TY - JOUR
T1 - Which Models Can I Use to Predict Adult ICU Length of Stay? A Systematic Review
AU - Verburg, Ilona Willempje Maria
AU - Atashi, Alireza
AU - Eslami, Saeid
AU - Holman, Rebecca
AU - Abu-Hanna, Ameen
AU - de Jonge, Everet
AU - Peek, Niels
AU - de Keizer, Nicolette Fransisca
PY - 2017
Y1 - 2017
N2 - We systematically reviewed models to predict adult ICU length of stay. We searched the Ovid EMBASE and MEDLINE databases for studies on the development or validation of ICU length of stay prediction models. We identified 11 studies describing the development of 31 prediction models and three describing external validation of one of these models. Clinicians use ICU length of stay predictions for planning ICU capacity, identifying unexpectedly long ICU length of stay, and benchmarking ICUs. We required the model variables to have been published and for the models to be free of organizational characteristics and to produce accurate predictions, as assessed by R across patients for planning and identifying unexpectedly long ICU length of stay and across ICUs for benchmarking, with low calibration bias. We assessed the reporting quality using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies. The number of admissions ranged from 253 to 178,503. Median ICU length of stay was between 2 and 6.9 days. Two studies had not published model variables and three included organizational characteristics. None of the models produced predictions with low bias. The R was 0.05-0.28 across patients and 0.01-0.64 across ICUs. The reporting scores ranged from 49 of 78 to 60 of 78 and the methodologic scores from 12 of 22 to 16 of 22. No models completely satisfy our requirements for planning, identifying unexpectedly long ICU length of stay, or for benchmarking purposes. Physicians using these models to predict ICU length of stay should interpret them with reservation
AB - We systematically reviewed models to predict adult ICU length of stay. We searched the Ovid EMBASE and MEDLINE databases for studies on the development or validation of ICU length of stay prediction models. We identified 11 studies describing the development of 31 prediction models and three describing external validation of one of these models. Clinicians use ICU length of stay predictions for planning ICU capacity, identifying unexpectedly long ICU length of stay, and benchmarking ICUs. We required the model variables to have been published and for the models to be free of organizational characteristics and to produce accurate predictions, as assessed by R across patients for planning and identifying unexpectedly long ICU length of stay and across ICUs for benchmarking, with low calibration bias. We assessed the reporting quality using the Checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies. The number of admissions ranged from 253 to 178,503. Median ICU length of stay was between 2 and 6.9 days. Two studies had not published model variables and three included organizational characteristics. None of the models produced predictions with low bias. The R was 0.05-0.28 across patients and 0.01-0.64 across ICUs. The reporting scores ranged from 49 of 78 to 60 of 78 and the methodologic scores from 12 of 22 to 16 of 22. No models completely satisfy our requirements for planning, identifying unexpectedly long ICU length of stay, or for benchmarking purposes. Physicians using these models to predict ICU length of stay should interpret them with reservation
U2 - https://doi.org/10.1097/CCM.0000000000002054
DO - https://doi.org/10.1097/CCM.0000000000002054
M3 - Article
C2 - 27768612
SN - 0090-3493
VL - 45
SP - e222-e231
JO - Critical Care Medicine
JF - Critical Care Medicine
IS - 2
ER -