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중환자실 입실 우선순위 결정에 따른 입실환자와 입실거절환자의 예후 비교

Other Titles
 Triage Decision For ICU Admission And Patients’ Outcome 
 이재훈  ;  신증수  ;  한솔  ;  고신옥 
 KOREAN JOURNAL OF ANESTHESIOLOGY, Vol.49(6) : 829-834, 2005 
Journal Title
Issue Date
intensive care unit ; mortality ; mortality probability model II0 (MPMII0) ; outcome ; triage
intensive care unit ; mortality ; mortality probability model II0 (MPMII0) ; outcome ; triage
Background: We constructed a prospective study to evaluate the outcome of patients referred to an intensivist for ICU admission as well as the factors associated with ICU admission refusal.

Methods: Patients referred for ICU admission to medico-surgical ICU in our hospital for 16 weeks were included in this study. We classified the reasons for refusal into three categories: inappropriate referral; triage; futility. Also we classified admitted patients into two categories: immediate admission; delayed admission. After initial evaluation of a patient by an intensivist, we checked the patient’s outcome for following 28 days.

Results: 632 patients had been referred for ICU admission during study period. Among them, 445 (70%) patients were admitted and 187 (30%) patients were refused ICU admission. 116 patients were refused because of inappropriate referral, 52 for triage and 19 for futility. 394 patients were admitted immediately and 51 were refused initially but were later admitted. When 116 inappropriate referral patients were excluded, the mortality rates for immediate admission, delayed admission and triage/futility were 14.4%, 39.2% and 56.3%, respectively (P < 0.05). Standardized mortality ratio was 0.70 for immediate admission, 1.20 for delayed admission, 1.28 for triage and 1.30 for futility (P < 0.05). The factors associated with refusal for ICU admission were age, medical division, diagnostic group and high Mortality Probability Model II0 (MPM II0) grades.

Conclusions: Because the triage decision for ICU admission influences the patients’ outcome, an intensivist must carefully come to a decision when admitting patients to ICU by considering the appropriate guidelines for ICU admission and triage.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Koh, Shin Ok(고신옥)
Shin, Cheung Soo(신증수) ORCID logo https://orcid.org/0000-0001-7829-8458
Lee, Jae Hoon(이재훈) ORCID logo https://orcid.org/0000-0001-6679-2782
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