不同筛查工具识别急诊患者安宁疗护需求准确性的Meta分析

doi:10.3761/j.issn.2096-7446.2024.05.007

Abstract

Abstract: Objective To evaluate the accuracy of commonly used hospice screening tools to identify hospice needs of emergency department patients. Methods We searched CNKI,Wanfang Database,China Biomedical Literature Database,PubMed,Cochrane Library,Embase,CINAHL,and Web of Science for all studies on hospice screening tools applied to emergency department patients from the time of database construction to November 2023,and two researchers independently performed literature screening,data extraction,and literature quality evaluation,and Stata 15.0 software was used to perform meta-analysis of the profile data. Results A total of 20 papers were included,containing 20,122 patients,involving a total of 6 screening tools,of which the most commonly used was the Surprise Questions（SQ;n=9）,followed by the Palliative Care and Rapid Emergency Screening（P-CaRES;n=7） and the Screen for Palliative and End-of-life care needs in the Emergency Department（SPEED;n=2）. 9 studies identified hospice needs by assessing the SQ for predicting patient mortality. Overall,the sensitivity of the SQ for predicting mortality was moderate at 0.72（0.59,0.82） and the specificity was moderate at 0.74（0.62,0.84）.The sensitivity of the SQ for predicting long-term mortality（within 1 year,2 years） was higher at 0.75（0.64,0.84） than the sensitivity of the SQ for predicting short-term mortality（within 1 month,within 3 months） of 0.65（0.35,0.86）. In addition,for emergency admissions or frequent emergency department visits within 1 year,SQ sensitivity was 0.72（0.41,0.90） and specificity was 0.52（0.32,0.72）.P-CaRES predicted mortality with a sensitivity of 0.73（0.57,0.85） and specificity of 0.64（0.48,0.77）. Conclusion The SQ is the most widely used tool for hospice screening in the emergency department,followed by the P-CaRES,and they both have moderate sensitivity and specificity in predicting patient mortality in the next one year,the conclusion that still requires further validation in high-quality,large-sample studies.

Key words: Emergency Department, End-of-Life, Palliative Care, Screening Tool, Meta-Analysis, Evidence-Based Nursing

LI Baiyu, GAO Weiwei, ZHANG Zhufeng, LI Keye, DENG Yayin. Accuracy of different screening tools for identifying hospice needs in emergency department patients：a meta-analysis[J]. Chinese Journal of Emergency and Critical Care Nursing, 2024, 5(5): 427-434.

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Accuracy of different screening tools for identifying hospice needs in emergency department patients：a meta-analysis

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