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Table 1 The main characteristics of the cohort studies included in this meta-analysis

From: Association between time of discharge from ICU and hospital mortality: a systematic review and meta-analysis

First author/publication year Study location Study design Age (years) Male (%) Definition of night or weekend Disease severity Population Adjustments Outcome OR and 95% CIs NOS score Reference
Santamaria et al./2015 40 ICUs in Australia and New Zealand Prospective multicenter cohort Median (IQR) 63 (49–74) 61 Night (18:00–06:00) APACHE III-J risk of death median (IQR) 0.09 (0.03–0.25) Adult Markers of illness severity at the time of ICU discharge: age, cardiac surgery, treatment limitation order, tracheostomy, ongoing dialysis, parenteral nutrition, and altered conscious state In-hospital mortality 1.16 (0.89, 1.53) 8 [15]
Azevedo et al./2015 5 ICUs in Canada Retrospective multicenter cohort 57.5 (18.0) 57.9 Night (19:00–07:59), weekend (Fri 19:00–Mon 07:59) APACHE II score 19.4 (7.5) Adult Demographics, co-morbidity, APACHE II score at ICU admission, use of mechanical ventilation, ICU length-of-stay, surgical status, admission source, primary diagnostic category, study year, type of hospital In-hospital mortality Night 1.29 (1.14, 1.46), weekend 0.95 (0.84, 1.07) 6 [31]
Gantner et al./2014 103 ICUs contributing to ANZICS APD from 2005 to 2012 Retrospective multicenter cohort After-hours 59.4 (19.8), in-hours 60.3 (19.3) NA Night (18:00–06:00) APACHE III score After-hours 50.0 (25.3), in-hours 46.5 (22.9) Adult APACHE III risk of death at ICU admission, presence of treatment limitation orders at ICU admission, diagnostic category, hospital site In-hospital mortality 1.34 (1.30, 1.38) 7 [30]
Laupland et al./2011 French ICUs The Outcomerea database Retrospective multicenter cohort Median (IQR) 62 (49–75) 61 Night 18:00-07:59) SAPS II score median (IQR) 40 (28–56) Adult Admission SAPSII, medical/surgical classification, presence of septic shock, admission decision to forego life-sustaining therapy(DFLST) order, discharge SOFA score In-hospital mortality 1.54 (1.12, 2.11) 7 [29]
Singh et al./2010 1 ICU in a tertiary care teaching hospital in Australia Retrospective single-center cohort Median 60 61.3 Night (18:00–07:59), weekend (Sat and Sun) APACHE II score median 18 (range, 1–44) Adult Age, APACHE II score at ICU admission, discharge destination In-hospital mortality Night 1.38 (1.01, 1.88), weekend 1.04 (0.73, 1.46) 6 [10]
Hanane et al./2008 3 ICUs of Mayo Medical Center in USA Retrospective single-center cohort Night 61.6 (18.0), day 62.7 (17.8) Night 56.0, day 53.1 Night (19:00–06:59) APACHE III score night 47.6 (21.1), day 44.9 (19.0) Adult DNR order by the time of transfer, the last ICU day APACHE III predicted mortality In-hospital mortality 1.05 (0.64, 1.70) 7 [13]
Laupland et al./2008 4 ICUs in the Calgary Health Region, Alberta, Canada Retrospective single-center cohort Median (IQR) 63.7 (49.9–73.8) 64 Night (18:00–07:59), weekend (Sat and Sun) APACHE II score 25.1 (8.48) Adult Noncardiac surgery, cardiac surgery, age, APACHE II at ICU admission, weekend admission, night admission, regional resident In-hospital mortality Weekday night discharge 1.20 (1.01, 1.41), weekend day discharge 0.81 (0.67, 0.98), weekend night discharge 1.35 (1.05, 1.73) 6 [12]
Pilcher et al./2007 40 ICUs in Australia and New Zealand Retrospective multicenter cohort Night 58.6 (0.08), day: 59.1 (0.17) NA Night (18:00–06:00) APACHE III score night 47.7 (0.2), day: 46.0 (0.1) Adult APACHE III risk of death at admission, emergency admission to ICU In-hospital mortality 1.42 (1.32, 1.53) 6 [9]
Tobin et al./2006 1 ICU in Australia Retrospective single-center cohort 64 (13–98) 65 Night (22:00–06:59), weekend (Fri 18:00–Mon 07:59) APACHE II score median 13 (range 0–53) Adult Age, APACHE II score at admission, origin of admission, treatment category In-hospital mortality Night 1.63 (1.03, 2.57), weekend 1.46 (1.18, 1.81) 6 [8]
Priestap et al./2006 31 Critical care units across Canada Retrospective multicenter cohort Night 61.6 (17.7), day 61.7 (17.5) Night 58, day 57.4 Night (21:00–06:59) APACHE II score night 15.7 (7.7), day 15.0 (7.4) Adult Differences in illness severity at admission, gender, age, admission source, admission diagnosis, site In-hospital mortality 1.22 (1.10, 1.36) 6 [11]
Duke et al./2004 1 ICU in the Northern Hospital in Australia Prospective single-center cohort Median (IQR) 62 (42–73) NA Night (22:00–07:30) APACHE II score 15 (10–21) Adult age, APACHE II predicted mortality at admission, premature discharge, delayed discharge, limitation of medical treatment decision, emergency admission, mechanical ventilation, APACHE II diagnosis, chronic health status categories In-hospital mortality 1.7 (1.03, 2.9) 7 [7]
Uusaro et al./2003 18 ICUs in university and central hospitals in Finland Retrospective multicenter cohort NA NA Night (16:00–08:00), weekend (Fri 16:00–Sun 24:00) SAPS II score 34 (17) Adult Disease severity at ICU admission, intensity of care, and whether restrictions for future care were set In-hospital mortality Night 1.11 (0.93, 1.31), weekend 0.88 (0.73, 1.07) 7 [14]
Beck et al./2002 9 ICUs in a district general hospital in United Kingdom Retrospective single-center cohort 57 (19) 61.7 Night (20:00–07:59) APACHE II probabilities 18.3 (18.7) Adult Disease severity at ICU admission In-hospital mortality 1.70 (1.28, 2.25) 6 [6]
Goldfrad et al./2000 88 ICUs in the United Kingdom Retrospective multicenter cohort Mean (95% CI) night 57.5 (56.4–58.7), day 58.2 (57.9–58.5) NA Night (22:00–06:59) APACHE II score mean (95% CI), night 15.5 (15.1–16.0), day 14.6 (14.5–14.7) Adult Case-mix (age, medical history, acute severity), premature discharge In-hospital mortality 1.17 (0.92, 1.49) 6 [5]
  1. Abbreviations: OR odds ratio, CI confidence interval, ICU intensive care unit, IQR interquartile range, APACHE Acute Physiology and Chronic Health Evaluation, SAPS Simplified Acute Physiology Score, SOFA sequential organ failure assessment, DNR do-not-resuscitate assessment, ANZICS APD Australian and New Zealand Intensive Care Society Adult Patient Database, NOS Newcastle-Ottawa Scale, NA information not available Continuous data given as mean (sd or 95% CI) or median (interquartile range) if provided by the study authors