老年综合评估对预防老年患者护理不良事件发生的Meta分析

目的 系统评价老年综合评估对预防老年患者护理不良事件发生的干预效果。方法 计算机检索中国知网、万方、中国生物医学文献数据库、PubMed、Cochrane、Embase、EBSCO、Medline、Web of Science,检索时间为建库截至2019年6月。收集所有关于老年综合评估对老年患者护理不良事件影响的随机对照试验。由2名研究员按照纳入和排除标准独立筛选文献并提取资料,运用RevMan 5.3进行Meta分析,Stata 15进行Begg秩相关分析。结果 最终纳入13篇随机对照实验,总计26 241例患者。Meta分析结果显示: 老年综合评估能够降低老年患者跌倒发生率（OR=0.42,95%CI：0.34~0.54,P<0.01）、降低患者非计划拔管发生率（OR=0.19,95%CI：0.08~0.47,P<0.01）,患者住院压疮发生率（OR=0.62,95%CI：0.38~1.00,P=0.05）未显著降低。结论 与常规护理评估相比,老年综合评估能够降低老年患者跌倒发生率和非计划拔管发生率,但不能降低老年患者住院压疮发生率。

Effect of Comprehensive Evaluation on Prevention of Nursing Adverse Events in Elderly Patients:A Systematic Review

Objective To systematically assess the effect of comprehensive evaluation on preventing the occurrence of nursing adverse events in elderly patients.Methods We searched CNKI,Wanfang,China Biomedical Literature Database,Pubmed,Cochrane,Embase,EBSCO,Medline,Web of Science for eligible literature on the impact of comprehensive geriatric assessment on nursing adverse events in elderly patients from the inception to June 2019.Two researchers independently screened the literature and extracted data according to the inclusion and exclusion criteria,using Review Manager 5.3 software for Meta analysis,and Stata 15 software for Begg rank correlation analysis.Results Thirteen articles(randomized controlled trials,RCTs)were included,covering 26,241 patients.Meta analysis showed that comprehensive evaluation of the elderly can reduce the incidence of falls(OR=0.42,95%CI:0.34~0.54),P<0.01),and the incidence of unplanned extubation(OR=0.19,95%CI:0.08~0.47,P<0.01),but the incidence of hospitalized pressure ulcer(OR=0.62,95%CI:0.38~1.00,P=0.05)did not decrease significantly.Conclusion Compared with routine nursing assessment,comprehensive evaluation for the elderly can significantly reduce the incidence of fall and unplanned extubation rate,but can not reduce the incidence of pressure ulcer during the hospitalization.