Your browser doesn't support javascript.
loading
A decision-aid tool for ICU admission triage is associated with a reduction in potentially inappropriate intensive care unit admissions.
Ramos, Joao Gabriel Rosa; Ranzani, Otavio T; Perondi, Beatriz; Dias, Roger Daglius; Jones, Daryl; Carvalho, Carlos Roberto Ribeiro; Velasco, Irineu Tadeu; Forte, Daniel Neves.
Afiliação
  • Ramos JGR; Medical Sciences PhD program, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil; Intensive Care Unit, Hospital Sao Rafael, Salvador, Brazil. Electronic address: jgramos@usp.br.
  • Ranzani OT; Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil.
  • Perondi B; Emergency Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil.
  • Dias RD; Emergency Department, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil; Emergency Department, Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
  • Jones D; Monash University, School of Public Health and Preventive Medicine, Australia; University of Melbourne, Australia; Austin Health, Melbourne, Australia. Electronic address: daryl.jones@austin.org.au.
  • Carvalho CRR; Pulmonary Division, Heart Institute (InCor), Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil. Electronic address: carlos.carvalho@hc.fm.usp.br.
  • Velasco IT; Emergency Medicine Discipline, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, Sao Paulo, Brazil. Electronic address: irineu.tadeu@hc.fm.usp.br.
  • Forte DN; Medical Sciences PhD program, Faculdade de Medicina FMUSP, Universidade de São Paulo, Sao Paulo, Brazil; Teaching and Research on Palliative Care Program, Hospital Sirio-Libanes, Sao Paulo, Brazil.
J Crit Care ; 51: 77-83, 2019 06.
Article em En | MEDLINE | ID: mdl-30769294
PURPOSE: Intensive care unit (ICU) admission triage occurs frequently and often involves highly subjective decisions that may lead to potentially inappropriate ICU admissions. In this study, we evaluated the effect of implementing a decision-aid tool for ICU triage on ICU admission decisions. METHODS: This was a prospective, before-after study. Urgent ICU referrals to ten ICUs in a tertiary hospital in Brazil were assessed before and after the implementation of the decision-aid tool. Our primary outcome was the proportion of potentially inappropriate ICU referrals (defined as priority 4B or 5 referrals, accordingly to the Society of Critical Care Medicine guidelines of 1999 and 2016, respectively) admitted to the ICU within 48 h. We conducted multivariate analyses to adjust for potential confounders and evaluated the interaction between phase and triage priority. RESULTS: Of the 2201 patients analyzed, 1184 (53.8%) patients were admitted to the ICU. After adjustment for confounders, implementation of the decision-aid tool was associated with a reduction in potentially inappropriate ICU admissions using either the 1999 [adjOR (95% CI) = 0.36 (0.13-0.97)] or 2016 [adjOR (95%CI) = 0.35 (0.13-0.96)] definitions. CONCLUSION: Implementation of a decision-aid tool for ICU triage was associated with a reduction in potentially inappropriate ICU admissions.
Assuntos
Palavras-chave

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Admissão do Paciente / Índice de Gravidade de Doença / Triagem / Técnicas de Apoio para a Decisão Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Admissão do Paciente / Índice de Gravidade de Doença / Triagem / Técnicas de Apoio para a Decisão Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Adult / Aged / Female / Humans / Male / Middle aged País/Região como assunto: America do sul / Brasil Idioma: En Revista: J Crit Care Assunto da revista: TERAPIA INTENSIVA Ano de publicação: 2019 Tipo de documento: Article País de publicação: Estados Unidos