Please use this identifier to cite or link to this item:
Full metadata record
DC FieldValueLanguage
dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorRAMOS, Joao Gabriel Rosa
dc.contributor.authorRANZANI, Otavio T.
dc.contributor.authorPERONDI, Beatriz
dc.contributor.authorDIAS, Roger Daglius
dc.contributor.authorJONES, Daryl
dc.contributor.authorCARVALHO, Carlos Roberto Ribeiro
dc.contributor.authorVELASCO, Irineu Tadeu
dc.contributor.authorFORTE, Daniel Neves
dc.identifier.citationJOURNAL OF CRITICAL CARE, v.51, p.77-83, 2019
dc.description.abstractPurpose: 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. (C) 2019 Published by Elsevier Inc.eng
dc.relation.ispartofJournal of Critical Care
dc.subjectIntensive care triageeng
dc.subjectDecision-support tooleng
dc.subjectIntensive care resource allocationeng
dc.subjectIntensive care unit admissioneng
dc.subjectCritically illeng
dc.subject.otherpolicy statementeng
dc.titleA decision-aid tool for ICU admission triage is associated with a reduction in potentially inappropriate intensive care unit admissionseng
dc.rights.holderCopyright W B SAUNDERS CO-ELSEVIER INCeng
dc.subject.wosCritical Care Medicineeng
dc.type.categoryoriginal articleeng
dc.type.versionpublishedVersioneng, Roger Daglius:Univ Sao Paulo, Fac Med, Hosp Clin HCFMUSP, Emergency Dept, Sao Paulo, Brazil; Harvard Med Sch, Brigham & Womens Hosp, Emergency Dept, Boston, MA 02115 USA, Daryl:Monash Univ, Sch Publ Hlth & Prevent Med, Clayton, Vic, Australia; Univ Melbourne, Melbourne, Vic, Australia; Austin Hlth, Melbourne, Vic, Australia
hcfmusp.relation.referenceAzoulay E, 2001, CRIT CARE MED, V29, P2132, DOI 10.1097/00003246-200111000-00014eng
hcfmusp.relation.referenceBassford C, 2017, CRIT CARE, V21, DOI 10.1186/s13054-017-1749-3eng
hcfmusp.relation.referenceBlanch L, 2016, J CRIT CARE, V36, P301, DOI 10.1016/j.jcrc.2016.06.014eng
hcfmusp.relation.referenceBosslet GT, 2015, AM J RESP CRIT CARE, V191, P1318, DOI 10.1164/rccm.201505-0924STeng
hcfmusp.relation.referenceBraithwaite RS, 2016, J MED ETHICS, V42, P325, DOI 10.1136/medethics-2015-103047eng
hcfmusp.relation.referenceCarvalho CRR, 2016, REV MED, V95, P37eng
hcfmusp.relation.referenceChristian MD, 2013, CRIT CARE, V17, DOI 10.1186/cc11842eng
hcfmusp.relation.referenceCroskerry P, 2003, ANN EMERG MED, V41, P110, DOI 10.1067/mem.2003.22eng
hcfmusp.relation.referenceDahine J, 2016, PLOS ONE, V11, DOI 10.1371/journal.pone.0149196eng
hcfmusp.relation.referenceEgol A, 1999, CRIT CARE MED, V27, P633eng
hcfmusp.relation.referenceEscher M, 2004, BMJ-BRIT MED J, V329, P425eng
hcfmusp.relation.referenceGarg AX, 2005, JAMA-J AM MED ASSOC, V293, P1223, DOI 10.1001/jama.293.10.1223eng
hcfmusp.relation.referenceGarrouste-Orgeas M, 2005, CRIT CARE MED, V33, P750, DOI 10.1097/01.CCM.0000157752.26180.F1eng
hcfmusp.relation.referenceGorini A, 2011, EUR J INTERN MED, V22, P547, DOI 10.1016/j.ejim.2011.06.008eng
hcfmusp.relation.referenceCaldeira VMH, 2010, REV ASSOC MED BRAS, V56, P528, DOI 10.1590/S0104-42302010000500012eng
hcfmusp.relation.referenceIapichino G, 2010, INTENS CARE MED, V36, P1772, DOI 10.1007/s00134-010-1933-2eng
hcfmusp.relation.referenceKahneman D, 2009, AM PSYCHOL, V64, P515, DOI 10.1037/a0016755eng
hcfmusp.relation.referenceKATZ S, 1963, JAMA-J AM MED ASSOC, V185, P914, DOI 10.1001/jama.1963.03060120024016eng
hcfmusp.relation.referenceKhandelwal N, 2016, CRIT CARE MED, V44, P1474, DOI 10.1097/CCM.0000000000001675eng
hcfmusp.relation.referenceKirby J, 2010, J MED ETHICS, V36, P758, DOI 10.1136/jme.2010.035501eng
hcfmusp.relation.referenceKNAUS WA, 1995, JAMA-J AM MED ASSOC, V274, P1591eng
hcfmusp.relation.referenceKon AA, 2016, CRIT CARE MED, V44, P1769, DOI 10.1097/CCM.0000000000001965eng
hcfmusp.relation.referenceLEMESHOW S, 1993, JAMA-J AM MED ASSOC, V270, P2478, DOI 10.1001/jama.270.20.2478eng
hcfmusp.relation.referenceLEMESHOW S, 1995, INTENS CARE MED, V21, P770, DOI 10.1007/BF01704747eng
hcfmusp.relation.referenceLouriz M, 2012, INTENS CARE MED, V38, P830, DOI 10.1007/s00134-012-2517-0eng
hcfmusp.relation.referenceMery E, 2013, CRIT CARE, V17, DOI 10.1186/cc12688eng
hcfmusp.relation.referenceMurthy S, 2015, PLOS ONE, V10, DOI 10.1371/journal.pone.0116949eng
hcfmusp.relation.referenceNates JL, 2016, CRIT CARE MED, V44, P1553, DOI 10.1097/CCM.0000000000001856eng
hcfmusp.relation.referenceOerlemans AJM, 2016, BMC ANESTHESIOL, V16, DOI 10.1186/s12871-016-0190-5eng
hcfmusp.relation.referencePiers RD, 2011, JAMA-J AM MED ASSOC, V306, P2694, DOI 10.1001/jama.2011.1888eng
hcfmusp.relation.referenceRamos João Gabriel Rosa, 2017, Rev. bras. ter. intensiva, V29, P154, DOI [10.5935/0103-507X.20170025, 10.5935/0103-507x.20170025]eng
hcfmusp.relation.referenceRobert R, 2015, ANN INTENSIVE CARE, V5, DOI 10.1186/s13613-015-0099-zeng
hcfmusp.relation.referenceRocco José Rodolfo, 2006, Rev. bras. ter. intensiva, V18, P114, DOI 10.1590/S0103-507X2006000200002eng
hcfmusp.relation.referenceRamos JGR, 2016, CRIT CARE, V20, DOI 10.1186/s13054-016-1262-0eng
hcfmusp.relation.referenceSchneiderman LJ, 2003, JAMA-J AM MED ASSOC, V290, P1166, DOI 10.1001/jama.290.9.1166eng
hcfmusp.relation.referenceSinuff T, 2004, CRIT CARE MED, V32, P1588, DOI 10.1097/01.CCM.0000130175.38521.9Feng
hcfmusp.relation.referenceSprung CL, 2013, INTENS CARE MED, V39, P1916, DOI 10.1007/s00134-013-3033-6eng
hcfmusp.relation.referenceSprung CL, 2012, CRIT CARE MED, V40, P125, DOI 10.1097/CCM.0b013e31822e5692eng
hcfmusp.relation.referenceStelfox HT, 2012, ARCH INTERN MED, V172, P467, DOI 10.1001/archinternmed.2011.2315eng
hcfmusp.relation.referenceTruog RD, 2006, CRIT CARE MED, V34, P958, DOI 10.1097/01.CCM.0000206116.10417.D9eng
hcfmusp.relation.referenceVesin A, 2013, INTENS CARE MED, V39, P1396, DOI 10.1007/s00134-013-2949-1eng
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCM
Departamento de Clínica Médica - FM/MCM

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/ICHC
Instituto Central - HC/ICHC

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/09
LIM/09 - Laboratório de Pneumologia

Artigos e Materiais de Revistas Científicas - LIM/51
LIM/51 - Laboratório de Emergências Clínicas

Files in This Item:
File Description SizeFormat 
  Restricted Access
publishedVersion (English)871.64 kBAdobe PDFView/Open Request a copy

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.