Adverse events associated with patient isolation: a systematic literature review and meta-analysis

Patient isolation is widely recommended and used in healthcare institutions to prevent transmission of multidrug-resistant organisms (MDROs). However, its risk: benefit ratio is debated. To assess, based on newly published studies, whether or not there are physical and psychological adverse events associated with patient isolation. Systematic literature review and meta-analysis were performed in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. Studies were systematically searched from PubMed, from May 1st, 2009 to January 31st, 2020. The concepts of the research questions were defined as: ‘Adverse events’, ‘patient isolation or cohorting’, and ‘multi-drug resistant organisms colonized or infection patients’. Three reviewers independently screened studies and extracted data. All statistical analysis was performed with Stata Software and R. After screening titles of 15,921 articles and abstracts of 196, and reviewing full texts of 50 studies, 19 studies were included. Studies were divided into three groups: four qualitative studies, seven observational studies suitable for meta-analysis, and eight other observational studies. Meta-analysis shows no adverse events related to clinical care or patients' experience associated with patient isolation. More studies with correct methodology, including a control group and standardized inclusion criteria, must be conducted to confirm our results.