کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
8931292 | 1644539 | 2015 | 12 صفحه PDF | دانلود رایگان |
عنوان انگلیسی مقاله ISI
Risk assessment tools validated for patients undergoing emergency laparotomy: a systematic review
ترجمه فارسی عنوان
ابزارهای ارزیابی ریسک برای بیماران تحت لاپاراتومی اورژانس معتبر: یک بررسی سیستماتیک
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کلمات کلیدی
لاپاروتومی اضطراری، مرگ و میر پس از عمل، ابزار پیش آگهی، تنظیم خطر، ارزیابی ریسک،
موضوعات مرتبط
علوم پزشکی و سلامت
پزشکی و دندانپزشکی
بیهوشی و پزشکی درد
چکیده انگلیسی
Emergency laparotomies are performed commonly throughout the world, but one in six patients die within a month of surgery. Current international initiatives to reduce the considerable associated morbidity and mortality are founded upon delivering individualised perioperative care. However, while the identification of high-risk patients requires the routine assessment of individual risk, no method of doing so has been demonstrated to be practical and reliable across the commonly encountered spectrum of presentations, co-morbidities and operative procedures. A systematic review of Embase and Medline identified 20 validation studies assessing 25 risk assessment tools in patients undergoing emergency laparotomy. The most frequently studied general tools were APACHE II, ASA-PS and P-POSSUM. Comparative, quantitative analysis of tool performance was not feasible due to the heterogeneity of study design, poor reporting and infrequent within-study statistical comparison of tool performance. Reporting of calibration was notably absent in many prognostic tool validation studies. APACHE II demonstrated the most consistent discrimination of individual outcome across a variety of patient groups undergoing emergency laparotomy when used either preoperatively or postoperatively (area under the curve 0.76-0.98). While APACHE systems were designed for use in critical care, the ability of APACHE II to generate individual risk estimates from objective, exclusively preoperative data items may lead to better-informed shared decisions, triage and perioperative management of patients undergoing emergency laparotomy. Future endeavours should include the recalibration of APACHE II and P-POSSUM in contemporary cohorts, modifications to enable prediction of morbidity and assessment of the impact of adoption of these tools on clinical practice and patient outcomes.
ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: British Journal of Anaesthesia - Volume 115, Issue 6, December 2015, Pages 849-860
Journal: British Journal of Anaesthesia - Volume 115, Issue 6, December 2015, Pages 849-860
نویسندگان
C.M. Oliver, E. Walker, S. Giannaris, M.P.W. Grocott, S.R. Moonesinghe,