文献分享·第84期|医院环境中老年人衰弱老年综合评估的有效性：系统评价和荟萃分析

文献分享 | The effectiveness of the comprehensive geriatric assessment for older adults with frailty in hospital settings: A systematic review and meta-analysis

来源： International journal of nursing studies

DOI： 10.1016/j.ijnurstu.2024.104849

Abstract 摘要

Background：Comprehensive geriatric assessment (CGA) is performed by a multidisciplinary team and includes systematic comprehensive team assessment and treatment. Comprehensive geriatric assessment has become a fundamental component of geriatric nursing, as a multidimensional approach is necessary to achieve the best diagnosis and therapy for older adults with frailty.

背景：老年综合评估 （CGA） 由多学科团队进行，包括系统的综合团队评估和治疗。全面的老年病学评估已成为老年护理的基本组成部分，因为多维方法对于实现对虚弱老年人的最佳诊断和治疗是必要的。

Objective：The aim of our review was to analyze the effects of comprehensive geriatric assessment interventions on older adults with frailty in hospital settings.

目的：本综述的目的是分析老年综合评估干预对医院环境中虚弱老年人的影响。

Methods：The PubMed, Web of Science, Embase, CINAHL and Cochrane Library databases were systematically searched from inception to February 28, 2024. Only randomized controlled trials were included in the analysis. The risk ratios (RRs) or standardized mean differences (SMDs) were calculated to determine the pooled intervention effects. Sensitivity analyses and publication bias analyses were also conducted. Methodological quality and evidence were assessed using the RoB2 tool and GRADE pro online tool.

方法：系统检索了 PubMed、Web of Science、Embase、CINAHL 和 Cochrane Library 数据库，检索时间从建库到 2024 年 2 月 28 日。分析仅纳入随机对照试验。计算风险比 （RRs） 或标准化均数差 （SMD） 以确定汇总干预效果。还进行了敏感性分析和发表偏倚分析。使用 RoB2 工具和 GRADE pro 在线工具评估方法学质量和证据。

Results：A total of 18 randomized controlled trials were included in this review. The results showed that participants in the intervention group had a lower risk of having decreased activities of daily living than did those in the control group (RR = 0.55, 95 % CI: 0.33 to 0.92, P = 0.021, low certainty evidence). Comprehensive geriatric assessment was associated with a reduced mortality risk (RR = 0.85, 95 % CI: 0.73 to 0.99, P = 0.038, high certainty evidence).

结果：本综述共纳入 18 项随机对照试验。结果显示，干预组的参与者日常生活活动减少的风险低于对照组（RR = 0.55,95% CI：0.33 至 0.92，P = 0.021，低质量证据）。 综合老年病学评估与降低死亡风险相关（RR = 0.85,95 % CI：0.73 至 0.99，P = 0.038，高质量证据）。

Conclusion：In conclusion, this systematic review analyzed the available literature, and the results showed that comprehensive geriatric assessment had significant benefits in terms of increased independence and was associated with a reduced mortality risk for older adults with frailty in hospital settings. However, the evidence was limited. Thus, more research is needed in the future to further enrich the evidence in the field of comprehensive geriatric assessment interventions for older adults with frailty.

结论:总之，本系统评价分析了现有文献，结果表明，全面的老年病学评估在提高独立性方面具有显着益处，并且与降低医院环境中虚弱老年人的死亡风险有关。然而，证据有限。因此，未来需要更多的研究，以进一步丰富老年人衰弱老年综合评估干预领域的证据。

Keywords：Comprehensive geriatric assessment；Frailty；Acute care；Older adults；Systematic review；Meta-analysis

关键字:老年综合评估;衰弱;急性期护理;老年人;系统评价;荟萃分析

（译文仅供参考）