Oxygen therapy in early warning scores: a systematic review and meta-analysis.

This ordinal binary approach may fail to recognise deteriorating patients who have an increasing oxygen requirement with otherwise stable observations.

这种序数二元方法可能无法识别出那些尽管其他观察指标稳定但对氧气需求不断增加的病情恶化的患者。

It is unclear whether weighting oxygen beyond binary scoring improves recognition of deterioration.

目前尚不清楚，超过二元评分的氧气加权是否能改善病情恶化的识别。

aims

We aimed to describe all general adult EWS that grade oxygen beyond binary scoring (part 1).

我们的目标是描述所有对成人早期预警评分系统（EWS）进行超过二元评分的氧气分级（第一部分）。

Where reported, we summarised the performance of graded oxygen EWS in comparison to binary scoring (part 2).

在报告中，我们总结了分级氧合早期预警评分（EWS）与二元评分相比的性能（第2部分）。

Methods

We systematically reviewed the literature, searching Embase, MEDLINE, CINAHL, Cochrane Central and Web of Science.

我们系统地回顾了文献，在Embase、MEDLINE、CINAHL、Cochrane中心和Web of Science中进行了搜索。

We included studies of vital-sign-only EWS, for adult inpatients, which included grades of oxygen therapy above binary weighting ('graded oxygen weighting').

我们纳入了仅包含生命体征早期预警评分（EWS）的研究，这些研究针对的是成年住院患者，并包括了高于二元加权的氧气治疗等级（'分级氧气加权'）。

We summarised methods of including graded oxygen therapy.

我们总结了包含分级氧气治疗的方法。

We performed a random-effects meta-analysisof the effects of graded oxygen weighting inclusion in comparison to binary weighting.

我们进行了一项随机效应荟萃分析，比较了分级氧加权纳入与二元加权的效果。

Risk of bias was assessed using the Prediction model Risk Of Bias ASsessment Tool.

使用预测模型风险偏倚评估工具评估了偏倚风险。

Results

15 studies reported the development of 16 EWS with graded oxygen weighting, classified by flow rate, delivery device and/or fraction of inspired oxygen.

15项研究报告了16种分级氧加权评分系统的开发，这些评分系统根据流量、输送装置和/或吸入氧分数进行分类。

Four studies compared graded oxygen EWS to binary oxygen EWS.

四项研究比较了分级氧加权EWS与二元氧加权EWS。

Meta-analysisshowed a significant improvement in the performance of graded oxygen EWS over binary oxygen EWS (logit(AUROC)=0.19; 95% CI 0.094 to 0.285; p=0.002). 15/16 models were at high risk of bias.

荟萃分析显示，分级氧预警评分（graded oxygen EWS）在性能上显著优于二元氧预警评分（binary oxygen EWS）（logit(AUROC)=0.19; 95% 置信区间 0.094 至 0.285; p=0.002）。16个模型中有15个存在高风险偏倚。

Conclusions

16 EWS with graded oxygen weighting were identified.

确定了16个具有分级氧加权的EWS。

Graded oxygen models had improved recognition of deterioration.

分级氧疗模型在识别病情恶化方面有所改善。

Future work should explore the optimal method of oxygen classification and how this could be integrated into future EWS.

未来的研究应探索氧疗分类的最佳方法以及如何将其整合到未来的早期预警系统中。

prospero_registration_number

CRD42024443362.

CRD42024443362。