Summary of findings 5. Length of hospital stay.
| Estimate of effects, confidence intervals, and certainty of the evidence for length of hospital stay for paediatric patients undergoing surgery for congenital heart disease | ||||||||
| Population: paediatric patients undergoing surgery for congenital heart disease Interventions: levosimendan, milrinone, dobutamine, placebo Comparator (reference): placebo Outcome: length of hospital stay Setting: inpatient |
Figure 5 | |||||||
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Total studies: 7 Total participants: 497 |
Relative effect (95% CI) | Anticipated absolute effect (95% CI) | No. of participants (studies) | Certainty of the evidence | Ranking (SUCRA) | Comments | ||
| Without intervention | With intervention | Difference | ||||||
| Levosimendan |
ROM 1.03 (0.84 to 1.27) Network estimate |
20 daysa | 21 days | 1 day more (3 less to 5 more) | 185 (5 RCTs) |
Moderate Due to imprecision |
0.28 | Levosimendan likely results in no difference in length of hospital stay, compared to placebo |
| Milrinone |
ROM 1 (0.78 to 1.30) Network estimate |
20 daysa | 20 days | Same number of days (4 less to 6 more) | 222 (7 RCTs) |
Moderate Due to imprecision |
0.41 | Milrinone likely results in no difference in length of hospital stay, compared to placebo |
| Dobutamine |
ROM 0.68 (0.37 to 1.26) Network estimate |
20 daysa | 14 days | 6 days less (13 less to 5 more) | 26 (1 RCT) |
Moderate Due to imprecision |
0.91 | Dobutamine likely reduces the length of hospital stay, compared to placebo |
| Placebo | ROM 1 | Not estimable | Not estimable | Not estimable | 199 (3 RCTs) |
Reference comparator | 0.41 | ‐ |
| Heterogeneity: tau2 = 0.01; I2 = 31.2% (95% CI 0.0% to 73.6%) Q total 5.81 (df = 4; P = 0.21) Q within designs 5.46 (df = 3; P = 0.14) Q between designs 0.36 (df = 1; P = 0.55) | ||||||||
*SUCRA: surface under the cumulative ranking curve, calculated with R package netmeta
GRADE Working Group grades of evidence (or certainty in the evidence)
High certainty: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate certainty: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low certainty: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.
Very low certainty: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.
Explanatory footnotes
aBaseline risk (assumed control risk) obtained from Wang 2019, placebo group, median length of hospital stay.
Certainty of the evidence for each intervention was downgraded one step due to imprecision, resulting in 'Moderate'.
Abbreviation(s) CI: confidence interval; df: degrees of freedom; No.: number; RCT: randomised controlled trial; ROM: ratio of means; SUCRA: surface under the cumulative ranking curve.