Utilizing triage rates to improve ICU admission guidelines of elderly rib fracture patients.
Publication/Presentation Date
1-1-2022
Abstract
BACKGROUND: Elderly rib fracture patients are generally admitted to an ICU which may result in overutilization of scarce resources. We hypothesized that this practice results in significant overtriage.
METHODS: Retrospective study of patients over age 70 with acute rib fracture(s) as sole indication for ICU admission. Primary outcomes were adverse events (intubation, pneumonia, death), which we classified as meriting ICU admission. We utilized Cribari matrices to calculate triage rates.
RESULTS: 101 patients met study criteria. 12% had adverse events occurring on average at day 5. Our undertriage rate was 6% and overtriage rate 87%. The 72 overtriaged patients utilized 295 total ICU days. Evaluating guideline modification, ≥3 fractures appears optimal. Changing to this would have liberated 50 ICU days with 3% undertriage.
CONCLUSION: Elderly patients with small numbers of rib fractures are overtriaged to ICUs. Modifying guidelines to ≥3 rib fractures will improve resource utilization and save ICU beds.
Volume
223
Issue
1
First Page
126
Last Page
130
ISSN
1879-1883
Published In/Presented At
Goldstein, C., Juthani, B., Livingston, D. H., Glass, N. E., & Sifri, Z. (2022). Utilizing triage rates to improve ICU admission guidelines of elderly rib fracture patients. American journal of surgery, 223(1), 126–130. https://doi.org/10.1016/j.amjsurg.2021.07.034
Disciplines
Medicine and Health Sciences
PubMedID
34373083
Department(s)
Department of Surgery
Document Type
Article