Impact of telemedicine intensive care unit coverage on patient outcomes: A systematic review and meta-analysis

Lance Brendan Young, Paul S. Chan, Xin Lu, Brahmajee K. Nallamothu, Comilla Sasson, Peter M. Cram

Research output: Contribution to journalReview articlepeer-review

162 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)498-506
Number of pages9
JournalArchives of Internal Medicine
Volume171
Issue number6
DOIs
StatePublished - Mar 28 2011
Externally publishedYes

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint

Dive into the research topics of 'Impact of telemedicine intensive care unit coverage on patient outcomes: A systematic review and meta-analysis'. Together they form a unique fingerprint.

Cite this