成人术中压力性损伤评估量表预测效能的Meta分析  

Predictive performance of adult intraoperatively acquired pressure injury assessment scales:a Meta-analysis

作　　者：许冰吟 李智[2] 李冬雪[2] 苏琼[3] Xu Bingyin;Li Zhi;Li Dongxue;Su Qiong(School of Nursing,Chongqing Medical University,Chongqing 400010,China;Operating Room,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Health Care Department,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)

机构地区：[1]重庆医科大学护理学院,重庆400010 [2]重庆医科大学附属第二医院手术室,重庆400010 [3]重庆医科大学附属第二医院保健科,重庆400010

出　　处：《中华现代护理杂志》2023年第12期1576-1582,共7页Chinese Journal of Modern Nursing

基　　金：重庆市2019年科卫联合医学科研重点项目(2019ZDXM050);重庆医科大学2019护理骨干科研项目基金(201904)。

摘　　要：目的:系统分析和评价成人术中获得性压力性损伤(IAPI)5种评估量表(Munro量表、Norton量表、Braden量表、Scott Triggers量表、Waterlow量表)的预测能力,为临床选择合适的评估量表提供参考。方法:本研究为Meta分析。计算机检索维普网、万方数据库、中国知网、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library等数据库,搜集与成人术中IAPI评估量表相关的研究,检索时限均为建库至2021年12月2日。2名研究者独立筛选文献、对纳入文献进行质量评价和数据提取,对各量表的灵敏度和特异度进行描述性分析;使用RevMan 5.3软件制作受试者工作特征(ROC)曲线,并计算曲线下面积。结果:共纳入13篇文献,累计纳入病例5 640例,IAPI发生率为8.09%(456/5 640)。对8篇关于Braden量表的文献合并后进行Meta分析,合并后发现量表的灵敏度为0.76[95%置信区间( CI):0.72~0.81],特异度为0.53(95% CI:0.51~0.54),ROC曲线下面积为0.70。对7篇关于Munro量表的文献合并分析后发现量表的灵敏度为0.81(95% CI:0.75~0.86),特异度为0.79(95% CI:0.77~0.81),ROC曲线下面积为0.84。对4篇关于Waterlow量表的文献合并分析后发现量表的灵敏度为0.78(95% CI:0.69~0.86),特异度为0.60(95% CI:0.58~0.62),ROC曲线下面积为0.72。对3篇关于Norton量表的文献合并分析后发现量表的灵敏度为0.67(95% CI:0.56~0.77),特异度为0.69(95% CI:0.67~0.71),ROC曲线下面积为0.74。对3篇关于Scott Triggers量表的文献合并分析后发现量表的灵敏度为0.80(95% CI:0.68~0.89),特异度为0.53(95% CI:0.50~0.56),ROC曲线下面积为0.67。 结论:作为手术患者的专用量表,Munro量表的灵敏度、特异度、ROC曲线下面积优于其他评估量表,推荐手术室护理人员优先选择Munro量表对成人手术患者进行IAPI发生风险的评估。Objective To systematically analyze and evaluate the predictive performance of 5 assessment scales(Munro Pressure Ulcer Risk Assessment Scale,Norton Scale,Braden Scale,Scott Triggers Scale and Waterlow Scale)for adult intraoperatively acquired pressure injury(IAPI),so as to provide reference for the selection of appropriate assessment scales.Methods This study is a Meta-analysis.Research on the adult IAPI assessment scale was retrieved through computers in databases such as VIP,WanFang Data,China National Knowledge Infrastructure,China Biology Medicine disc,PubMed,Embase,Web of Science and Cochrane Library.The search time limit was from the establishment of the database to December 2,2021.Two researchers independently screened the article,conducted quality evaluation and data extraction on the included article,and conducted descriptive analysis on the sensitivity and specificity of each scale.The researchers used RevMan 5.3 software to create a receiver operating characteristic(ROC)curve and calculate the area under the curve.Results A total of 13 articles were included,with a total of 5640 cases,and the incidence of IAPI was 8.09%(456/5640).A Meta-analysis was conducted after merging 8 articles on the Braden scale.After merging,it was found that the sensitivity of the scale was 0.76[95%confidence interval(CI)(0.72,0.81)],the specificity was 0.53[95%CI(0.51,0.54)],and the area under the ROC curve was 0.70.After a combined analysis of 7 articles on the Munro Pressure Ulcer Risk Assessment Scale,it was found that the sensitivity of the scale was 0.81[95%CI(0.75,0.86)],the specificity was 0.79[95%CI(0.77,0.81)],and the area under the ROC curve was 0.84.After a combined analysis of 4 articles on the Waterlow scale,it was found that the sensitivity of the scale was 0.78[95%CI(0.69,0.86)],the specificity was 0.60[95%CI(0.58,0.62)],and the area under the ROC curve was 0.72.After a combined analysis of 3 articles on the Norton scale,it was found that the sensitivity of the scale was 0.67[95%CI(0.56,0.77)],the specificity

关 键 词：META分析 压力性损伤 手术患者 评估量表 

分 类 号：R472.3[医药卫生—护理学]