The Eldicus prospective, observational study of triage decision making in European intensive care units: Part I-European Intensive Care Admission Triage Scores

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 c 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. (Crit Care Med 2012; 40:125-131)