Unifying Concepts

Criteria for Consideration of ICU Admission for Patients without an Obvious Need

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

Criterion Definition
IDSA–ATS minor criteria
Confusion None specified
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
Thrombocytopenia <100,000 platelets/mm3
Hypotension Hypotension (systolic pressure <90 mm Hg) requiring aggressive fluid resuscitation
Hypothermia Core temperature of <36 °C
Leukopenia White-cell count <4000/mm3
Other criteria
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.

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