• Hoi-Ping Shum, King-Chung Chan, Chun-Wing Lau, Anne Kit-Hung Leung, Kin-Wai Chan, and Wing-Wa Yan.
• Department of Intensive Care, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China. shumhp@ha.org.hk
• Crit Care Resusc. 2010 Mar 1;12(1):42-9.

ObjectiveTo identify factors associated with the triage decision for patients classified as Society of Critical Care Medicine (SCCM) Triage Priority 3, and their outcomes.DesignSingle-centre, prospective, observational cohort study.SettingGeneral intensive care unit in a tertiary regional hospital, over the 9 months January to September 2007.PatientsSCCM Triage Priority 3 patients.ResultsAll patients were followed up for at least 6 months. Among the 1346 triaged patients, 250 were classified as SCCM Triage Priority 3. Fewer than a third of these (76, 30.4%) were admitted to the ICU. Medical patients were more likely to be rejected than surgical or neurosurgical patients. Those with a poorer physicianpredicted chance of long-term survival were more likely to be rejected than those with a better predicted prognosis. The MPMII0-predicted mortality was higher for those denied ICU admission. Non-postoperative status (odds ratio [OR], 26.3) and physician-predicted risk > 50% of death within 1 month (OR, 11.8) were independently correlated with denial of ICU admission in a multiple logistic regression analysis. Cox regression analysis showed that independent risk factors for mortality were denial of ICU admission (hazard ratio [HR], 2.80), higher MPMII0-predicted mortality (HR, 1.12 for every 10% increment) and the presence of renal disease as an admission diagnosis (HR, 2.28).ConclusionsFor SCCM Triage Priority 3 patients, postoperative status and better physician-predicted prognosis correlated with ICU admission. Patients had lower medium-term survival if they were denied ICU admission, or had higher MPMII0-predicted mortality, or renal disease as the admission diagnosis.

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