Development a Reverse Triage System Based on Modified Sequential Organ Failure Assessment for Increasing the Critical Care Surge Capacity

CONTEXT: The capacity completeness are one of the serious problems in the bed's managements of the critical care units in a crisis and disaster situation. Reverse triage can help to hospital surge capacity in this situations. AIMS: The aim of this study was to develop a reverse triage system based on Modified Sequential Organ Failure Assessment (MSOFA) for increasing critical care surge capacity. SETTINGS AND DESIGN: This study was a prospective design that performed on the medical patients in critical care unit. SUBJECTS AND METHODS: The MSOFA score for each patient was calculated in admission time and be continued until discharging time from critical care unit. STATISTICAL ANALYSIS USED: The Cox regression method was used to determine the relative risk values. At last, the patients were divided into three levels for reverse triage. RESULTS: Four hundred and twenty patients were participated in this study. The mean of patients' MSOFA scores in the 1(st) day of admission in Critical Care was 5.40 ± 3.8. The relative risk of internal patients discharge from critical care was (8.2%). Death relative risks were <25%, higher than 70% and between 25.1% and 69.9% for three color level of green, black, and red, respectively. CONCLUSION: The MSOFA scores can contribute to the design a leveling system for discharging patients from critical care unit. Based on this system, the members of the caring team can predict the final health status of the patient.