tailieunhanh - Báo cáo y học: " Risk scoring systems for adults admitted to the emergency department: a systematic review"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Risk scoring systems for adults admitted to the emergency department: a systematic review | Brabrand et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2010 18 8 http content 18 1 8 SCANDINAVIAN JOURNAL OF 8 emergency medicine REVIEW Open Access Risk scoring systems for adults admitted to the emergency department a systematic review Mikkel Brabrand1 Lars Folkestad1 Nicola Groes Clausen2 Torben Knudsen1 Jesper Hallas3 Abstract Background Patients referred to a medical admission unit MAU represent a broad spectrum of disease severity. In the interest of allocating resources to those who might potentially benefit most from clinical interventions several scoring systems have been proposed as a triaging tool. Even though most scoring systems are not meant to be used on an individual level they can support the more inexperienced doctors and nurses in assessing the risk of deterioration of their patients. We therefore performed a systematic review on the level of evidence of literature on scoring systems developed or validated in the MAU. We hypothesized that existing scoring systems would have a low level of evidence and only few systems would have been externally validated. Methods We conducted a systematic search using Medline EMBASE and the Cochrane Library according to the PRISMA guidelines on scoring systems developed to assess medical patients at admission. The primary endpoints were in-hospital mortality or transfer to the intensive care unit. Studies derived for only a single or few diagnoses were excluded. The ability to identify patients at risk discriminatory power and agreement between observed and predicted outcome calibration along with the method of derivation and validation application on a new cohort were extracted. Results We identified 1 655 articles. Thirty were selected for further review and 10 were included in this review. Eight systems used vital signs as variables and two relied mostly on blood tests. Nine systems were derived using regression analysis and eight included patients admitted to a MAU.