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首页> 美国卫生研究院文献>BMJ Open Respiratory Research >Factors associated with relapse in adult patients discharged from the emergency department following acute asthma: a systematic review
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Factors associated with relapse in adult patients discharged from the emergency department following acute asthma: a systematic review

机译：急性哮喘后急诊出院的成年患者复发相关因素的系统评价

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A significant proportion of patients discharged from the emergency department (ED) with asthma exacerbations will relapse within 4 weeks. This systematic review summarises the evidence regarding relapses and factors associated with relapse in adult patients discharged from EDs after being treated for acute asthma. Following a registered protocol, comprehensive literature searches were conducted. Studies tracking outcomes for adults after ED management and discharge were included if they involved adjusted analyses. Methodological quality was assessed using the Newcastle–Ottawa Scale (NOS) and the Risk of Bias (RoB) Tool. Results were summarised using medians and IQRs or mean and SD, as appropriate. 178 articles underwent full-text review and 10 studies, of various methodologies, involving 32 923 patients were included. The majority of the studies were of high quality according to NOS and RoB Tool. Relapse proportions were 8±3%, 12±4% and 14±6% at 1, 2 and 4 weeks, respectively. Female sex was the most commonly reported and statistically significant factor associated with an increased risk of relapse within 4 weeks of ED discharge for acute asthma. Other factors significantly associated with relapse were past healthcare usage and previous inhaled corticosteroids (ICS) usage. A median of 17% of patients who are discharged from the ED will relapse within the first 4 weeks. Factors such as female sex, past healthcare usage and ICS use at presentation were commonly and significantly associated with relapse occurrence. Identifying patients with these features could provide clinicians with guidance during their ED discharge decision-making.
机译：从急诊科（ED）出院的哮喘加重患者中，很大一部分将在4周内复发。这篇系统的综述总结了在接受急性哮喘治疗后从EDs出院的成年患者中复发和与复发相关因素的证据。按照注册的协议，进行了全面的文献检索。如果他们涉及调整后的分析，则包括追踪急诊治疗和出院后成人结局的研究。使用纽卡斯尔-渥太华量表（NOS）和偏倚风险（RoB）工具评估方法学质量。适当时使用中位数和IQR或均值和SD汇总结果。 178篇文章接受了全文审查，并进行了10项不同方法的研究，涉及32至923例患者。根据NOS和RoB Tool，大多数研究都是高质量的。在1、2和4周时，复发率分别为8±3％，12±4％和14±6％。女性性是最常见的报道，并且是与急性哮喘ED出院后4周内复发风险增加相关的统计学上显着因素。与复发显着相关的其他因素是过去的医疗保健使用和先前吸入的皮质类固醇（ICS）使用。从ED出院的患者中，有17％会在前4周内复发。诸如女性性别，既往医疗习惯和演讲时使用ICS等因素通常与复发的发生密切相关。识别具有这些特征的患者可以为临床医生在ED出院决策过程中提供指导。

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