成人癫痫监测单元的质量和安全性：系统评价和Meta分析_Journal of Epilepsy

Authors：

Khara M.Sauro , NatalieWiebe , SophieMacrodimitris , 高慧 , 慕洁

Corresponding author：

Keywords：

癫痫监测单元; 护理质量; 安全性; 视频脑电图

DOI：

10.7507/2096-0247.20170025

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癫痫监测单元 (Epilepsy monitoring unit，EMU) 在优化癫痫人群管理方面是一项很有价值的资源，但也许会因为在其停止治疗和诱导发作的过程而将患者置于一定的风险之中。研究目的是总结已有的关于EMU质量和安全性的数据，从而得出能够指导未来EMU发展相关的一些指标。根据系统评价和Meta分析推荐的分析和汇报标准进行系统评价。文献的搜索方法为在6个医学数据库以及会议进展中广泛搜索与EMU相关的名词及其同义词。针对纳入文献，提取病人和EMU的特征信息以及与质量、安全性相关的变量。根据一个共计15项的修正版流行病学观察性研究汇报重点 (Strengthening the Reporting of Observational Studies in Epidemiology，STROBE) 的对照表进行文献质量的评估分析。研究得出的证据建立在描述性统计和Meta分析的基础上。共计搜索出7 601篇相关文献，其中604篇回顾了全文，最终纳入135项研究。由此而得出的分析结果建立在181 823例患者和34项不同的与质量和安全性相关的变量纳入的研究。患者数 (108项研究，中位患者数为171.5例)，患者年龄 (49项研究，中位患者年龄为35.7岁) 以及患者收治入EMU的原因 (34项研究)。其中与质量和安全性相关最普遍的相关汇报为收治入EMU的有效性 (38项研究)。有33项研究 (24.4%) 汇报了不良事件，由此而得出的不良事件发生概率为7%[95% CI(5%-9%)]。这些关于EMU的文献平均质量评估得分为73.3%(方差为17.2)。研究说明了不同研究在汇报EMU的质量及安全性方面有很大的差异。不同研究之间的研究质量也有较大的差异。目前这些发现都突出了在评估EMU急需发展出一套建立在证据和共识基础上的质量评估标准。

Citation： Khara M.Sauro, NatalieWiebe, SophieMacrodimitris, 高慧, 慕洁. 成人癫痫监测单元的质量和安全性：系统评价和Meta分析. Journal of Epilepsy, 2017, 3(2): 167-178. doi: 10.7507/2096-0247.20170025 Copy

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3.	Lynn FH. Incidents: need they be accidents?. Am J Nurs, 1980, 80(2): 1098-1101.
4.	Rohde JM, Myers AH, Vlahov D. Variation in risk for falls by clinicaldepartment: implications for prevention. Infect Control Hosp Epidemiol, 1990, 11(4): 521-524.
5.	Ryvlin P, Nashef L, Lhatoo SD, et al. Incidence and mechanisms of cardio respiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol, 2013, 12(7): 966-977.
6.	Fitzsimons M, Browne G, Kirker J, et al. An international surveyof long-term video/EEG services. J Clin Neurophysiol, 2000, 17(3): 59-67.
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10.	Kontopantelis E, Reeves D. metaan: Random-effects meta-analysis.Stata J, 2010, 10(12): 395-407.
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12.	Shafer PO, Buelow JM, Noe K, et al. A consensus-based approach topatient safety in epilepsy monitoring units: recommendations for preferred practices. Epilepsy Behav, 2012, 25(2): 449-456.
13.	Anonymous. Guideline twelve: guidelines for long-term monitoringfor epilepsy. American Electroencephalographic Society. J Clin Neurophysiol, 1994, 11(6): 88-110.
14.	de Vries EN, Ramrattan MA, Smorenburg SM, et al. The incidence and nature of in-hospital adverse events: a systematic review. Qual SafHealth Care, 2008, 17(7): 216-223.

1. Murray CJ, Vos T, Lozano R, et al. Disability-adjusted life years (DALYs) for 291 diseases and injuries in 21 regions, 1990-2010: a systematicanalysis for the Global Burden of Disease Study 2010. Lancet, 2012, 380(12): 2197-2223.
2. In Mary Jane E, Catharyn TL, Andrea MS, et al. Epilepsyacross the spectrum: promoting health and understanding. Chapter 1: Introduction The National Academies Press, 2012: 1948.
3. Lynn FH. Incidents: need they be accidents?. Am J Nurs, 1980, 80(2): 1098-1101.
4. Rohde JM, Myers AH, Vlahov D. Variation in risk for falls by clinicaldepartment: implications for prevention. Infect Control Hosp Epidemiol, 1990, 11(4): 521-524.
5. Ryvlin P, Nashef L, Lhatoo SD, et al. Incidence and mechanisms of cardio respiratory arrests in epilepsy monitoring units (MORTEMUS): a retrospective study. Lancet Neurol, 2013, 12(7): 966-977.
6. Fitzsimons M, Browne G, Kirker J, et al. An international surveyof long-term video/EEG services. J Clin Neurophysiol, 2000, 17(3): 59-67.
7. Moher D, Liberati A, Tetzlaff J, et al. Preferred reporting items for systematicreviews and meta-analyses: the PRISMA statement. BMJ, 2009, 339(Suppl B): 2535.
8. Institute of Medicine. Crossing the quality chasm. Washington, DC: National Academy Press; 2001.
9. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reportingof Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet, 2007, 370(10): 1453-1457.
10. Kontopantelis E, Reeves D. metaan: Random-effects meta-analysis.Stata J, 2010, 10(12): 395-407.
11. Nyaga VN, Arbyn M, Aerts M. Metaprop: a Stata command to performmeta-analysis of binomial data. Arch Public Health, 2014, 72(3): 39.
12. Shafer PO, Buelow JM, Noe K, et al. A consensus-based approach topatient safety in epilepsy monitoring units: recommendations for preferred practices. Epilepsy Behav, 2012, 25(2): 449-456.
13. Anonymous. Guideline twelve: guidelines for long-term monitoringfor epilepsy. American Electroencephalographic Society. J Clin Neurophysiol, 1994, 11(6): 88-110.
14. de Vries EN, Ramrattan MA, Smorenburg SM, et al. The incidence and nature of in-hospital adverse events: a systematic review. Qual SafHealth Care, 2008, 17(7): 216-223.

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