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Multicenter Study
A multicentre evaluation of two intensive care unit triage protocols for use in an influenza pandemic.
- Winston K Cheung, John Myburgh, Ian M Seppelt, Michael J Parr, Nikki Blackwell, Shannon Demonte, Kalpesh Gandhi, Larissa Hoyling, Priya Nair, Melissa Passer, Claire Reynolds, Nicholas M Saunders, Manoj K Saxena, Govindasamy Thanakrishnan, and Influenza Pandemic ICU Triage Study Investigators.
- Concord Repatriation General Hospital, Sydney, NSW. winston.cheung@sswahs.nsw.gov.au
- Med. J. Aust. 2012 Aug 6; 197 (3): 178-81.
ObjectiveTo determine the increase in intensive care unit (ICU) bed availability that would result from the use of the New South Wales and Ontario Health Plan for an Influenza Pandemic (OHPIP) triage protocols.Design, Setting And PatientsProspective evaluation study conducted in eight Australian, adult, general ICUs, between September 2009 and May 2010. All patients who were admitted to the ICU, excluding those who had elective surgery, were prospectively evaluated using the two triage protocols, simulating a pandemic situation. Both protocols were originally developed to determine which patients should be excluded from accessing ICU resources during an influenza pandemic.Main Outcome MeasureIncrease in ICU bed availability.ResultsAt admission, the increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 3.5%, 14.7% and 22.7%, respectively, and 52.8% using the OHPIP triage protocol (P < 0.001). Re-evaluation of patients at 12 hours after admission using Tiers 1, 2 and 3 of the NSW triage protocol incrementally increased ICU bed availability by 19.2%, 16.1% and 14.1%, respectively (P < 0.001). The maximal cumulative increases in ICU bed availability using Tiers 1, 2 and 3 of the NSW triage protocol were 23.7%, 31.6% and 37.5%, respectively, at 72 hours (P < 0.001), and 65.0% using the OHPIP triage protocol, at 120 hours (P < 0.001).ConclusionBoth triage protocols resulted in increases in ICU bed availability, but the OHPIP protocol provided the greatest increase overall. With the NSW triage protocol, ICU bed availability increased as the protocol was escalated.
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