收稿日期: 2024-12-31
网络出版日期: 2025-09-02
基金资助
河北省医学科学研究课题计划(20250870)
Triage standards of elderly trauma patients in emergency department：a scoping review
目的 对急诊老年创伤患者分诊标准的研究进行范围综述，归纳分析分诊标准内容、准确性和相关临床结局。 方法 系统检索PubMed、Web of Science、Embase、CINAHL、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库和维普数据库，检索时限为建库至2024年11月30日。筛选老年创伤患者分诊标准相关文献，提取汇总分诊标准内容、准确性、临床结局等资料。 结果 共纳入14篇文献，老年创伤患者分诊标准内容包含生理指标、损伤机制和解剖学指标，并对相应的成人标准进行了修改。8项研究提高收缩压和格拉斯哥昏迷评分阈值；3项研究对损伤机制和解剖学指标进行修改；2项研究分别增加抗凝/抗血小板使用和≥2个合并症。分诊标准敏感性为23.5%~93%，特异性为41.5%~95.7%。没有研究评估分诊标准对患者临床结局的影响。 结论 既有老年创伤分诊标准内容差异较大，准确性有待提高，对患者临床结局的影响有待验证。未来应开发更精确的老年创伤分诊标准，评估其临床应用价值，为优化老年创伤患者救治策略，改善患者临床结局提供依据。
杨云利 , 张晓峰 , 刘亚楠 , 王华荣 . 急诊老年创伤患者分诊标准研究的范围综述[J]. 中华急危重症护理杂志, 2025 , 6(9) : 1074 -1081 . DOI: 10.3761/j.issn.2096-7446.2025.09.008
Objective To conduct a scoping review of studies on the triage standards for elderly trauma patients，to summarize and analyze the content，accuracy and related clinical outcomes of triage standards. Methods PubMed，Web of Science，Embase，CINAHL，Cochrane Library，CBM，CNKI，Wanfang，and VIP databases were searched up to November 30，2024. Studies reporting elderly-specific triage standards were screened. Data regarding the content，accuracy and related clinical outcomes were extracted. Results Fourteen articles were included. Most standards involved physiological indicators，mechanisms of injury，and anatomical considerations，with adjustments to conventional adult criteria. Eight studies elevated thresholds for systolic blood pressure and Glasgow Coma Scale scores. Three studies modified injury mechanisms and anatomical indicators. Two studies included anticoagulant/antiplatelet use and ≥2 comorbidities. Sensitivity ranged from 23.5% to 93%，and specificity from 41.5% to 95.7%. No studies directly evaluated the impact of triage standards on clinical outcomes. Conclusion Existing triage standards for elderly trauma patients vary widely in content and require improvement in accuracy. The effect of such standards on patient outcomes remains uncertain. In the future，we should develop more precise triage criteria for elderly trauma，evaluate its clinical application value，and provide basis for optimizing the treatment strategies of elderly trauma patients and improving the clinical outcomes of patients.
Key words： Elderly; Trauma; Triage; Scoping Review
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