title: Triage decisions and outcomes for patients with Triage Priority 3 on the Society of Critical Care Medicine scale.
abstract: OBJECTIVE
  To identify factors associated with the triage decision for patients classified as Society of Critical Care Medicine (SCCM) Triage Priority 3, and their outcomes.
  
  
  METHODS
  Single-centre, prospective, observational cohort study.
  
  
  METHODS
  General intensive care unit in a tertiary regional hospital, over the 9 months January to September 2007.
  
  
  METHODS
  SCCM Triage Priority 3 patients.
  
  
  RESULTS
  All patients were followed up for at least 6 months. Among the 1346 triaged patients, 250 were classified as SCCM Triage Priority 3. Fewer than a third of these (76, 30.4%) were admitted to the ICU. Medical patients were more likely to be rejected than surgical or neurosurgical patients. Those with a poorer physicianpredicted chance of long-term survival were more likely to be rejected than those with a better predicted prognosis. The MPMII0-predicted mortality was higher for those denied ICU admission. Non-postoperative status (odds ratio [OR], 26.3) and physician-predicted risk > 50% of death within 1 month (OR, 11.8) were independently correlated with denial of ICU admission in a multiple logistic regression analysis. Cox regression analysis showed that independent risk factors for mortality were denial of ICU admission (hazard ratio [HR], 2.80), higher MPMII0-predicted mortality (HR, 1.12 for every 10% increment) and the presence of renal disease as an admission diagnosis (HR, 2.28).
  
  
  CONCLUSIONS
  For SCCM Triage Priority 3 patients, postoperative status and better physician-predicted prognosis correlated with ICU admission. Patients had lower medium-term survival if they were denied ICU admission, or had higher MPMII0-predicted mortality, or renal disease as the admission diagnosis.
authors.affiliation: Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. shumhp@ha.org.hk
authors.forename: Hoi-Ping
authors.initials: HP
authors.lastname: Shum
authors.forename: King-Chung
authors.initials: KC
authors.lastname: Chan
authors.forename: Chun-Wing
authors.initials: CW
authors.lastname: Lau
authors.forename: Anne Kit-Hung
authors.initials: AK
authors.lastname: Leung
authors.forename: Kin-Wai
authors.initials: KW
authors.lastname: Chan
authors.forename: Wing-Wa
authors.initials: WW
authors.lastname: Yan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016638:Critical Illness / Q000145:classification* / Q000401:mortality*; D003657:Decision Making; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D011446:Prospective Studies; D014218:Triage