Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/20315
Title: A decision-aid tool for ICU admission triage is associated with a reduction in potentially inappropriate intensive care unit admissions.
Austin Authors: Ramos, Joao Gabriel Rosa;Ranzani, Otavio T;Perondi, Beatriz;Dias, Roger Daglius;Jones, Daryl A ;Carvalho, Carlos Roberto Ribeiro;Velasco, Irineu Tadeu;Forte, Daniel Neves
Affiliation: Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
Emergency Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
Emergency Department, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
Medical Sciences PhD program, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil
Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
Monash University, School of Public Health and Preventive Medicine, Australia
Intensive Care Unit, Hospital Sao Rafael, Salvador, Brazil
Austin Health, Heidelberg, Victoria, Australia
University of Melbourne, Australia
Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil
Teaching and Research on Palliative Care Program, Hospital Sirio-Libanes, Sao Paulo, Brazil
Issue Date: Jun-2019
metadata.dc.date: 2019-02-04
Publication information: Journal of Critical Care 2019; 51: 77-83
Abstract: Intensive care unit (ICU) admission triage occurs frequently and often involves highly subjective decisions that may lead to potentially inappropriate ICU admissions. In this study, we evaluated the effect of implementing a decision-aid tool for ICU triage on ICU admission decisions. This was a prospective, before-after study. Urgent ICU referrals to ten ICUs in a tertiary hospital in Brazil were assessed before and after the implementation of the decision-aid tool. Our primary outcome was the proportion of potentially inappropriate ICU referrals (defined as priority 4B or 5 referrals, accordingly to the Society of Critical Care Medicine guidelines of 1999 and 2016, respectively) admitted to the ICU within 48 h. We conducted multivariate analyses to adjust for potential confounders and evaluated the interaction between phase and triage priority. Of the 2201 patients analyzed, 1184 (53.8%) patients were admitted to the ICU. After adjustment for confounders, implementation of the decision-aid tool was associated with a reduction in potentially inappropriate ICU admissions using either the 1999 [adjOR (95% CI) = 0.36 (0.13-0.97)] or 2016 [adjOR (95%CI) = 0.35 (0.13-0.96)] definitions. Implementation of a decision-aid tool for ICU triage was associated with a reduction in potentially inappropriate ICU admissions.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20315
DOI: 10.1016/j.jcrc.2019.02.002
PubMed URL: 30769294
Type: Journal Article
Subjects: Critically ill
Decision-making
Decision-support tool
Intensive care resource allocation
Intensive care triage
Intensive care unit admission
Appears in Collections:Journal articles

Show full item record

Google ScholarTM

Check


Items in AHRO are protected by copyright, with all rights reserved, unless otherwise indicated.