An assessment of the validity of SOFA score based triage in H1N1 critically ill patients during an influenza pandemic.
Sequential Organ Failure Assessment (SOFA) score based triage of influenza A H1N1 critically ill patients has been proposed for surge capacity management as a guide for clinical decision making. We conducted a retrospective records review and SOFA scoring of critically ill patients with influenza A H1N1 in a mixed medical-surgical intensive care unit in an urban hospital. Eight critically ill patients with influenza A H1N1 were admitted to the intensive care unit. Their mean (range) age was 39 (26-52) years with a length of stay of 11 (3-17) days. All patients met SOFA score based triage admission criteria with a modal SOFA score of five. Five patients required invasive ventilation for a mean (range) of 5 (4-11) days. Five patients would have been considered for withdrawal of treatment using SOFA scoring guidelines at 48 h. All patients survived. We conclude that SOFA score based triage could lead to withdrawal of life support in critically ill patients who could survive with an acceptably low length of stay in the intensive care unit.
Department of Anaesthesia and Critical Care Medicine, City Hospital, Sandwell and West Birmingham NHS Trust, Birmingham, UK.
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Khan
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Hulme
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Sherwood
D000328:Adult; D016638:Critical Illness / Q000628:therapy; D004196:Disease Outbreaks; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D007362:Intensive Care Units / Q000706:statistics & numerical data; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy / Q000821:virology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D014218:Triage / Q000379:methods*