Ramos et al developed an algorithm to aid in triaging a patient for admission to the intensive care unit )ICU). This can help guide admissions during periods of high demand. The authors are from the University of Sao Paulo in Brazil.
Outcome: priority for ICU admission (1 highest, 4 lowest)
Parameters:
(1) comorbidities
(2) functional status
(3) prognosis
(4) reason for ICU admission
Comorbidities were classified into four strata:
(C1) no comorbidities,
(C2) compensated comorbidities,
(C3) decompensated comorbidities (frequent hospital admissions in the last few months, unintended weight loss or loss of functionality)
(C4) advanced, end-stage disease with a probable life expectancy of months
Functional status:
(F1) functionally independent
(F2) partially dependent
(F3) severely dependent (capable of performing a maximum of two ADLs)
Prognosis:
(P1) probable survivor without severe disabilities
(P2) probable survivor with severe disabilities
(P3) probable non-survivor
Reason for ICU admission:
(1) Intervention: defined as the need for vasoactive drugs, mechanical ventilation (invasive or noninvasive), or urgent hemodialysis in unstable patients.
(2) Monitoring: defined as the need for active monitoring with possibility of active intervention (e.g., high-risk surgical patients, acute coronary syndromes, post-thrombolysis stroke patients).
|
Comorbid
|
Functional
|
Prognosis
|
Reason
|
Priority
|
|
C4
|
F2 or F3
|
NA
|
NA
|
4
|
|
C4
|
F1
|
P3
|
NA
|
4
|
|
C4
|
F1
|
P1 or P2
|
NA
|
3
|
|
C3
|
F3
|
NA
|
NA
|
4
|
|
C3
|
F2
|
NA
|
NA
|
3
|
|
C2
|
F3
|
NA
|
NA
|
3
|
|
other
|
other
|
other
|
monitoring
|
2
|
|
other
|
other
|
other
|
intervention
|
1
|
