A Model for Decision Making for Intensive Care Unit Admission in Source Limited Hospitals

被引:4
作者
Maghsoudi, Behzad [1 ]
Tabei, Seyed Hesamodin [1 ]
Zand, Farid [1 ]
Tabatabaee, Hamidreza [2 ]
Akbarzadeh, Armin [3 ]
机构
[1] Shiraz Univ Med Sci, Shiraz Anesthesiol & Crit Care Res Ctr, Dept Anesthesiol, Shiraz, Iran
[2] Shiraz Univ Med Sci, Sch Hlth, Dept Epidemiol, Shiraz, Iran
[3] Shiraz Univ Med Sci, Sch Hlth, Student Res Comm, Shiraz, Iran
关键词
Intensive Care Unit; Delphi; Prioritizing; MORTALITY; OUTCOMES; REFUSAL; TRIAGE;
D O I
10.5812/ircmj.15497
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Demand for ICU beds is exceeding its supply. Since the sources are limited in some centers, it is necessary to design a model to identify the patients who benefit more from ICU beds. Objectives: The present study aimed to develop a model to prioritize adult patients according to their clinical indications by a three rounded Delphi method study. Patients and Methods: In this study, 22 physicians who practiced in a source limited hospital in southern Iran were invited to participate in a three phase Delphi survey. Results: At first, the panelists recommended 30 indications. The indications in the first checklist plus those obtained by literature review formed the second checklist which contained 36 items. The items were scored from 0 to 10 by the panelists. According to the scores, the indications were categorized into three priority levels, which were confirmed by the panelists in the third round. Conclusions: This simple checklist contains the indications for ICU admission categorized into three priority levels. This checklist can be considered as a guide for physicians who practice in hospitals with limited number of ICU beds.
引用
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页数:5
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共 22 条
[1]   Worldwide demand for critical care [J].
Adhikari, Neill K. J. ;
Rubenfeld, Gordon D. .
CURRENT OPINION IN CRITICAL CARE, 2011, 17 (06) :620-625
[2]   Critical Care 1 Critical care and the global burden of critical illness in adults [J].
Adhikari, Neill K. J. ;
Fowler, Robert A. ;
Bhagwanjee, Satish ;
Rubenfeld, Gordon D. .
LANCET, 2010, 376 (9749) :1339-1346
[3]   Trauma admissions to the Intensive care unit at a reference hospital in Northwestern Tanzania [J].
Chalya, Phillipo L. ;
Gilyoma, Japhet M. ;
Dass, Ramesh M. ;
Mchembe, Mabula D. ;
Matasha, Michael ;
Mabula, Joseph B. ;
Mbelenge, Nkinda ;
Mahalu, William .
SCANDINAVIAN JOURNAL OF TRAUMA RESUSCITATION & EMERGENCY MEDICINE, 2011, 19
[4]  
Egol A, 1999, CRIT CARE MED, V27, P633
[5]   Predictors of intensive care unit refusal in French intensive care units: A multiple-center study [J].
Garrouste-Orgeas, M ;
Montuclard, L ;
Timsit, JF ;
Reignier, J ;
Desmettre, T ;
Karoubi, P ;
Moreau, D ;
Montesino, L ;
Duguet, A ;
Boussat, S ;
Ede, C ;
Monseau, Y ;
Paule, T ;
Misset, B ;
Carlet, J .
CRITICAL CARE MEDICINE, 2005, 33 (04) :750-755
[6]   Critical care medicine in the United States 2000-2005: An analysis of bed numbers, occupancy rates, payer mix, and costs [J].
Halpern, Neil A. ;
Pastores, Stephen M. .
CRITICAL CARE MEDICINE, 2010, 38 (01) :65-71
[7]   Reasons for refusal of admission to intensive care and impact on mortality [J].
Iapichino, Gaetano ;
Corbella, Davide ;
Minelli, Cosetta ;
Mills, Gary H. ;
Artigas, Antonio ;
Edbooke, David L. ;
Pezzi, Angelo ;
Kesecioglu, Jozef ;
Patroniti, Nicol ;
Baras, Mario ;
Sprung, Charles L. .
INTENSIVE CARE MEDICINE, 2010, 36 (10) :1772-1779
[8]   Prospective evaluation of patients refused admission to an intensive care unit: triage, futility and outcome [J].
Joynt, GM ;
Gomersall, CD ;
Tan, P ;
Lee, A ;
Cheng, CAY ;
Wong, ELY .
INTENSIVE CARE MEDICINE, 2001, 27 (09) :1459-1465
[9]   APACHE-II - A SEVERITY OF DISEASE CLASSIFICATION-SYSTEM [J].
KNAUS, WA ;
DRAPER, EA ;
WAGNER, DP ;
ZIMMERMAN, JE .
CRITICAL CARE MEDICINE, 1985, 13 (10) :818-829
[10]   THE APACHE-III PROGNOSTIC SYSTEM - RISK PREDICTION OF HOSPITAL MORTALITY FOR CRITICALLY ILL HOSPITALIZED ADULTS [J].
KNAUS, WA ;
WAGNER, DP ;
DRAPER, EA ;
ZIMMERMAN, JE ;
BERGNER, M ;
BASTOS, PG ;
SIRIO, CA ;
MURPHY, DJ ;
LOTRING, T ;
DAMIANO, A ;
HARRELL, FE .
CHEST, 1991, 100 (06) :1619-1636