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References flowchart.
- FIGURE 2
Index admission characteristics: sensitivity analysis. Studies that included patients who were readmitted after 48 hours in the control arm were removed in our sensitivity analysis.
Tables
Study, y Country Design Setting Population N Early Unplanned Readmissions, n (%) Age, y Bernard et al,15 2013 United States Retrospective cohort Tertiary care pediatric academic hospital Patients with ≥1 PICU admission during a single hospitalization; admissions to the cardiac intensive care team were excluded 212 70 (33.01) NR Czaja et al,12 2013 United States Retrospective cohort 73 PICUs in VPS (2005–2008); most were academic centers with an accredited pediatric residency program All patients admitted to the PICU; children who died on their first admission or who were directly discharged from the ICU were excluded 3798 1499 (39.47) NR De Kroon et al,16 2013 Netherlands Case-control Children’s hospital All patients admitted to the PICU 3368 1024 (NA) NR Edwards et al,13 2013 United States Retrospective cohort 90 North American PICUs in VPS (2009–2011) All patients admitted to the PICU 95 028 1161 (1.22) 0–18 Kaur et al,14 2018 United States Case-control Academic children’s hospital with a 16-bed mixed medical-surgical unit All patients (0–17 y) who required unscheduled readmission to the PICU within 48 h were included. Controls were selected randomly from all patients who did not require readmission. 256 86 (NA) 3.75 (0.8–10.1)a Khan et al,17 2014 Pakistan Retrospective cohort PICU and step-down unit at a university hospital Pediatric patients <15 y 1022 24 (2.34) 4.07 (0–8.49)b,c Kotsakis et al,18 2016 Canada Case-control Academic pediatric hospital with all subspecialty services available Patients (index discharge) who survived to PICU discharge and were discharged to hospital wards 6370 135 (NA) 5.27 (0.96–12.87)a Linton et al,19 2009 Australia Case-control Children’s hospital with the largest PICU in the country; access to all medical and surgical pediatric subspecialties Children discharged from ICU 375 114 (NA) 3.65 (0–19)c Mandell et al,20 2015 United States Case-control Tertiary care, academic, freestanding children’s hospital All patients ≤18 from the PICU to the pediatric ward; patients who were discharged directly from the PICU to home or transferred to another PICU were excluded 189 38 (NA) 7.27 (1.4–14.3)a Odetola et al,21 2007 United States Case-control (retrospective analysis of prospectively collected data) 16-bed medical-surgical PICU and a 15-bed pediatric cardiac ICU at a tertiary care university children’s hospital Data collected prospectively within the PRISM III data 8885 711 (NA) 2.93 (0.46–10.68)a Wagh et al,22 2013 United Kingdom Case-control (retrospective analysis of prospectively collected data) 22-bed cardiac and general PICU with ∼1100 admissions per year PICU episodes were evaluated; no further details provided 9471 330 (NA) NR Study Design Selection Comparability of Cases and Controls Based on Design or Analysis Exposure Is the Case Definition Adequate? Are the Cases Representative? Is the Control Definition Adequate? Was the Control Selection Appropriate? Ascertainment of Exposure Same Method of Ascertainment for Cases and Controls Nonresponse Rate Bernard et al,15 2013 Retrospective cohort Yes, based on medical records Yes, consecutive patients Patients admitted to the same PICU who required readmission >48 h later Hospital controls Yes, per design Yes, based on secure records Yes 0 Czaja et al,12 2013 Retrospective cohort Yes, based on secure database information Yes, consecutive patients Patients admitted to the same PICUs who required readmission >48 h later Hospital controls Yes, per design Yes, based on secure records Yes 0 De Kroon et al,16 2013 Case-control Yes, based on secure medical records Yes Yes, no history of PICU readmission Patients admitted to the same PICU who did not require readmission Yes, per design Yes, based on secure medical records Yes 0 Edwards et al,13 2013 Retrospective cohort Yes, based on secure database information Yes Yes, no history of PICU readmission Patients admitted to the PICUs (same database) who did not require readmission Yes, per design Yes, based on secure records Yes 0 Kaur et al,14 2018 Case-control Yes, based on secure database information Yes Yes, no history of PICU readmission Controls were selected randomly from all patients who did not require readmission Yes, per design Yes, based on secure medical records Yes 0 Khan et al,17 2014 Retrospective cohort Yes, based on secure medical records Yes Yes, no history of PICU readmission Patients discharge from the PICU to the step-down unit who did not require readmission to the PICU Yes, per design Yes, based on secure medical records Yes 0 Kotsakis et al,18 2016 Case-control Yes, source of information unclear Yes Yes, no history of PICU readmission Patients admitted to the same PICU who did not require readmission Yes, per design Yes, based on secure medical records Yes 0 Linton et al,19 2009 Case-control Yes, based on secure medical records Yes Yes, no history of PICU readmission Patients admitted to the same PICU who did not require readmission Yes, per design Yes, based on secure medical records Yes 0 Mandell et al,20 2015 Case-control Yes, based on secure medical records Yes Yes, no history of PICU readmission Patients admitted to the same PICU who did not require readmission after being discharge to the pediatric ward Yes, per design Yes, based on secure medical records Yes 0 Odetola et al,21 2007 Case-control Yes, based on secure database information Yes Yes, no history of PICU readmission Patients admitted to the same PICU who did not require readmission Yes, per design Yes, based on secure medical records Yes 0 Wagh et al,22 2013 Case-control Yes, based on secure database information Yes Yes, patients discharged from the same PICU at different time Yes, patients from the same PICU Yes, per design Yes, based on secure records Yes 0
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Is Unplanned PICU Readmission a Proper Quality Indicator? A Systematic Review and Meta-analysis
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