摘要
目的 提取并汇总国内外老年髋部骨折患者衰弱管理的最佳证据,为制订适合临床实践的衰弱管理方案提供参考.方法 按照循证资源"6S"模型,系统检索国内外数据库及指南网关于老年髋部骨折衰弱管理相关的证据,包括指南、证据总结、系统评价、最佳实践、专家共识等,检索时限为2018年6月-2023年12月.由2名研究人员独立对文献进行整体评价,选择符合纳入、排除标准的文献,评价文献质量并提取证据.结果 共检索到2 589篇文献,最终纳入20篇,其中7篇指南、2篇最佳实践标准、1篇证据总结、7篇专家共识、3篇系统评价.总结的最佳证据包括老年髋部骨折患者衰弱筛查、多学科协作、疼痛管理、营养管理、功能锻炼、出院指导6个方面,共45条推荐意见.结论 本研究总结的老年髋部骨折患者衰弱管理最佳证据具有一定的前沿性与科学性,可以为临床医护人员实施衰弱管理提供相应的循证依据.建议使用相关证据时先进行本土化调试,结合所在医疗机构的环境、医疗政策、患者意向等综合评估后再开展证据转化的实施性研究.
Abstract
Objective To extract and summarize the best available evidence on frailty management for elderly patients with hip fractures,providing a reference for developing clinically applicable management protocols.Methods Following the"6S"evidence model,a systematic search was conducted across national and international databases and guideline websites for evidence on frailty management in elderly hip fracture patients,including guidelines,evidence summaries,systematic reviews,best practices,and expert consensus,with a search period from June 2018 to December 2023.Two researchers independently evaluated the quality of the literature,selecting studies that met inclusion criteria and extracting relevant evidence.Results A total of 2 589 articles were identified,with 20 articles included:seven guidelines,two best practice standards,one evidence summary,seven expert consensus documents,and three systematic reviews.The best evidence was summarized across six domains:frailty screening,multidisciplinary collaboration,pain management,nutritional management,functional exercise,and discharge guidance,yielding 45 recommendations.Conclusions The best evidence for frailty management in elderly patients with hip fractures summarized in this study offers valuable insights and scientific guidance for clinical healthcare providers.When applying this evidence,it is recommended to first adapt it to local contexts,considering factors such as institutional environment,healthcare policies,and patient preferences,before conducting implementation research on evidence translation.
维普
万方数据