• Igor Tona Peres, Silvio Hamacher, Fernando Luiz Cyrino Oliveira, Antônio Márcio Tavares Thomé, and Fernando Augusto Bozza.
• Department of Industrial Engineering, Pontifical Catholic University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. Electronic address: igor.peres@aluno.puc-rio.br.
• J Crit Care. 2020 Dec 1; 60: 183-194.

PurposeStudies have shown that a small percentage of ICU patients have prolonged length of stay (LoS) and account for a large proportion of resource use. Therefore, the identification of prolonged stay patients can improve unit efficiency. In this study, we performed a systematic review and meta-analysis to understand the risk factors of ICU LoS.Materials And MethodsWe searched MEDLINE, Embase and Scopus databases from inception to November 2018. The searching process focused on papers presenting risk factors of ICU LoS. A meta-analysis was performed for studies reporting appropriate statistics.ResultsFrom 6906 citations, 113 met the eligibility criteria and were reviewed. A meta-analysis was performed for six factors from 28 papers and concluded that patients with mechanical ventilation, hypomagnesemia, delirium, and malnutrition tend to have longer stay, and that age and gender were not significant factors.ConclusionsThis work suggested a list of risk factors that should be considered in prediction models for ICU LoS, as follows: severity scores, mechanical ventilation, hypomagnesemia, delirium, malnutrition, infection, trauma, red blood cells, and PaO2:FiO2. Our findings can be used by prediction models to improve their predictive capacity of prolonged stay patients, assisting in resource allocation, quality improvement actions, and benchmarking analysis.Copyright © 2020 Elsevier Inc. All rights reserved.

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