SynthesisCritical care (London, England)2018
Indicators of intensive care unit capacity strain: a systematic review.
Synthesis in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
32 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patients and staff perspectives on hospital ward strain and its impacts on patient care and the workforce: a mixed-methods systematic review.International journal for quality in health care : journal of the International Society for Quality in Health Care · 2026Pooled it
- Implementation and feasibility evaluation of a standard set of intensive care unit discharge criteria in a prospective before-after observational pilot study.BMC health services research · 2026Observational
- Intensive care patients eligible for intermediate care unit-level care: a single-centre prospective cohort study in Belgium.Critical care science · 2026Article
- Strain in the Pediatric Intensive Care Unit and its Association with Patient Outcomes.Journal of intensive care medicine · 2025Article
- Policy Proposals for Mitigating Intensive Care Unit Strain: Insights from the COVID-19 Pandemic.Annals of the American Thoracic Society · 2024Article
- Feasibility of forecasting future critical care bed availability using bed management data.BMJ health & care informatics · 2024Article
- Development of a Simple Scoring System for Predicting Discharge Safety from the Medical ICU to Low-Acuity Wards: The Role of the Sequential Organ Failure Assessment Score, Albumin, and Red Blood Cell Distribution Width.Journal of personalized medicine · 2024Article
- A quality improvement study on how a simulation model can help decision making on organization of ICU wards.BMC health services research · 2024Article
- Human resource management at the intensive care unit: A pragmatic review and future research agenda for building a learning health system.Learning health systems · 2024Article
- The effect of occupational coping self-efficacy on presenteeism among ICU nurses in Chinese public hospitals: a cross-sectional study.Frontiers in psychology · 2024Article
- Flow-Sizing Critical Care Resources.Critical care medicine · 2023Article
- Fatigue as a Cause of Professional Dissatisfaction Among Chinese Nurses in Intensive Care Unit During COVID-19 Pandemic.Risk management and healthcare policy · 2023Article
- Recommendations for developing clinical care protocols during pandemics: From theory and practice.Best practice & research. Clinical anaesthesiology · 2021Review
- Assessment of a novel marker of ICU strain, the ICU Activity Index, during the COVID-19 pandemic in Victoria, Australia.Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine · 2021Article
- Risk Scoring System of Mortality and Prediction Model of Hospital Stay for Critically Ill Patients Receiving Parenteral Nutrition.Healthcare (Basel, Switzerland) · 2021Article
- Availability of Pediatric Inpatient Services in the United States.Pediatrics · 2021Article
- Variation in Initial U.S. Hospital Responses to the Coronavirus Disease 2019 Pandemic.Critical care medicine · 2021Observational
- A qualitative study of physician perceptions and experiences of caring for critically ill patients in the context of resource strain during the first wave of the COVID-19 pandemic.BMC health services research · 2021Article
- US Hospital Capacity Managers' Experiences and Concerns Regarding Preparedness for Seasonal Influenza and Influenza-like Illness.JAMA network open · 2021Article
- Demand for Intensive Care beds and patient classification according to the priority criterion.Revista latino-americana de enfermagem · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundStrained intensive care unit (ICU) capacity represents a fundamental supply-demand mismatch in ICU resources. Strain is likely to be influenced by a range of factors; however, there has been no systematic evaluation of the spectrum of measures that may indicate strain on ICU capacity.
methodsWe performed a systematic review to identify indicators of strained capacity. A comprehensive peer-reviewed search of MEDLINE, EMBASE, CINAHL, Cochrane Library, and Web of Science Core Collection was performed along with selected grey literature sources. We included studies published in English after 1990. We included studies that: (1) focused on ICU settings; (2) included description of a quality or performance measure; and (3) described strained capacity. Retrieved studies were screened, selected and extracted in duplicate. Quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Analysis was descriptive.
resultsOf 5297 studies identified in our search; 51 fulfilled eligibility. Most were cohort studies (n = 39; 76.5%), five (9.8%) were case-control, three (5.8%) were cross-sectional, two (3.9%) were modeling studies, one (2%) was a correlational study, and one (2%) was a quality improvement project. Most observational studies were high quality. Sixteen measures designed to indicate strain were identified 110 times, and classified as structure (n = 4, 25%), process (n = 7, 44%) and outcome (n = 5, 31%) indicators, respectively. The most commonly identified indicators of strain were ICU acuity (n = 21; 19.1% [process]), ICU readmission (n = 18; 16.4% [outcome]), after-hours discharge (n = 15; 13.6% [process]) and ICU census (n = 13; 11.8% [structure]). There was substantial heterogeneity in the operational definitions used to define strain indicators across studies.
conclusionsWe identified and characterized 16 indicators of strained ICU capacity across the spectrum of healthcare quality domains. Future work should aim to evaluate their implementation into practice and assess their value for evaluating strategies to mitigate strain. SYSTEMATIC REVIEW REGISTRATION: This systematic review was registered at PROSPERO (March 27, 2015; CRD42015017931 ).
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