[Patients refused in admission to an intensive care unit. Prospective evaluation of the causes and outcome].
OBJECTIVE
To determine the reasons for refusing admission to an intensive care unit and the immediate outcome of the patients refused.


METHODS
All patients triaged for admission to a medical intensive care unit ICU during a three-month period were studied prospectively. The frequency and reason for refused admission were studied. The immediate outcome of the refused patients, together with the time lapse before their subsequent management were determined.


RESULTS
Out of 251 patients, 132 (53%) were refused admission. Primary reasons for refusal was lack of beds (92%). Nearly one patient out of 5 was not subsequently treated in an intensive care unit.


CONCLUSIONS
Some refusals could have been avoided if the downstream networks (short-hospitalisation, re-habilitation centres.) had been able to accommodate the patients proposed. Moreover, by abandoning the strategy of wide admission to intensive care to the benefit of a selective triage of the patients proposed, a certain number of refusals would probably have been avoided. Nevertheless, there are obvious difficulties in the application of the latter method.
Mohammedi
Ismaël
I
Réanimation médicale, Hôpital Edouard Herriot, Lyon. ismael.mohammedi@chu-lyon.fr
Martin
Olivier
O
Argaud
Laurent
L
St Denis
Marc
M
Ferry
Tristan
T
Robert
Dominique
D
D000368:Aged; D005260:Female; D006742:Hospital Bed Capacity; D006801:Humans; D007362:Intensive Care Units; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D011446:Prospective Studies; D016079:Refusal to Treat; D016896:Treatment Outcome