基于早期预警评分启动快速反应小组的范围综述

A scoping review of activating rapid response teams based on early warning scores

目的对国内外基于早期预警评分启动快速反应小组(rapid response team,RRT)的应用效果进行范围综述。方法系统检索PubMed、Embase、Scopus、CINAHL、Web of Science、CochraneLibrary、中国知网、维普数据库、万方数据库、中国生物医学数据库中相关文献,检索时限为建库至2024年3月31日,依据纳入排除标准对文献进行筛选及信息资料提取。结果共纳入文献24篇,其中中文3篇、英文21篇。总结了基于早期预警评分启动RRT在4个方面的内容:病情恶化的识别、RRT的启动情况、RRT的响应情况和评价指标。病情恶化的识别涉及评估时机和评分工具的选择;RRT的启动情况包括RRT的启动方和立即启动标准;RRT的响应情况包括RRT的组成和响应时间;评价指标涉及患者的临床结局和RRT启动现况结论基于早期预警评分启动的RRT能及时识别患者病情恶化的迹象并进行干预.对改善患者临床结局方面具有积极作用;但国内应用尚处于初步探索阶段,需进一步的研究和实践来完善和优化。

Objective To undertake a scoping review of the application research on the activation of Rapid Response Teams(RRT)for early warning scoring,both domestically and internationally.Methods We conducted a systematic search for relevant literatures in the fllowing databases:PubMed,Embase,Scopus,CINAHL,Web of Science,The Cochrane Library,CNKI,VIP,WanFang,and CBM.The search period limited from the establishment of the database to March 31,2024,and the literature was screened and information materials were extracted based on the inclusion criteria.Results A total of 24 articles were included,including 3 in Chinese and 21 in English.We summarized the early warning score initiation of RRT in four areas:identification of deterioration,initiation of RRT,response to RRT,and evaluation metrics.Identification of deterioration involved timing of assessment and selection of scoring tools.RRT initiation scenarios included RRT initiator and immediate initiation criteria.The response profile of the RRT included the composition of the RRT and the response time.The evaluation metrics related to the clinical outcome of the patient and the current status of RRT initiation.Conclusion RRT initiated based on early warning scores can identify signs of deterioration in patients and intervene in a timely manner,which has a positive effects on improving the clinical outcomes of patients,but its application in China is still in the preliminary stage of exploration,and further research and practice are needed to improve and optimize it.