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The Capital Region of Denmark - a part of Copenhagen University Hospital
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The Eldicus prospective, observational study of triage decision making in European intensive care units: Part I-European Intensive Care Admission Triage Scores (EICATS)

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  1. Clinical Examination for the Prediction of Mortality in the Critically Ill: The Simple Intensive Care Studies-I

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Validation and Clinical Evaluation of a Method for Double-Blinded Blood Pressure Target Investigation in Intensive Care Medicine

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  3. Platelet Transfusion Practices in Critically Ill Children

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  1. Impact of triage-to-admission time on patient outcome in European intensive care units: A prospective, multi-national study

    Research output: Contribution to journalJournal articleResearchpeer-review

  2. Gennemgang af Early Warning Score til forebyggelse af uventet kritisk sygdom og død

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  3. A critical assessment of early warning score records in 168,000 patients

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  4. Forced fluid removal in intensive care patients with acute kidney injury: The randomised FFAKI feasibility trial

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  5. Modifications of the National Early Warning Score for patients with chronic respiratory disease

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  • Charles L Sprung
  • Mario Baras
  • Gaetano Iapichino
  • Jozef Kesecioglu
  • Anne Lippert
  • Chris Hargreaves
  • Angelo Pezzi
  • Romain Pirrachio
  • David L Edbrooke
  • Antonio Pesenti
  • Jan Bakker
  • Gabriel Gurman
  • Simon L Cohen
  • Joergen Wiis
  • Didier Payen
  • Antonio Artigas
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OBJECTIVE:: Life and death triage decisions are made daily by intensive care unit physicians. Scoring systems have been developed for prognosticating intensive care unit mortality but none for intensive care unit triage. The objective of this study was to develop an intensive care unit triage decision rule based on 28-day mortality rates of admitted and refused patients. DESIGN:: Prospective, observational study of triage decisions from September 2003 until March 2005. SETTING:: Eleven intensive care units in seven European countries. PATIENTS:: All patients >18 yrs with a request for intensive care unit admission. INTERVENTIONS:: Admission or rejection to an intensive care unit. MEASUREMENTS AND MAIN RESULTS:: Clinical, laboratory, and physiological variables and data from severity scores were collected. Separate scores for accepted and rejected patients with 28-day mortality end point were built. Values for variables were grouped into categories determined by the locally weighted least squares graphical method applied to the logit of the mortality and by univariate logistic regressions for reducing candidates for the score. Multivariate logistic regression was used to construct the final score. Cutoff values for 99.5% specificity were determined. Of 6796 patients, 5602 were admitted and 1194 rejected. The initial refusal score included age, diagnosis, systolic blood pressure, pulse, respirations, creatinine, bilirubin, PaO2, bicarbonate, albumin, use of vasopressors, Glasgow Coma Scale score, Karnofsky Scale, operative status and chronic disorder, and the initial refusal receiver operating characteristics were area under the curve 0.77 (95% confidence interval [CI], 0.76-0.79). The final triage score included age, diagnosis, creatinine, white blood cells, platelets, albumin, use of vasopressors, Glasgow Coma Scale score, Karnofsky Scale, operative status and chronic disorder, and the final score receiver operating characteristics were area under the curve 0.83 (95% CI, 0.80-0.86). Patients with initial refusal scores >173.5 or final triage scores = 0 should be rejected. CONCLUSIONS:: The initial refusal score and final triage score provide objective data for rejecting patients that will die even if admitted to the intensive care unit and survive if refused intensive care unit admission.
Original languageEnglish
JournalCritical Care Medicine
Volume40
Issue number1
Pages (from-to)125-131
ISSN0090-3493
DOIs
Publication statusPublished - 2012

ID: 33104762