Utilizing triage rates to improve ICU admission guidelines of elderly rib fracture patients
Copyright © 2021 Elsevier Inc. All rights reserved..
BACKGROUND: Elderly rib fracture patients are generally admitted to an ICU which may result in overutilization of scarce resources. We hypothesized that this practice results in significant overtriage.
METHODS: Retrospective study of patients over age 70 with acute rib fracture(s) as sole indication for ICU admission. Primary outcomes were adverse events (intubation, pneumonia, death), which we classified as meriting ICU admission. We utilized Cribari matrices to calculate triage rates.
RESULTS: 101 patients met study criteria. 12% had adverse events occurring on average at day 5. Our undertriage rate was 6% and overtriage rate 87%. The 72 overtriaged patients utilized 295 total ICU days. Evaluating guideline modification, ≥3 fractures appears optimal. Changing to this would have liberated 50 ICU days with 3% undertriage.
CONCLUSION: Elderly patients with small numbers of rib fractures are overtriaged to ICUs. Modifying guidelines to ≥3 rib fractures will improve resource utilization and save ICU beds.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:223 |
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| Enthalten in: |
American journal of surgery - 223(2022), 1 vom: 15. Jan., Seite 126-130 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Goldstein, Carma [VerfasserIn] |
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| Anmerkungen: |
Date Completed 25.01.2022 Date Revised 25.01.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.amjsurg.2021.07.034 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM329172034 |
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| 500 | |a Date Completed 25.01.2022 | ||
| 500 | |a Date Revised 25.01.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Elderly rib fracture patients are generally admitted to an ICU which may result in overutilization of scarce resources. We hypothesized that this practice results in significant overtriage | ||
| 520 | |a METHODS: Retrospective study of patients over age 70 with acute rib fracture(s) as sole indication for ICU admission. Primary outcomes were adverse events (intubation, pneumonia, death), which we classified as meriting ICU admission. We utilized Cribari matrices to calculate triage rates | ||
| 520 | |a RESULTS: 101 patients met study criteria. 12% had adverse events occurring on average at day 5. Our undertriage rate was 6% and overtriage rate 87%. The 72 overtriaged patients utilized 295 total ICU days. Evaluating guideline modification, ≥3 fractures appears optimal. Changing to this would have liberated 50 ICU days with 3% undertriage | ||
| 520 | |a CONCLUSION: Elderly patients with small numbers of rib fractures are overtriaged to ICUs. Modifying guidelines to ≥3 rib fractures will improve resource utilization and save ICU beds | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Elderly | |
| 650 | 4 | |a ICU | |
| 650 | 4 | |a Rib fractures | |
| 650 | 4 | |a Trauma | |
| 650 | 4 | |a Triage | |
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| 700 | 1 | |a Livingston, David H |e verfasserin |4 aut | |
| 700 | 1 | |a Glass, Nina E |e verfasserin |4 aut | |
| 700 | 1 | |a Sifri, Ziad |e verfasserin |4 aut | |
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