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Triage Procedures for Critical Care Resource Allocation During Scarcity.
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- Author(s): Ennis JS;Ennis JS; Riggan KA; Riggan KA; Nguyen NV; Nguyen NV; Kramer DB; Kramer DB; Kramer DB; Smith AK; Smith AK; Smith AK; Sulmasy DP; Sulmasy DP; Sulmasy DP; Tilburt JC; Tilburt JC; Tilburt JC; Wolf SM; Wolf SM; Wolf SM; DeMartino ES; DeMartino ES; DeMartino ES
- Source:
JAMA network open [JAMA Netw Open] 2023 Aug 01; Vol. 6 (8), pp. e2329688. Date of Electronic Publication: 2023 Aug 01.- Publication Type:
Journal Article; Research Support, N.I.H., Extramural- Language:
English - Source:
- Additional Information
- Source: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
- Publication Information: Original Publication: Chicago, IL : American Medical Association, [2018]-
- Subject Terms:
- Abstract: Importance: During the COVID-19 pandemic, many US states issued or revised pandemic preparedness plans guiding allocation of critical care resources during crises. State plans vary in the factors used to triage patients and have faced criticism from advocacy groups due to the potential for discrimination.
Objective: To analyze the role of comorbidities and long-term prognosis in state triage procedures.
Design, Setting, and Participants: This cross-sectional study used data gathered from parallel internet searches for state-endorsed pandemic preparedness plans for the 50 US states, District of Columbia, and Puerto Rico (hereafter referred to as states), which were conducted between November 25, 2021, and June 16, 2023. Plans available on June 16, 2023, that provided step-by-step instructions for triaging critically ill patients were categorized for use of comorbidities and prognostication.
Main Outcomes and Measures: Prevalence and contents of lists of comorbidities and their stated function in triage and instructions to predict duration of postdischarge survival.
Results: Overall, 32 state-promulgated pandemic preparedness plans included triage procedures specific enough to guide triage in clinical practice. Twenty of these (63%) included lists of comorbidities that excluded (11 of 20 [55%]) or deprioritized (8 of 20 [40%]) patients during triage; one state's list was formulated to resolve ties between patients with equal triage scores. Most states with triage procedures (21 of 32 [66%]) considered predicted survival beyond hospital discharge. These states proposed different prognostic time horizons; 15 of 21 (71%) were numeric (ranging from 6 months to 5 years after hospital discharge), with the remaining 6 (29%) using descriptive terms, such as long-term.
Conclusions and Relevance: In this cross-sectional study of state-promulgated critical care triage policies, most plans restricted access to scarce critical care resources for patients with listed comorbidities and/or for patients with less-than-average expected postdischarge survival. This analysis raises concerns about access to care during a public health crisis for populations with high burdens of chronic illness, such as individuals with disabilities and minoritized racial and ethnic groups. - Comments: Comment in: JAMA Netw Open. 2023 Aug 1;6(8):e2329676. (PMID: 37642969)
- References: Chest. 2022 Feb;161(2):504-513. (PMID: 34506791)
Chest. 2020 Oct;158(4):1332-1334. (PMID: 32450243)
Hastings Cent Rep. 2021 Sep;51(5):18-29. (PMID: 34529846)
Chest. 2022 Feb;161(2):e136. (PMID: 35131074)
J Racial Ethn Health Disparities. 2021 Aug;8(4):824-836. (PMID: 32789816)
JAMA. 2012 Jan 11;307(2):182-92. (PMID: 22235089)
Bioethics. 2022 Sep;36(7):802-808. (PMID: 35533287)
N Engl J Med. 2013 Jun 27;368(26):2448-50. (PMID: 23802514)
BMC Fam Pract. 2015 Aug 27;16:110. (PMID: 26310664)
PLoS One. 2016 Aug 25;11(8):e0161407. (PMID: 27560380)
Clin Oncol (R Coll Radiol). 2001;13(3):209-18. (PMID: 11527298)
JAMA. 2021 Apr 13;325(14):1469-1470. (PMID: 33595630)
Disabil Health J. 2011 Apr;4(2):59-67. (PMID: 21419369)
Rehabil Psychol. 2020 May;65(2):101-112. (PMID: 32105109)
Prev Chronic Dis. 2020 Sep 17;17:E106. (PMID: 32945769)
JAMA Netw Open. 2021 Jun 1;4(6):e2113891. (PMID: 34143190)
J Health Polit Policy Law. 2021 Oct 1;46(5):831-860. (PMID: 33769474)
Arch Intern Med. 2011 Oct 24;171(19):1721-6. (PMID: 21788535)
Prev Chronic Dis. 2014 Jan 30;11:130251. (PMID: 24480632)
JAMA Netw Open. 2020 Jun 1;3(6):e2012606. (PMID: 32558916)
BMJ. 2003 Jul 26;327(7408):195-8. (PMID: 12881260)
PLoS One. 2021 Sep 17;16(9):e0257608. (PMID: 34535009)
Health Aff (Millwood). 2021 Feb;40(2):297-306. (PMID: 33523739)
J Palliat Care. 2007 Summer;23(2):93-112. (PMID: 17853845)
JAMA Health Forum. 2022 Jan 4;3(1):e214799. (PMID: 36218861)
J Clin Epidemiol. 2008 Apr;61(4):344-9. (PMID: 18313558)
BMJ. 2000 Feb 19;320(7233):469-72. (PMID: 10678857)
PLoS One. 2019 Jun 17;14(6):e0218462. (PMID: 31206556)
Am J Respir Crit Care Med. 2021 Jul 15;204(2):178-186. (PMID: 33751910)
Alzheimers Dement. 2019 Jan;15(1):17-24. (PMID: 30243772)
Prev Chronic Dis. 2017 Oct 19;14:E101. (PMID: 29049018) - Grant Information: R03 AG073987 United States AG NIA NIH HHS; K24 AG068312 United States AG NIA NIH HHS
- Publication Date: Date Created: 20230829 Date Completed: 20230831 Latest Revision: 20231002
- Publication Date: 20240628
- Accession Number: PMC10466166
- Accession Number: 10.1001/jamanetworkopen.2023.29688
- Accession Number: 37642967
- Source:
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