ArticleJournal of clinical medicine research2014
Triage of Patients Consulted for ICU Admission During Times of ICU-Bed Shortage.
Article in Journal of clinical medicine research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02663505 (I See You Risk Your ICU Capacity - Development Of An ICU Risk Score), which is not on this map. Cited by 21 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
I See You Risk Your ICU Capacity - Development Of An ICU Risk Score
Who cites it
21 citing papers in PubMed, 45 citations in OpenAlex.
- Review
- Priority setting in critical care: a multicriteria approach to ranking access to Intensive Care Unit beds.BMC health services research · 2025Article
- Outcome and critical care resources utilised by do not attempt cardiopulmonary resuscitation (DNACPR) patients admitted to the ICU at a tertiary hospital in Saudi Arabia: a retrospective review of the critical care database.Critical care (London, England) · 2025Article
- The working experience of medical staff in the hospital-wide bed-sharing mode: A qualitative study.Nursing open · 2023Article
- Article
- Outcome prediction for patients assessed by the medical emergency team: a retrospective cohort study.BMC emergency medicine · 2022Observational
- Prognosis of patients with tracheal intubation in the emergency department.Trends in anaesthesia & critical care · 2021Article
- Developing machine learning models to personalize care levels among emergency room patients for hospital admission.Journal of the American Medical Informatics Association : JAMIA · 2021Article
- Outcome of cancer patients considered for intensive care unit admission in two university hospitals in the Netherlands: the danger of delayed ICU admissions and off-hour triage decisions.Annals of intensive care · 2021Article
- Critical emergency medicine and the resuscitative care unit.Acute and critical care · 2021Article
- Clinical characteristics and outcomes of 952 hospitalized COVID-19 patients in The Netherlands: A retrospective cohort study.PloS one · 2021Article
- Referral and admission to intensive care: A qualitative study of doctors' practices in a Tanzanian university hospital.PloS one · 2019Article
- Decision-making in intensive care medicine - A review.Journal of the Intensive Care Society · 2018Review
- Effect of Emergency Department and ICU Occupancy on Admission Decisions and Outcomes for Critically Ill Patients.Critical care medicine · 2018Article
- Next-generation, personalised, model-based critical care medicine: a state-of-the art review of in silico virtual patient models, methods, and cohorts, and how to validation them.Biomedical engineering online · 2018Review
- Determinants and outcomes associated with decisions to deny intensive care unit admission in Tunisian ICU.The Pan African medical journal · 2018Article
- Intermediate care to intensive care triage: A quality improvement project to reduce mortality.Journal of critical care · 2017Article
- The Ability of the Acute Physiology and Chronic Health Evaluation (APACHE) IV Score to Predict Mortality in a Single Tertiary Hospital.Korean journal of critical care medicine · 2017Article
- Article
- Refusal of beds and triage of patients admitted to intensive care units in Brazil: a cross-sectional national survey.Revista Brasileira de terapia intensivaArticle
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe demand for specialized medical services such as critical care often exceeds availability, thus rationing of intensive care unit (ICU) beds commonly leads to difficult triage decisions. Many factors can play a role in the decision to admit a patient to the ICU, including severity of illness and the need for specific treatments limited to these units. Although triage decisions would be based solely on patient and institutional level factors, it is likely that intensivists make different decisions when there are fewer ICU beds available. The objective of this study is to evaluate the characteristics of patients referred for ICU admission during times of limited beds availability.
methodsA single center, prospective, observational study was conducted among consecutive patients in whom an evaluation for ICU admission was requested during times of ICU overcrowding, which comprised the months of April and May 2014.
resultsA total of 95 patients were evaluated for possible ICU admission during the study period. Their mean APACHE-II score was 16.8 (median 16, range 3 - 36). Sixty-four patients (67.4%) were accepted to ICU, 18 patients (18.9%) were triaged to SDU, and 13 patients (13.7%) were admitted to hospital wards. ICU had no beds available 24 times (39.3%) during the study period, and in 39 opportunities (63.9%) only one bed was available. Twenty-four patients (25.3%) were evaluated when there were no available beds, and eight of those patients (33%) were admitted to ICU. A total of 17 patients (17.9%) died in the hospital, and 15 (23.4%) expired in ICU.
conclusionICU beds are a scarce resource for which demand periodically exceeds supply, raising concerns about mechanisms for resource allocation during times of limited beds availability. At our institution, triage decisions were not related to the number of available beds in ICU, age, or gender. A linear correlation was observed between severity of illness, expressed by APACHE-II scores, and the likelihood of being admitted to ICU. Alternative locations outside the ICU in which care for critically ill patients could be delivered should be considered during times of extreme ICU-bed shortage.
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