Admission decisions to a medical intensive care unit are based on functional status rather than severity of illness. A single center experience

Minerva Anestesiologica

Volumn 78, Issue 11, 2012, Pages 1226-1233

  Cohen, R I ^a,c   Eichorn, A ^b   Silver, A ^d  

^a Department of Medicine   (United States)

^b Krasnoff Quality Management Institute   (United States)

^c DONALD AND BARBARA ZUCKER SCHOOL OF MEDICINE AT HOFSTRA NORTHWELL   (United States)

^d IPRO Inc   (United States)

Author keywords

Hospitalization; Intensive care units; Triage

Indexed keywords

ADULT; AGED; APACHE; ARTICLE; COMORBIDITY; CONSULTATION; DISEASE SEVERITY; EMERGENCY HEALTH SERVICE; FEMALE; FUNCTIONAL DISEASE; HOSPITAL ADMISSION; HUMAN; INTENSIVE CARE; LENGTH OF STAY; MAJOR CLINICAL STUDY; MALE; MEDICAL DECISION MAKING; MORTALITY; OBSERVATIONAL STUDY; PROSPECTIVE STUDY; RANKIN SCALE;

AGED; APACHE; DATA COLLECTION; FEMALE; HUMANS; INTENSIVE CARE UNITS; LIKELIHOOD FUNCTIONS; MALE; MIDDLE AGED; NEW YORK CITY; PATIENT ADMISSION; REFERRAL AND CONSULTATION; SOCIOECONOMIC FACTORS; TREATMENT OUTCOME; TRIAGE;

EID: 84871340422     PISSN: 03759393     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (27)

1. Halpern NA, Pastores SM, Greenstein RJ. Critical care medicine in the United States 1985-2000: an analysis of bed numbers, use, and costs. Crit Care Med 2004;32:1254-9.
2. Higgins TL. Placing bets with a full house. Crit Care Med 2008;36:1008-9.
3. Guidelines for intensive care unit admission, discharge, and triage: Task Force of the American College of Critical Care Medicine, Society of Critical Care Medicine. Crit Care Med 1999;27:633-8.
4. American Thoracic Society Statement. Fair allocation of intensive care unit resources. Am JRespir Crit Care Med 1997;156:1282-301.
5. Walter KL, Siegler M, Hall JB. How decisions are made to admit patients to medical intensive care units (MICUs): A survey of MICU directors at academicmedical centers across the United States. Crit Care Med 2008;36:414-20.
6. Azoulay E, Pochard F, Chevret S, Vinsonneau C, Garrouste M, Cohen Y et al. PROTOCETIC Group. Compliance with triage to intensive care recommendations. Crit Care Med 2001;29:2132-6.
7. Sprung CL, Geber D, Eidelman LA, Baras M, Pizov R, Nimrod A et al. Evaluation of triage decisions for intensive care admission. Crit Care Med 1999;27:1073-9.
8. Marshall MF, Schwenzer KJ, Orsina M, Fletcher JC, Durbin CG Jr. Influence of political power, medical provincialism, and economic incentives on the rationing of surgical intensive care unit beds. Crit Care Med 1992;20:387-94.
9. Joynt GM, Gomersall CD, Tan P, Lee A, Cheng CA, Wong EL. Prospective evaluation of patients declined admission toan intensive care unit: triage, futility, and outcome. Intensive Care Med 2001;27:1459-65.
10. Metcalfe MA, Sloggett A, McPherson K. Mortality among appropriately referred patients declined admission to intensive care units. Lancet 1997;350:7-12.
11. Frisho-Lima P, Gurman G, Schapira A, Porath A. Rationing critical care - what happens to patientswho are not admitted? TheoreticalSurgery 1994;39:208-11.
12. Garrouste-Orgeas M, Montuclard L, Timsit JF, Reignier J, Desmettre T, Karoubi P et al. French ADMISSIONREA Study Group. Predictors of intensive care unit refusal in French intensive care units: a multiple-center study. Crit Care Med 2005;33:750-5.
13. Cohen RI, Lisker GN, Eichorn A, Multz AS, Silver A. The impact of do-not-resuscitate order on triage decisions to a medical intensive care unit. J Crit Care 2009;24:311-5.
14. de Haan R, Limburg M, Bossuyt P, van der Meulen J, Aaronson N. The clinical meaning of Rankin 'handicap' grades after stroke. Stroke 1995;26:2027-30.
15. Rojas M, Silver A, Llewellyn C, Rances L. A study of adverse occurrences and major functional impairment following surgery. Advances in patient safety: from research to implementation, Agency Health Care Res Qual 2005;1:275-89.
16. Sprung CL, Baras M, Iapichino G, Kesecioglu J, Lippert A, Hargreaves C et al. The Eldicus prospective, observational study of triage decision making in European intensive care units: Part I - European Intensive Care Admission Triage Scores. Crit Care Med 2012;40:125-31.
17. Vanhecke TE, Gandhi M, McCullough PA, Lazar MH, Ravikrishnan KP, Kadaj P et al. Outcomes of patients considered for, but not admitted to, the intensive care unit. Crit Care Med 2008;36:812-7.
18. Sinuff T, Kahnamoui K, Cook DJ, Luce JM, Levy MM. Values ethics and rationing in critical care task force. Rationing critical care beds: asystematic review. Crit Care Med 2004;32:1588-97.
19. Garrouste-Orgeas M, Montuclard L, Timsit JF, Misset B, Christias M, Carlet J. Triaging patientsto the ICU: a pilot study of factors influencing admission decisions and patient outcomes. Intensive Care Med 2003;29:774-81.
20. Giannini A, Consonni D. Physicians' perception and attitudes regarding inappropriate admissions and resource allocation in the intensive care setting. Br J Anaesth 2006;96:57-62.
21. Truog RD, Brock DW, Cook DJ, Danis M, Luce JM, Rubenfeld GD et al. for the Task Force on Values, Ethics, and Rationing in Critical Care (VERICC). Rationing in the intensive care unit. Crit Care Med 2006;34:958-96.
22. Aufderheide TP, Nichol G, Rea TD, Brown SP, Leroux BG, Pepe PE et al. A trial of an impedance threshold device in outof-hospital cardiac arrest. N Engl J Med 2011;365:798-806.
23. Stiell IG, Nichol G, Leroux BG, Rea TD, Ornato JP, Powell J et al. Early versus later rhythm analysis in patients with out-of-hospital cardiac arrest. N Engl J Med 2011;365:787-97.
24. Danieli MG, Cappelli M, Malcangi G, Logullo F, Salvi A, Danieli G. Long-term effectiveness of intravenous immunoglobulin in Churg-Strauss syndrome. Ann Rheum Dis 2004;63:1649-54.
25. Greer DM, Yang J, Scripko PD, Sims JR, Cash S, Kilbride R et al. Clinical examination for outcome prediction in nontraumatic coma. Crit Care Med 2012;40:1150-6.
26. Quinn TJ, Dawson J, Walters MR, Lees KR. Exploring the reliability of the modified rankin scale. Stroke 2009;40:762-6.
27. Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med 2005;37:360-3.