Intensive care unit length of stay is reduced by protocolized family support intervention: a systematic review and meta-analysis View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-07-03

AUTHORS

Hyun Woo Lee, Yeonkyung Park, Eun Jin Jang, Yeon Joo Lee

ABSTRACT

PurposeThis study aimed to elucidate the impact of protocolized family support intervention on length of stay (LOS) in the intensive care unit (ICU) through a systematic review and meta-analysis.MethodsMedline, EMBASE, the Cochrane Central Register of Controlled Trials, and other web-based databases were referenced since inception until November 26, 2018. We included randomized-controlled trials wherein protocolized family support interventions were conducted for enhanced communication and shared medical decision-making. LOS (in days) and mortality were evaluated using a random-effects model, and adjusted LOS was estimated using a mixed-effects model.ResultsWe included seven randomized-controlled trials with 3477 patients. Protocolized family support interventions were found to significantly reduce the ICU LOS {mean difference = − 0.89 [95% confidence interval (CI) = − 1.50 to − 0.27]} and hospital LOS [mean difference = − 3.78 (95% CI = − 5.26 to − 2.29)]; the results of the mixed-effect model showed that they significantly reduced ICU LOS after adjusting for the therapeutic goal [mean difference = − 1.30 (95% CI = − 2.35 to − 0.26)], methods of measurement [mean difference = − 0.89 (95% CI = − 1.55 to − 0.22)], and timing of intervention [mean difference = − 1.05 (95% CI = − 2.05 to − 0.05)]. Similar results were found after adjusting for patients’ disease severity [mean difference = − 1.21 (95% CI = − 2.03 to − 0.39)] and the trim-and-fill method [mean difference = − 0.86 (95% CI = − 1.44 to − 0.28)]. There was no difference in mortality rate in ICU and hospital between the protocolized intervention and control groups.ConclusionsProtocolized family support intervention for enhanced communication and shared decision-making with the family reduced ICU LOS in critically ill patients without impacting mortality. More... »

PAGES

1072-1081

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00134-019-05681-3

DOI

http://dx.doi.org/10.1007/s00134-019-05681-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1117734023

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/31270579


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