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. 2019 May 15;19(1):98.
doi: 10.1186/s12911-019-0820-1.

Patient centred variables with univariate associations with unplanned ICU admission: a systematic review

James Malycha  1 , Timothy Bonnici  2 , David A Clifton  3 , Guy Ludbrook  4 , J Duncan Young  5 , Peter J Watkinson  5
Affiliations

Patient centred variables with univariate associations with unplanned ICU admission: a systematic review

James Malycha et al. BMC Med Inform Decis Mak. .

Abstract

Background: Multiple predictive scores using Electronic Patient Record data have been developed for hospitalised patients at risk of clinical deterioration. Methods used to select patient centred variables for inclusion in these scores varies. We performed a systematic review to describe univariate associations with unplanned Intensive Care Unit (ICU) admission with the aim of assisting model development for future scores that predict clinical deterioration.

Methods: Data sources were MEDLINE, EMBASE, CINAHL, CENTRAL and the Cochrane Database of Systematic Reviews. Included studies were published since 2000 describing an association between patient centred variables and unplanned ICU admission determined using univariate analysis. Two authors independently screened titles, abstracts and full texts against inclusion and exclusion criteria. DistillerSR (Evidence Partners, Canada, Ottawa, Ontario) software was used to manage the data and identify duplicate search results. All screening and data extraction forms were implemented within DistillerSR. Study quality was assessed using an adapted version of the Newcastle-Ottawa Scale. Variables were analysed for strength of association with unplanned ICU admission.

Results: The database search yielded 1520 unique studies; 1462 were removed after title and abstract review; 57 underwent full text screening; 16 studies were included. One hundred and eighty nine variables with an evaluated univariate association with unplanned ICU admission were described.

Discussion: Being male, increasing age, a history of congestive cardiac failure or diabetes, a diagnosis of hepatic disease or having abnormal vital signs were all strongly associated with ICU admission.

Conclusion: These findings will assist variable selection during the development of future models predicting unplanned ICU admission.

Trial registration: This study is a component of a larger body of work registered in the ISRCTN registry ( ISRCTN12518261 ).

Keywords: Clinical deterioration; Critical care; EHR; EPR; ICU admission; Intensive care; Predictive scores; Systematic review; Variable selection.

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Conflict of interest statement

Ethics approval and consent to participate

This study was a secondary analysis of published material and did not require ethical approval.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow diagram of the included and excluded studies
See this image and copyright information in PMC

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