急诊成年患者谵妄发生危险因素Meta分析

A Meta-analysis of risk factors for delirium in adult patients at department of emergency

目的 分析急诊成年患者谵妄发生危险因素,为早期识别和管理谵妄高危患者,预防急诊患者谵妄发生提供依据。方法 检索中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方数据库(WanFang Data)、维普(VIP)和PubMed数据库,检索研究急诊成年患者谵妄发生危险因素文献,时间为建库至2020年10月,选择RevMan 5.3软件进行分析。结果 最终纳入8篇文献,观察组累计790例,对照组累计1167例,各危险因素Meta分析合并比值比(OR)或加权均数差(WMD)分别为年龄OR=3.96(95%CI:3.24,4.86)、糖尿病OR=3.03(95%CI:2.86,3.21)、APACHEⅡ评分OR=4.86(95%CI:3.78,6.24)、机械通气OR=12.10(95%CI:8.95,16.36)和呼吸衰竭OR=4.86(95%CI:3.78,6.24)。结论 基于现有证据,年龄、糖尿病病史、机械通气、APACHEⅡ评分和呼吸衰竭是急诊成年患者谵妄发生的危险因素。

Objective To analyze the risk factors of delirium in adult emergency patients, so as to provide basis for early identification and management of delirium high-risk patients and prevention of delirium in emergency patients. Methods The Pub Med,CBM, CNKI, Wan Fang Data, VIP databases were searched for the literature about the risk factors of delirium in adult emergency patients from the beginning of the database to October 2020, and the Rev Man 5.3 software was used for Meta analysis. Results There were 8articles included, a total of 790 cases were included in the observation group and 1167 cases were included in the control group.Meta-analysis combined odds ratio(OR)or weighted mean difference(WMD)showed that age OR was 3.96(95%CI: 3.24, 4.86), OR of diabetes was 3.03(95%CI: 2.86, 3.21), OR of APACHEⅡscore was 4.86(95%CI: 3.78,6.24), OR of mechanical ventilation was 12.10(95%CI: 8.95, 16.36)and OR of respiratory failure was 4.86(95%CI: 3.78, 6.24). Conclusion Based on the existing evidence, risk factors of the development of delirium in emergency adult patients include age, history of diabetes, APACHE Ⅱ score, mechanical ventilation, and respiratory failure.