This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on Web of Science (26)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

A Prospective Study of Physician Triage and Patient Outcome

Frederic L. Sax, MD; Mary E. Charlson, MD

Arch Intern Med. 1987;147(5):929-934.

Abstract
• To identify patients likely to be admitted to a critical care unit as well as those at high risk of deterioration, we studied all patients admitted to the medical service. Cardiac patients had a high likelihood of unit admission even if they were rated as not ill and stable, whereas ill and unstable noncardiac patients went to the floor. Stable cardiac or noncardiac patients who were not severely ill had very low deterioration and mortality, but unstable, severely ill patients with cardiac or noncardiac reasons for admission had high deterioration rates. If the goal is to admit patients at highest risk, the optimal strategy is to admit unstable, severely ill, and moribund patients in both the cardiac and noncardiac groups. By doing this, it is possible to decrease unit admission of patients likely to do well, increase the admission of patients likely to do poorly, while decreasing the number of patients admitted.

(Arch Intern Med 1987;147:929-934)

Author Affiliations
From the Clinical Epidemiology Unit, Division of General Internal Medicine, Department of Medicine, Cornell University, New York. Dr Sax is a fellow of the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md. Dr Charlson is a Henry J. Kaiser Family Foundation faculty scholar in general internal medicine.

Footnotes
Accepted for publication Nov 12, 1986.

Reprint requests to 515 E 71st St, Room 800, New York, NY 10021 (Dr Charlson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Evaluation of Changes in Forgoing Life-Sustaining Treatment in Israeli ICU Patients
Jakobson et al.
Chest 2004;126:1969-1973.
ABSTRACT | FULL TEXT  

Patients Readmitted to ICUs* : A Systematic Review of Risk Factors and Outcomes
Rosenberg and Watts
Chest 2000;118:492-502.
ABSTRACT | FULL TEXT  

Triage Considerations in Medical Intensive Care
Franklin et al.
Arch Intern Med 1990;150:1455-1459.
ABSTRACT  

The Therapeutic Efficacy of Critical Care Units: Identifying Subgroups of Patients Who Benefit
Ron et al.
Arch Intern Med 1989;149:338-341.
ABSTRACT  

Intermediate Care: How Do We Know It Works?
Charlson and Sax
Arch Intern Med 1988;148:1270-1271.
ABSTRACT  

Decreases in Mortality on a Large Urban Medical Service by Facilitating Access to Critical Care: An Alternative to Rationing
Franklin et al.
Arch Intern Med 1988;148:1403-1405.
ABSTRACT