Triaging critical ill patients for ICU admission by attending doctors may not be effective particularly in scarcely available ICU bed condition. Thus, we assumed that systematic scoring ICU admission guideline can improve mortality rate of critical ill patients in such circumstance.
This study is a non-randomized controlled prospective study between two clusters of population. We compared the mortality rate of ICU patients between before and after applying the triaging guideline. The guideline was applied for 6-month period from September 2005 to February 2006. The data collected from the six months period prior to application of this guideline were used as the control group. The primary outcome was hospital mortality rate of those patients. The secondary outcome was ICU mortality rate and delayed admission.
Hospital mortality rate of ICU patients declined from 56.51% to 43.20% after application of this guideline (P < 0.01). Likewise the ICU mortality rate also reduced from 50.34% to 35.68% (P < 0.01). The result from the Log Rank test exhibited the overall increase in survival outcome after admission in the guideline group (p < 0.05). Most of patients (89.08%) were admitted to ICU within the date of reservation. Delayed admission was found in 45 patients (10.92%), 34 of whom (75.56%) were delayed by 1 day whereas only 6 patients (13.33%) were delayed by 2 days.
We concluded that this ICU admission guideline can improve hospital mortality in critical ill patients with small amount of patients with delay admissions. Moreover, this systematic approach does not affect to the mortality in general ward.
This systematic guideline is beneficial to the doctor for triaging critical ill patients to ICU. It can improve the quality of care particularly in the hospital with a small number of ICU beds.
Pongdhep Theerawit, No Financial Disclosure Information; No Product/Research Disclosure Information