【摘要】 目的:系统评价病人非计划重返重症监护室(ICU)的危险因素。方法:计算机检索中英文数据库，搜集病人发生非计划重返ICU危险因素的病例对照研究、队列研究，检索时限均从建库至2021年5月31日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后，采用Stata 16.1软件进行Meta分析。结果:30篇文献符合纳入标准，共纳入21个危险因素作为本次Meta分析。经过Meta分析得出年龄、男性、糖尿病史、慢性阻塞性肺疾病(COPD)、肝硬化、医院获得性肺炎(HAP)、非择期手术、留置人工气道、首次入ICU为普通病房转入、夜间转出ICU、ICU住院时长、使用机械通气、透析治疗、ICU住院期间液体正平衡、序贯器官衰竭评估(SOFA)、急性生理与慢性健康评估(APACHEⅡ)、格拉斯哥昏迷指数评分(GCS)、急性生理评分(APS)、转移评分的稳定性和工作量指标(SWIFT)、嗜酸性粒细胞、C-反应蛋白是病人非计划重返ICU的独立危险因素。其中年龄因素具有发表偏倚的可能性大。结论:当前证据显示年龄、男性、糖尿病史、COPD、肝硬化、HAP、非择期手术、留置人工气道、首次入ICU为普通病房转入、夜间转出ICU、ICU住院时长、使用机械通气、透析治疗、ICU住院期间液体正平衡、SOFA、APACHEⅡ、GCS、APS、SWIFT、嗜酸性粒细胞、C-反应蛋白是病人非计划重返ICU的独立危险因素，医护人员应对具有以上危险因素的ICU病人在做出转出决定时谨慎考虑，以降低病人非计划重返ICU的发生率。更多还原

【Abstract】 Objective:To systematically evaluate the risk factors of unplanned readmit to the ICU.Methods:The case-control studies and cohort studies on the risk factors of unplanned readmit to the ICU were searched from Chinese and English databases.The retrieval time was from inception to May 31,2021.After two researchers independently screened the literature, extracted data and evaluated the risk of bias included in the study, Meta-analysis was carried out by Stata 16.1 software.Results:Thirty literatures met the inclusion criteria, and a total of 21 risk factors were included as the Meta-analysis of unplanned intensive care unit readmissions.Meta-analysis results showed that age, male, history of diabetes, COPD,liver cirrhosis, HAP,Non-elective surgical, indwelling artificial airway, ICU for the first time were transferred into general wards, night out of ICU,ICU length of hospital stay, mechanical ventilation, dialysis treatment, fluid positive balance during ICU hospitalization, the score of SOFA,APACHEⅡ,GCS,APS and SWIFT eosinophils, C-reactive protein were independent risk factors for unplanned readmit to the ICU.Among them, age was more likely to have publication bias.Conclusions:Current evidence shows that age, male, history of diabetes, COPD,liver cirrhosis, HAP,Non-elective surgical, indwelling artificial airway, ICU for the first time were transferred into general wards, night out ICU,ICU length of stay, mechanical ventilation, dialysis treatment, fluid positive balance during ICU hospitalization, the score of SOFA,APACHEⅡ,GCS,APS and SWIFT were independent risk factors for for unplanned readmit to the ICU.Medical staff should carefully consider the patients with the above risk factors when making the transfer out decision, so as to reduce the incidence of unplanned readmit to the ICU.更多还原