title: Variables associated with unplanned general adult ICU admission in hospitalised patients: protocol for a systematic review.
abstract: Failure to promptly identify deterioration in hospitalised patients is associated with delayed admission to intensive care units (ICUs) and poor outcomes. Existing vital sign-based Early Warning Score (EWS) algorithms do not have a sufficiently high positive predictive value to be used for automated activation of an ICU outreach team. Incorporating additional patient data might improve the predictive power of EWS algorithms; however, it is currently not known which patient data (or variables) are most predictive of ICU admission. We describe the protocol for a systematic review of variables associated with ICU admission.
  
  
  
  MEDLINE, EMBASE, CINAHL and the Cochrane Library, including Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials (CENTRAL) will be searched for studies that assess the association of routinely recorded variables associated with subsequent unplanned ICU admission. Only studies involving adult patients admitted to general ICUs will be included. We will extract data relating to the statistical association between ICU admission and predictor variables, the quality of the studies and the generalisability of the findings.
  
  
  
  The results of this review will aid the development of future models which predict the risk of unplanned ICU admission.
  
  
  
  PROSPERO: CRD42015029617.
authors.affiliation: Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK. james.malycha@ndcn.ox.ac.uk.
authors.forename: James
authors.identifier: 0000-0002-9668-1431
authors.initials: J
authors.lastname: Malycha
authors.affiliation: Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Tim
authors.initials: T
authors.lastname: Bonnici
authors.affiliation: Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Katarina
authors.initials: K
authors.lastname: Sebekova
authors.affiliation: University of Oxford, Bodleian Health Care Libraries, Academic Centre, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Tatjana
authors.initials: T
authors.lastname: Petrinic
authors.affiliation: Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Duncan
authors.initials: D
authors.lastname: Young
authors.affiliation: Kadoorie Centre for Critical Care Research and Education, John Radcliffe Hospital, Level 3, Headley Way, Oxford, OX3 9DU, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Watkinson
mesh_terms: D000328:Adult; D000465:Algorithms; D006801:Humans; D007362:Intensive Care Units; D010343:Patient Admission; D012107:Research Design; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D000078202:Systematic Reviews as Topic