CHEST Guidelines-Long-term-Survival-of-Critically-Ill-Patients-Stra

Long-term-Survival-of-Critically-Ill-Patients-Stra

Pdf Summary

The study, "Long-term Survival of Critically Ill Patients Stratified According to Pandemic Triage Categories," investigates the outcomes of ICU patients classed under COVID-19 pandemic triage criteria. The retrospective cohort study used data from 126,687 ICU admissions in Victoria, Australia, spanning 2007-2018. Patients were categorized into low, medium, or high priority for ICU admission based on age, chronic illness, and the Sequential Organ Failure Assessment (SOFA) score.<br /><br />The primary goal was to assess long-term survival, noting that patients labeled as "low priority" under existing triage protocols often demonstrated significant survival potential. Among low-priority patients, 33% aged 85 years or with severe chronic illnesses, and 26% with a SOFA score of 12 survived for five years. Long-term survival at ten years was 22% for these patients. The study highlighted that while low-priority patients accounted for 27% of ICU bed-days, they displayed lower in-hospital mortality (22%) compared to high-priority patients (28%).<br /><br />The findings challenge existing triage protocols that often exclude patients with potentially significant survival rates. The data suggests that triage criteria could benefit from more complex assessments that incorporate a combination of age, comorbidities, organ dysfunction, and frailty rather than solely relying on SOFA scores.<br /><br />This study underscores the necessity for more evidence-based ICU triage protocols that can accommodate the longer-term survival potential of patients, suggesting refinements in prioritization criteria for admissions during high-demand periods, such as pandemics. The research advocates for the development of a scoring system that incorporates several metrics to improve triage decision-making and resource allocation in ICUs.

Keywords

ICU triage

pandemic triage

long-term survival

SOFA score

retrospective cohort

Victoria Australia ICU

low priority patients

in-hospital mortality

triage protocol refinement

resource allocation