SynthesisIntensive care medicine2018
Out-of-hours discharge from intensive care, in-hospital mortality and intensive care readmission rates: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 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
28 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medication-related interventions to improve medication safety and patient outcomes on transition from adult intensive care settings: a systematic review and meta-analysis.BMJ quality & safety · 2022Pooled it
- Impact of the ICU admission of patients with COVID-19 on the outcomes of patients without COVID-19 in the ICU: a retrospective cohort study.Journal of anesthesia · 2026Article
- Non-pharmacological post-intensive care interventions to improve patient outcome following critical illness: a scoping review.Critical care (London, England) · 2025Review
- Impact of patient admission source on respiratory intensive care unit outcomes.BMC pulmonary medicine · 2025Observational
- Circumstantial risk factors for death after intensive care unit-to-unit inter-hospital transfer-a Swedish registry study.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- Critical Care Challenges and Mortality Predictors in Older Adults: A Comprehensive Cohort Analysis.Cureus · 2024Article
- Outcomes of traumatically injured patients after nighttime transfer from the intensive care unit.Trauma surgery & acute care open · 2024Article
- Patient transfer from intensive care units to general wards: An exploratory qualitative study of ward nurses' experiences of patient safety.Nursing open · 2023Article
- Article
- Clinical frailty and polypharmacy in older emergency critical care patients: a single-centre retrospective case series.European journal of hospital pharmacy : science and practice · 2023Article
- Neonatal intensive care unit occupancy rate and probability of discharge of very preterm infants.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Predictive Modeling for Readmission to Intensive Care: A Systematic Review.Critical care explorations · 2023Review
- A systematic review on quality of life (QoL) of patients with peritoneal metastasis (PM) who underwent pressurized intraperitoneal aerosol chemotherapy (PIPAC).Pleura and peritoneum · 2022Review
- Mortality and readmission rates of patients discharged in-hours and out-of-hours from a British ICU over a 3-year period.Scientific reports · 2022Article
- Incidence, risk and impact of ICU readmission on patient outcomes and resource utilisation in tertiary level ICUs in Nepal: A cohort study.Wellcome open research · 2022Article
- A Simple Scoring Tool to Predict Medical Intensive Care Unit Readmissions Based on Both Patient and Process Factors.Journal of general internal medicine · 2021Article
- Problems in care and avoidability of death after discharge from intensive care: a multi-centre retrospective case record review study.Critical care (London, England) · 2021Article
- Association between intensive care unit occupancy at discharge, afterhours discharges, and clinical outcomes: a historical cohort study.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2020Article
- Assessment of Costs of Avoidable Delays in Intensive Care Unit Discharge.JAMA network open · 2020Observational
- Accuracy of Clinicians' Ability to Predict the Need for Intensive Care Unit Readmission.Annals of the American Thoracic Society · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
purposeDischarge from an intensive care unit (ICU) out of hours is common. We undertook a systematic review and meta-analysis to explore the association between time of discharge and mortality/ICU readmission.
methodsWe searched Medline, Embase, Web of Knowledge, CINAHL, the Cochrane Library and OpenGrey to June 2017. We included studies reporting in-hospital mortality and/or ICU readmission rates by ICU discharge "out-of-hours" and "in-hours". Inclusion was limited to patients aged ≥ 16 years discharged alive from a non-specialist ICU to a lower level of hospital care. Studies restricted to specific diseases were excluded. We assessed study quality using the Newcastle Ottowa Scale. We extracted published data, summarising using a random-effects meta-analysis.
resultsOur searches identified 1961 studies. We included unadjusted data from 1,191,178 patients from 18 cohort studies (presenting data from 1994 to 2014). "Out of hours" had multiple definitions, beginning between 16:00 and 22:00 and ending between 05:59 and 09:00. Patients discharged out of hours had higher in-hospital mortality [relative risk (95% CI) 1.39 (1.24, 1.57) p < 0.0001] and readmission rates [1·30 (1.19, 1.42), p < 0.001] than patients discharged in hours. Heterogeneity was high (I
conclusionsOut-of-hours discharge from an ICU is strongly associated with both in-hospital death and ICU readmission. These effects persisted across all definitions of "out of hours" and across healthcare systems in different geographical locations. Whether these increases in mortality and readmission result from patient differences, differences in care, or a combination remains unclear.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.