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Diarrhea and patient outcomes in the intensive care unit: Systematic review and meta-analysis.
J Crit Care. 2019 Jun 18;53:142-148
Authors: Taito S, Kawai Y, Liu K, Ariie T, Tsujimoto Y, Banno M, Kataoka Y
Abstract
PURPOSE: We aimed to determine whether diarrhea experienced by patients in the intensive care unit (ICU) is related to their clinical outcomes.
MATERIAL AND METHODS: We performed a systematic review and meta-analysis. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, and the World Health Organization International Clinical Trials Registry Platform between inception and August 2018. The primary outcome was ICU mortality, and secondary outcomes included hospital mortality, ICU length of stay, hospital length of stay. The quality of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.
RESULTS: Twelve studies (enrolling 13,140 patients) compared patients with diarrhea to patients without diarrhea in the ICU. Diarrhea was related to ICU mortality (relative risk [RR]: 1.43; 95% confidence interval [CI]: 1.03 to 1.98). The mean difference (MD) in ICU length of stay between patients with and without diarrhea was 8.08 days (95% CI: 5.85 to 10.32), while the MD in hospital length of stay was 9.67 (95% CI: 2.17 to 17.16). The certainty of evidence for these outcomes was low.
CONCLUSIONS: The diarrhea experienced by patients may be associated with higher mortality and prolonged length of stay in the ICU and hospital.
PMID: 31238230 [PubMed - as supplied by publisher]