Evaluation of triage decisions for intensive care admission

Sprung, Charles L.; Geber, D; Eidelman, Leonid A.; Baras, Mario; Pizov, Reuven; Nimrod, Adi; Oppenheim, Arieh; Epstein, Leon; Cotev, Shamay

doi:10.1097/00003246-199906000-00021

Cited by 269 publications

(207 citation statements)

References 24 publications

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“…Mortality outside the ICU was regrettably much higher, up to 53% (28). This has been confirmed by other reports (29)(30)(31)(32)(33)(34)(35), and it strongly suggests that all patients with severe sepsis and septic shock should be admitted to the ICU.…”

Section: Discussionsupporting

confidence: 68%

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Ortíz¹,

Dueñas²,

Rodríguez

et al. 2013

biomedica

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Section: Discussionsupporting

confidence: 68%

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Ortíz¹,

Dueñas²,

Rodríguez

et al. 2013

biomedica

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“…First, it was performed in a single country. Previous studies have shown that haematological patients are often denied ICU admission based on guidelines from learned societies [30][31][32]. However, guidelines are applied in a uniform manner across industrialised countries [33].…”

Section: Discussionmentioning

confidence: 99%

“…The three case volume tertiles were: low volume (,12 admissions per year), intermediate volume (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30) admissions per year), and high volume (.30 admissions per year). In univariate analyses, ICU case volume was not associated with ICU mortality.…”

mentioning

confidence: 99%

Case volume and mortality in haematological patients with acute respiratory failure

Lécuyer

Chevret²,

Guidet³

et al. 2008

European Respiratory Journal

103

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High case volume is associated with improved survival in medical and surgical conditions. The present study sought to determine whether intensive care unit (ICU) case volume was associated with survival of critically ill patients with haematological malignancies and acute respiratory failure (ARF).A regional database containing data from 1,753 haematological patients with ARF admitted to 28 medical ICUs from 1997 to 2004 was used. Multivariate analysis using mixed models was performed to adjust for severity of illness and other confounding factors, including a propensity score that incorporates differences between ICUs with different case volumes.The three case volume tertiles were: low volume (,12 admissions per year), intermediate volume (12-30 admissions per year), and high volume (.30 admissions per year). In univariate analyses, ICU case volume was not associated with ICU mortality. After adjusting for prognostic factors for ICU mortality and the propensity score, patients in high-volume ICUs had lower mortality than other patients. A case volume increase of one admission per year led to a significant mortality reduction with an odds ratio of 0.98 (95% confidence limits 0.97-0.99). Mortality was independently associated with severity of organ dysfunction.In intensive care units admitting larger numbers of critically ill haematological patients with acute respiratory failure, mortality was lower than in other intensive care units. The mechanisms of the relationship between volume and outcome among haematological patients with acute respiratory deserve additional studies.

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“…However, in the past decade, there have been several reports of patients appropriately referred to, but refused, ICU admission [2,3,[8][9][10][11][12]. These studies can be used to compute the mortality risk reduction achieved by intensive care.…”

mentioning

confidence: 99%

Cost effectiveness of adult intensive care in the UK

Ridley

Morris

2007

Anaesthesia

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SummaryWe wished to investigate whether intensive care represents good value for money to the National Health Service in the UK using cost-effectiveness analysis. We developed a cost-effectiveness model using secondary data sources to estimate the incremental cost per quality adjusted life year gained of treatment in intensive care vs non-intensive care treatment in adults. Estimates of hospital mortality with and without intensive care were obtained from seven published studies and from data published by the Intensive Care National Audit and Research Centre. Quality of life estimates were obtained from a literature review and NHS reference costs were used. Relative to nonintensive care treatment, the incremental cost per quality adjusted life year gained of treatment in intensive care is £7010. This figure is sensitive to the mortality risk reduction associated with intensive care. Despite the high daily cost of intensive care, its cost-effectiveness is excellent and compares favourably with other commonly used health interventions. Our findings suggest that adult intensive care represents good value for money.

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Evaluation of triage decisions for intensive care admission

Cited by 269 publications

References 24 publications

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Epidemiología de la sepsis en unidades de cuidado intensivo en Colombia

Case volume and mortality in haematological patients with acute respiratory failure

Cost effectiveness of adult intensive care in the UK

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