION

The readmission rate of stroke due to infection is high and tackling infection-related readmissions in stroke patients necessitates a holistic strategy that combines clinical care, technological advancements, and education. More studies are needed in this field.

摘要

背景

准确识别感染与中风患者再入院之间的关系有助于更加强调相应策略。我们旨在确定中风患者感染与再入院之间的关系。

方法

本系统评价和荟萃分析基于PRISMA 2020指南。通过在多个数据库中进行全面检索,包括PubMed、Web of Science、CINAHL、Scopus和谷歌学术,使用“中风”、“再入院”、“复发”、“再次住院”和“感染”等关键词,检索截至2024年的文献。使用随机效应模型,通过Comprehensive Meta-Analysis V.2软件计算感染导致的再入院率以及感染的比值比(OR)。

结果

根据纳入的研究,中风患者因感染导致的30天再入院率在6.5%至30.0%之间,一年再入院率在5.1%至24.5%之间。此外,基于队列研究(RR 1.38,95%CI:1.16 - 1.65,<0.001)、病例对照研究(OR 1.68,95%CI:1.16 - 2.42,= 0.006)和描述性分析研究(OR 1.31,95%CI:1.07 - 1.59,= 0.008),感染是中风患者再入院的重要危险因素。

结论

中风因感染导致的再入院率很高,应对中风患者与感染相关的再入院需要一种综合策略,该策略应结合临床护理、技术进步和教育。该领域需要更多研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e4d/12325853/60b4d72d6e7a/IJPH-54-1389-g001.jpg

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