McPeake, J. , Bateson, M., Christie, F., Robinson, C., Cannon, P. , Mikkelsen, M., Iwashyna, T.J., Leyland, A.H. , Shaw, M. and Quasim, T. (2022) Hospital re-admission after critical care survival: a systematic review and meta-analysis. Anaesthesia, 77(4), pp. 475-485. (doi: 10.1111/anae.15644) (PMID:34967011)
![[img]](https://eprints.gla.ac.uk/style/images/fileicons/text.png) |
Text
259945.pdf - Published Version Available under License Creative Commons Attribution. 422kB |
Abstract
Survivors of critical illness frequently require increased healthcare resources after hospital discharge. We undertook a systematic review and meta-analysis to assess hospital re-admission rates following critical care admission and to explore potential re-admission risk factors. We searched the MEDLINE, Embase and CINAHL databases on 05 March 2020. Our search strategy incorporated controlled vocabulary and text words for hospital re-admission and critical illness, limited to English language. Two reviewers independently applied pre-defined eligibility criteria and assessed quality using the Newcastle Ottawa Score checklist and extracted data. Primary outcome was acute hospital re-admission in the year after critical care discharge. Of the 8851 studies screened, 87 met inclusion criteria and 41 were used within the meta-analysis. The analysis incorporated data from 3,897,597 individual patients and 741,664 re-admission episodes. Pooled estimates for hospital re-admission after critical illness were 16.9% (95%CI: 13.3–21.2%) at 30 days; 31.0% (95%CI: 24.3–38.6%) at 90 days; 29.6% (95%CI: 24.5–35.2%) at six months; and 53.3% (95%CI: 44.4–62.0%) at 12 months. Significant heterogeneity was observed across included studies. Three risk factor contributed to excess acute care rehospitalisation one year after discharge: the presence of comorbidities; events during initial hospitalisation (e.g. the presence of delirium and duration of mechanical ventilation); and subsequent infection during the post-hospital discharge period. Hospital re-admission is common in survivors of critical illness. Careful attention to the management of pre-existing comorbidities during transitions of care may help reduce healthcare utilisation after critical care discharge. Future research should determine if targeted interventions for at-risk critical care survivors can reduce the risk of subsequent rehospitalisation.
| Item Type: | Articles |
|---|---|
| Additional Information: | This study was registered with PROSPERO (CRD420 20170962). JM is funded by a University of Cambridge THIS Institute Research Fellowship. AL is part of the Social and Public Health Sciences Unit, funded by the Medical Research Council and the Scottish Government Chief Scientist Office. |
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Christie, Ms Fiona and Cannon, Dr Paul and Quasim, Professor Tara and Leyland, Professor Alastair and Bateson, Miss Meghan and Shaw, Dr Martin and McPeake, Dr Jo |
| Authors: | McPeake, J., Bateson, M., Christie, F., Robinson, C., Cannon, P., Mikkelsen, M., Iwashyna, T.J., Leyland, A.H., Shaw, M., and Quasim, T. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Nursing and Health Care University Services > Library and Collection Services > Library |
| Journal Name: | Anaesthesia |
| Publisher: | Wiley |
| ISSN: | 0003-2409 |
| ISSN (Online): | 1365-2044 |
| Published Online: | 29 December 2021 |
| Copyright Holders: | Copyright © 2021 The Authors |
| First Published: | First published in Anaesthesia 77(4): 475-485 |
| Publisher Policy: | Reproduced under a Creative Commons licence |
University Staff: Request a correction | Enlighten Editors: Update this record
Altmetric
Altmetric