• René Robert, Rémi Coudroy, Stéphanie Ragot, Olivier Lesieur, Isabelle Runge, Vincent Souday, Arnaud Desachy, Jean-Paul Gouello, Michel Hira, Mouldi Hamrouni, and Jean Reignier.
• Réanimation Médicale, Université de Poitiers, CHU Poitiers, Inserm Unit CIC 1402; Groupe ALIVE, Poitiers, France. rene.robert@chu-poitiers.fr.
• Ann Intensive Care. 2015 Dec 1; 5 (1): 55.

BackgroundThe potential influence of bed availability on triage to intensive care unit (ICU) admission is among the factors that may influence the ideal ratio of ICU beds to population: thus, high bed availability (HBA) may result in the admission of patients too well or too sick to benefit, whereas bed scarcity may result in refusal of patients likely to benefit from ICU admission.MethodsCharacteristics and outcomes of patient admitted in four ICUs with usual HBA, defined by admission refusal rate less than 11 % because of bed unavailability, were compared to patients admitted in six ICUs with usual low bed availability (LBA), i.e., an admission refusal rate higher than 10 % during a 90-day period.ResultsOver the 90 days, the mean number of days with no bed available was 30 ± 16 in HBA units versus 48 ± 21 in LBA units (p < 0.01). The proportion of admitted patients was significantly higher in the HBA (80.1 %; n = 659/823) than in the LBA units [61.6 %: n = 480/779; (p < 0.0001)]. The proportion of patients deemed too sick to benefit from admission was higher in LBA (9.0 %; n = 70) than in the HBA (6.3 %; n = 52) units (p < 0.05). The HBA group had a significantly greater proportion of patients younger than 40 years of age (22.5 %; n = 148 versus 14 %; n = 67 in LBA group; p < 0.001) and higher proportions of patients with either high or low simplified acute physiologic score II values.ConclusionsBed availability affected triage decisions. Units with HBA trend to admit patients too sick or too well to benefit.

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