A patient without an obvious need was defined as one who did not require endotracheal intubation and mechanical ventilation or as one who did not have hypotension requiring vasopressors while in the emergency department. Risk increases proportionally with the presence of more than three criteria.
Criteria for Consideration of ICU Admission for Patients without an Obvious Need
|IDSA–ATS minor criteria|
|Elevated blood urea nitrogen||Blood urea nitrogen >/=20 mg/dl|
|Tachypnea||Respiratory rate >/=30 breaths/min|
|Multilobar infiltrates observed on radiograph||None specified|
|Hypoxemia||Ratio of partial pressure of oxygen in arterial blood to fraction of inspired oxygen <250 mm Hg|
|Hypotension||Hypotension (systolic pressure <90 mm Hg) requiring aggressive fluid resuscitation|
|Hypothermia||Core temperature of <36 °C|
|Leukopenia||White-cell count <4000/mm3|
|Lactic acidosis||Lactic acid level >/=4 mmol/liter|
|Low pH||<7.30–7.35, depending on scoring system*|
|Low albumin||<3.5 g/dl|
|Hyponatremia||Sodium level <130 mmol/liter|
|Leukocytosis||Leukocyte count >20,000/mm3|
|Tachycardia||Heart rate >/=125 beats/min|
|Older age||>80 yr|
* The criterion of a pH level of less than 7.30 is used in the calculation of the CURXO score. The criterion of a pH level of less than 7.35 is used in the calculation of the SMART-COP and REA-ICU scores.
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Created Mar 14, 2014.