Decision support aid for patients with COVID-19 who are likely to benefit from critical care
The Decision Support Aid (linked below) has been developed by the Welsh Intensive Care Society and the Wales Critical Care and Trauma Network to support the decision about which patients would benefit from critical care. It was developed following publication from the Intensive Care National Audit and Research Centre (ICNARC) (also linked below) which summarised the clinical course of more than 5,000 patients with COVID-19.
It was put together to help clinicians decide whether their patients would benefit from critical care, but was NOT designed to be used as a scoring system to determine whether a patient should go to critical care.
The Decision Support Aid consists of three main parts:
The patient’s age
As age increases, the benefit of critical care decreases.
The patient’s frailty score (according to the Clinical Frailty Scale)
As frailty increases, the benefit of critical care decreases. The Clinical Frailty Scale is not validated in individuals younger than 65 years. In addition, the CFS should be considered in the context of the patient’s long-term physical and non-physical disabilities.
The number and range of the patient’s comorbidities
The more comorbidities a patient has, the benefit of critical care decreases.
Even if a patient ticks boxes further down on the decision support aid, if the clinician thinks a patient might benefit from critical care, they should discuss with their local critical care teams.
Decision support aid for patients with COVID-19 who are likely to benefit from critical care
The Decision Support Aid (linked below) has been developed by the Welsh Intensive Care Society and the Wales Critical Care and Trauma Network to support the decision about which patients would benefit from critical care. It was developed following publication from the Intensive Care National Audit and Research Centre (ICNARC) (also linked below) which summarised the clinical course of more than 5,000 patients with COVID-19.
It was put together to help clinicians decide whether their patients would benefit from critical care, but was NOT designed to be used as a scoring system to determine whether a patient should go to critical care.
The Decision Support Aid consists of three main parts:
The patient’s age
As age increases, the benefit of critical care decreases.
The patient’s frailty score (according to the Clinical Frailty Scale)
As frailty increases, the benefit of critical care decreases. The Clinical Frailty Scale is not validated in individuals younger than 65 years. In addition, the CFS should be considered in the context of the patient’s long-term physical and non-physical disabilities.
The number and range of the patient’s comorbidities
The more comorbidities a patient has, the benefit of critical care decreases.
Even if a patient ticks boxes further down on the decision support aid, if the clinician thinks a patient might benefit from critical care, they should discuss with their local critical care teams.
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Decision Support Aid
The Wales Critical Care and Trauma Network in collaboration with the Welsh Intensive Care Society, alongside senior intensivists across Wales, offer a process for assisting with the assessment of risks and benefits to patients of critical care treatment which, used judiciously, is of benefit to referring clinicians to better understand the rationale behind the decision making of the Intensivist on whether escalation of treatment will likely benefit an individual.
