Industrial Engineering Department, Ondokuz Mayıs University, Samsun, Turkey.
Industrial Engineering Department, Gaziantep University, Gaziantep, Turkey.
Comput Methods Programs Biomed. 2021 Sep;209:106348. doi: 10.1016/j.cmpb.2021.106348. Epub 2021 Aug 8.
The COVID-19 pandemic results in an intense flow of patients to hospitals especially to the intensive care units (ICUs) to be treated. The ICUs will therefore be confronted with a massive influx of patients (e.g. Spain and Italy). However, if the number of patients is higher than the resources available in ICUs, rationing decisions such as determining and evaluating the criteria for ICU admission becomes essential. In this case, the decision of which patients will be admitted to the ICUs may put significant pressure on healthcare personnel. The goal of this paper is to determine the criteria to be used in the decision of admission of COVID-19 patients to the ICUs.
A three-step methodology is applied. In the first step, the evaluation criteria are determined, and then the criteria are prioritized using a fuzzy analytical hierarchy process (AHP) in an uncertain and multiple-criteria environment choice. Finally, COVID-19 patients are ranked using the Multi-Objective Optimization Method by Ratio Analysis to find out which patient is more urgent.
According to experts' evaluation of ICU admission criteria, "increment of >2 in SOFA score" seems the most dominant factor among others. The proposed methodology is tested on 10 anonymous COVID-19 positive patients being treated in a public hospital and the ICU admission results are discussed.
Obtained priorities and ranking is in line with the hospitals' behavior that potentially depicts the usefulness and validity of the proposed approach.
COVID-19 大流行导致大量患者涌入医院，尤其是重症监护病房（ICU）进行治疗。因此，ICU 将面临大量患者涌入的情况（例如西班牙和意大利）。然而，如果患者人数超过 ICU 可用资源，就需要做出配给决策，例如确定和评估 ICU 入院标准。在这种情况下，决定哪些患者将被收入 ICU 可能会给医疗保健人员带来巨大压力。本文的目的是确定用于决定 COVID-19 患者入住 ICU 的标准。
采用三步法。在第一步中，确定评估标准，然后使用模糊层次分析法（AHP）在不确定和多标准环境选择中对标准进行优先级排序。最后，使用比率分析的多目标优化方法对 COVID-19 患者进行排名，以找出哪个患者更紧急。
根据专家对 ICU 入院标准的评估，“SOFA 评分增加>2”似乎是其他标准中最主要的因素。该方法在一家公立医院治疗的 10 名匿名 COVID-19 阳性患者中进行了测试，并讨论了 ICU 入院结果。
得到的优先级和排名符合医院的行为，这表明所提出方法的有用性和有效性。
