Surgical ICU Admission Criteria: A Scoping Review

Area of Science:

• Critical Care Medicine
• Surgical Intensive Care Unit (SICU) Management
• Healthcare Operations Research

Background:

• Surgical Intensive Care Unit (SICU) admission decisions are complex, influenced by various patient and procedural factors.
• Current practices for SICU admission require environmental scanning to identify areas for improvement and standardization.

Purpose of the Study:

• To explore factors influencing surgical intensive care unit (SICU) admission decisions.
• To conduct an environmental scan of current SICU admission practices.
• To identify underexplored areas in SICU triage, admission, and discharge.

Main Methods:

• A comprehensive literature search was conducted across Embase, PubMed, and Medline databases.
• Studies published in English peer-reviewed journals focusing on adult SICU admission criteria and decision-making were included.
• Data from 44 selected articles were abstracted to analyze SICU structure, function, findings, and future research directions.

Main Results:

• The majority of studies (52%) focused on identifying risk factors for SICU admission, such as demographics and comorbidities.
• Fewer studies (11%) evaluated admission protocols, though these showed promise in reducing unnecessary admissions.
• Future research should prioritize admission/discharge protocol development (39%), multicenter studies (36%), and the implementation of clinical decision-support aids (5%).

Conclusions:

• Current research on SICU triage predominantly centers on identifying admission risk factors, with limited focus on protocol evaluation and implementation.
• There is a need to refine SICU triage strategies, incorporating discharge and surge-related decision-making.
• The development and deployment of clinical decision-support tools are crucial for enhancing SICU triage practices.