Development a reverse triage system based on modified sequential organ failure assessment for increasing the critical care surge capacity

Abstract

Context:The capacity completeness are one of the serious problems in the bed's managements of the critical care units in a crisis and disaster situation. Reverse triage can help to hospital surge capacity in this situations.Aims:The aim of this study was to develop a reverse triage system based on Modified Sequential Organ Failure Assessment (MSOFA) for increasing critical care surge capacity.Settings and Design:This study was a prospective design that performed on the medical patients in critical care unit.Subjects and Methods:The MSOFA score for each patient was calculated in admission time and be continued until discharging time from critical care unit.Statistical Analysis Used:The Cox regression method was used to determine the relative risk values. At last, the patients were divided into three levels for reverse triage.Results:Four hundred and twenty patients were participated in this study. The mean of patients' MSOFA scores in the 1st day of admission in Critical Care was 5.40 ± 3.8. The relative risk of internal patients discharge from critical care was (8.2%). Death relative risks were <25%, higher than 70% and between 25.1% and 69.9% for three color level of green, black, and red, respectively.Conclusion:The MSOFA scores can contribute to the design a leveling system for discharging patients from critical care unit. Based on this system, the members of the caring team can predict the final health status of the patient.