Journal article
Impact of Telemedicine Intensive Care Unit Coverage on Patient Outcomes A Systematic Review and Meta-analysis
Archives of internal medicine (1960), Vol.171(6), pp.498-506
03/28/2011
DOI: 10.1001/archinternmed.2011.61
PMID: 21444842
Abstract
Background: Although remote intensive care unit (ICU) coverage is rapidly being adopted to enhance access to intensivists, its effect on patient outcomes is unclear. We conducted a meta-analysis to examine the impact of telemedicine ICU (tele-ICU) coverage on mortality and length of stay (LOS).
Methods: We conducted a systematic review of studies published from January 1, 1950, through September 30, 2010, using PubMed, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Global Health, Web of Science, the Cochrane Library, and conference abstracts. We included studies that reported data on the primary outcomes of ICU and in-hospital mortality or on the secondary outcomes of ICU and hospital LOS.
Results: We identified 13 eligible studies involving 35 ICUs. All the studies used a before-and-after design. The studies included 41 374 patients (15 667 pre-tele-ICU and 25 707 post-tele-ICU patients). Tele-ICU coverage was associated with a reduction in ICU mortality (pooled odds ratio, 0.80; 95% confidence interval [CI], 0.66-0.97; P = .02) but not in-hospital mortality for patients admitted to an ICU (pooled odds ratio, 0.82; 95% CI, 0.65-1.03; P = .08). Similarly, tele-ICU coverage was associated with a reduction in ICU LOS (mean difference, -1.26 days; 95% CI, -2.21 to -0.30; P = .01) but not hospital LOS(mean difference, -0.64; 95% CI, -1.52 to 0.25; P = .16).
Conclusion: Tele-ICU coverage is associated with lower ICU mortality and LOS but not with lower in-hospital mortality or hospital LOS.
Details
- Title: Subtitle
- Impact of Telemedicine Intensive Care Unit Coverage on Patient Outcomes A Systematic Review and Meta-analysis
- Creators
- Lance Brendan Young - Veterans Health AdministrationPaul S. Chan - University of MissouriXin Lu - University of IowaBrahmajee K. Nallamothu - University of Michigan Medical SchoolComilla Sasson - University of Colorado Anschutz Medical CampusPeter M. Cram - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Archives of internal medicine (1960), Vol.171(6), pp.498-506
- DOI
- 10.1001/archinternmed.2011.61
- PMID
- 21444842
- NLM abbreviation
- Arch Intern Med
- ISSN
- 0003-9926
- eISSN
- 1538-3679
- Publisher
- American Medical Association
- Number of pages
- 9
- Grant note
- Veterans Health Administration; US Department of Veterans Affairs Health Services Research and Development Veterans Affairs Midwest Rural Health Resource Center Department of Veterans Affairs; US Department of Veterans Affairs Office of Research and Development
- Language
- English
- Date published
- 03/28/2011
- Academic Unit
- Preventive and Community Dentistry; Dentistry Administration
- Record Identifier
- 9984367634402771
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