Table 1

Study characteristics

First author, publication year, countryHospitalsPaediatric inpatients admissions, nInclusion period, year (months)Type of hospital(s)Academic level of hospital(s)Inclusion and exclusion criteria of patientsType of included unitsPatient days, nAge, (years) meanLOS, (days) mean
General care population, GTT/TT methodology
 Chapman 201440 GBRMulticentre39922008–2011 (46)MixedMixedLOS >24 hoursMixed—not explicitly statedNSNSNS
 Davenport 201741 ARGSingle centre2002013 (12)PaediatricNSLOS ≥48 hours, if >1 hospitalisation the most recent one was included, no psychiatric patients and not for social reasonsICU, neonatology, general care (multipurpose unit)16904.48.5
 Fajreldines 201945 ARGSingle centre3182015–2016 (13)Tertiary careAcademicLOS ≥48 hours, patient s<18 yearsNeonatal care, PICU, nursery, paediatric22573.0NS
 Kirkendall 201250 USASingle centre2402009 (12)PaediatricAcademicLOS ≥24 hours, any age, no psychiatric and rehabilitation patientsMixed—not explicitly stated12067.85.1
 Matlow 201254–56 CANMulticentre*35522008–2009 (12)Mixed*Mixed*LOS ≥24 hours, patients <19 years, no obstetrics, or psychiatric patients and external transfers (except newborns)Surgical, internal medicine, emergency, maternal/obstetrics, other14738†4.1†*4.5†*
 Paredes Esteban 2015,58 ESPSingle centre952014 (12)NSNSPatients admitted to paediatric surgery, no patients with adverse events as the reason for admissionSurgical4066.74.2
 Salimath 202046 60 INDSingle centre520NS (26‡)Acute careAcademicLOS≥24 hours, patients≤18 years, no psychiatric and rehabilitation patientsNICU, PICU, medicine, surgical, emergency and trauma†2743†NSNS
 Shah 200951 61 USASingle centre50NSPaediatricAcademicPatients admitted to the otolaryngology serviceOtolaryngology87NSNS
 Solevag, 201463 NORSingle centre494‡2011 (3)Acute careAcademicPatients <18 yearsOrthopaedic, surgical, ear/nose/ throat, medicine2001†6.8†4.1†
 Stockwell 201566 USAMulticentre6002012 (1)PaediatricAcademicLOS between 24 hours and 6 months, patients <22 years, no rehabilitation, normal newborn nursery, day treatment, psychiatric or obstetric patientsNS43726.27.3
 Stockwell 201813 67 USAMulticentre37902007–2012 (72)MixedMixedLOS ≥24 hours, patients age <18 years, no psychiatric (without a concurrent acute medical issue) or rehabilitation patientsMixed—not explicitly stated21 789NS3.0§
 Stroupe 201868 USASingle centre1002014 (12)PaediatricAcademicAdmitted patients ≤18 yearsGeneral paediatric, surgery, PICU, other4116.73.8
 Unbeck 201414 SWESingle centre6002010 (12)Acute careAcademicLOS ≥24 hours, patient <19 yearsNeonatal, surgical/orthopaedic, medicine, emergency medicine55594.39.3
General care population, HMPS methodology
 Brennan 199111 43 47 48 52 USAMulticentre¶6661**1984 (12)Acute careMixed¶Admitted patients, no psychiatric patientsAll types¶NSNSNS
 Davis 200242–44 NZLMulticentre¶1349†**1998 (12)Acute careMixed¶Admitted patients, no day, psychiatric and rehabilitation-only patientsMixed—not explicitly stated¶4134‡3.1†3.1†
 Letaief 201053 TUNSingle centre116‡**2005 (12)PublicAcademicAdmitted patientsMixed—not explicitly statedNSNSNS
 Requena 201159 ESPMulticentre665NS (NS)NSMixedLOS >24 hours, had a clinical history in the selected hospitalsNS3318NSNS
 Sommella 201464 ITASingle centre11‡**2008 (12)Acute careNSLOS >24 hours, no day hospital dischargesMedical, surgical, ICU¶NSNSNS
 Soop 200965 SWEMulticentre ¶159**2003–2004 (12)Acute careMixed¶Admitted patients, no psychiatric, palliative care, rehabilitation, and day-only patientsMixed—not explicitly stated¶NSNSNS
 Wilson 199512 AUSMulticentre¶2020**1992 (12)Acute careMixed¶Admitted patients, no psychiatric and day-only patientsDifferent kind of medical and surgical†8697†4.1†4.3†
 Woods 200569 70 74 USAMulticentre¶3719**1992 (12)Profit/non-profit, governmentMixed¶Admitted patients, no psychiatric, rehabilitation and drug/alcohol treatment patientsMixed—not explicitly statedNSNSNS
 Zegers, 200933 75 NLDMulticentre¶330**2004 (12)Acute careMixed¶LOS of >24 hours, no psychiatric, obstetrics and <1 year patientsMixed—explicitly stated¶NSNSNS
Intensive care population, GTT/TT methodology††
 Agarwal 201038 USAMulticentre7342005 (4)MixedMixedLOS ≥48 hours, no postoperative cardiac patientsPICU52016.37.1
 Barrionuevo 201039 ARGSingle centre4842006 (12)PublicNSLOS >24 hoursNICU6465†NS13.4†
 Hooper 201448 AUSSingle centre592011 (3)PaediatricAcademicAdmitted patientsPICU164NS2.8
 Jorro-Baron 202149 ARGMulticentre14652018–2019 (11)PublicNSLOS ≥24 hours, patients <18 years and admitted for acute carePICU15 8424.6†10.8†
 Larsen 20078 USASingle centre2592002–2003 (12)PaediatricAcademicAdmitted patientsPICU962†NS1.6§
 Matlow 201254–56 CANMulticentre*1172008–2009 (12)Mixed*Mixed*LOS ≥24 hours, patients <19 years, no obstetrics or psychiatric patients and external transfers (except newborns)NICU, PICU1574†0.0†13.5†
 Maziero 202057 BRAMulticentre792017–2018 (NS)PublicNSAdmitted patientsNICU, PICUNSNSNS
 Sharek 200662 USA/CANMulticentre7492004–2005 (3)MixedMixedLOS ≥48 hoursNICU17 106NS22.8
 Ventura 201271 BRASingle centre2182009 (6)NSNSLOS ≥48 hoursNICU2958NS13.5
 Verlaat, 201872 NLDMulticentre482006–2012 (72)NSNSLOS ≥2 hours, patient <18 years, no patients with corrected age <36 weeks (GA)PICU608†6.412.7†
 Vermeulen 201473 ZAFSingle centre80‡‡2012 (4)PaediatricAcademicLOS >48 hours, patients included only once if >1 admissionPICU512NS4.0§
  • *Outcome for the total cohort.

  • †Additional data from authors.

  • ‡Calculations are made.

  • §Median.

  • ¶Information for the total cohort in a study with both paediatric and adult patients, information for the paediatric cohort not reported.

  • **Paediatric cohort.

  • ††Studies using the HMPS methodology did not predominantly include intensive care patients.

  • ‡‡Retrospective cohort.

  • Academic, academic medical centre/university hospital; Adm, admission; GA, gestational age; GTT, Global Trigger Tool; HMPS, Harvard Medical Practice Study; ICU, Intensive care unit; LOS, length of stay; Mixed, both paediatric and adult hospital type; NICU, neonatal intensive care unit; NS, not specified; PICU, paediatric intensive care unit; TT, Trigger Tool.