Development a Reverse Triage System Based on Modified Sequential Organ Failure Assessment for Increasing the Critical Care Surge Capacity.

CONTEXT

The capacity completeness are one of the serious problems in the bed's managements of the critical care units in a crisis and disaster situation. Reverse triage can help to hospital surge capacity in this situations.

AIMS

The aim of this study was to develop a reverse triage system based on Modified Sequential Organ Failure Assessment (MSOFA) for increasing critical care surge capacity.

SETTINGS AND DESIGN

This study was a prospective design that performed on the medical patients in critical care unit.

SUBJECTS AND METHODS

The MSOFA score for each patient was calculated in admission time and be continued until discharging time from critical care unit.

STATISTICAL ANALYSIS USED

The Cox regression method was used to determine the relative risk values. At last, the patients were divided into three levels for reverse triage.

RESULTS

Four hundred and twenty patients were participated in this study. The mean of patients' MSOFA scores in the 1 day of admission in Critical Care was 5.40 ± 3.8. The relative risk of internal patients discharge from critical care was (8.2%). Death relative risks were <25%, higher than 70% and between 25.1% and 69.9% for three color level of green, black, and red, respectively.

CONCLUSION

The MSOFA scores can contribute to the design a leveling system for discharging patients from critical care unit. Based on this system, the members of the caring team can predict the final health status of the patient.