key: cord-0713340-l1tkze32
authors: Park, SeungYong
title: Can the intensivists predict the outcomes of critically ill patients on the appropriateness of intensive care unit admission for limited intensive care unit resources ?
date: 2021-11-30
journal: Acute Crit Care
DOI: 10.4266/acc.2021.01641
sha: 3d8b18fe0eeefb8acbabad3e7600a87deec56023
doc_id: 713340
cord_uid: l1tkze32

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and beneficial admission groups was significantly different (36% vs. 78%), and it further diverged at the 6-month follow-up (0% vs. 52%).

The authors concluded that the outcomes of patients perceived as having non-beneficial ICU admissions were extremely poor. The intensivists' perceptions were important in predicting patients' outcomes and were more consistent with the long-term prognosis than with immediate outcomes. Therefore, intensivists should play a role in determining how to utilize limited ICU resources.

The numerous extant clinical scoring systems for critically ill patients, such as Acute Physiology And Chronic Health Evaluation (APACHE), Sequential Organ Failure Assessment (SOFA), and Simplified Acute Physiology Score (SAPS), provide information on the short-term mortality rate but have limitations in predicting the patient's long-term prognosis and quality of life [7] [8] [9] . This gap underscores the importance of the role played by critical care physicians or intensivists.

Furthermore, in this study, when intensivists judged the futility of ICU admission based on their expertise, their perceptions were found to be in good agreement with both the short-term and long-term prognoses. These results suggest the possibility that intensivists' perceptions can supplement and compensate for the limitations of current scoring systems for critically ill patients.

Of course, there is no single method to predict the prognosis of ICU patients and to resolve the issue of futile ICU care. However, through a combination of diverse clinical parameters, scoring systems, and intensivists' perceptions, we will arrive at better and more efficient solutions for resolving these limitations. Future studies should also focus on improving the allocation of scarce ICU resources during the COVID-19 pandemic.

No potential conflict of interest relevant to this article was reported.

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