Triage decisions and outcomes for patients with Triage Priority 3 on the Society of Critical Care Medicine scale.
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.
Shum
Hoi-Ping
HP
Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. shumhp@ha.org.hk
Chan
King-Chung
KC
Lau
Chun-Wing
CW
Leung
Anne Kit-Hung
AK
Chan
Kin-Wai
KW
Yan
Wing-Wa
WW
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