Validation of a Crisis Standards of Care Model for Prioritization of Limited Resources During the Coronavirus Disease 2019 Crisis in an Urban, Safety-Net, Academic Medical Center

Albert Nadjarian, MD, MPH; Jessica LeClair, BS; Taylor F. Mahoney, MA; Eric H. Awtry, MD, FACC; Jasvinder S. Bhatia, MD; Lisa B. Caruso, MD, MPH; Alexis Clay, MD; David Greer, MD, MA; Karan S. Hingorani, MD, PhD; L. F. B. Horta, MD; Michel Ibrahim, MD; Michael H. Ieong, MD; Thea James, MD; Matthew H. Kulke, MD; Remington Lim, BA; Robert C. Lowe, MD; James M. Moses, MD; Jaime Murphy, MD; Ala Nozari, MD; Anuj D. Patel, MD; Brent Silver, MD; Arthur C. Theodore, MD; Ryan Shufei Wang, MD; Ellen Weinstein, JD; Stephen A. Wilson, MD, MPH, FAAFP; Anna M. Cervantes-Arslanian, MD


Crit Care Med. 2021;49(10):1739-1748. 

In This Article


Our CSC triage algorithm proved useful in predicting greater than 50% 1- and 5-year mortality among our sample of scored patients with ESRD, metastatic cancer, CHF, and neurodegenerative disease in a sample of socioeconomically and racially diverse critically ill patients. However, mortality varied between conditions. The relatively low prevalence of major or severe underlying conditions in this critically ill population appears to support prioritizing acute survival as well as patients without underlying conditions carrying a greater than 50% predicted likelihood of 1-year mortality. Simplification and clarification of these criteria may improve the validity and utility of the scoring process in future iterations of CSC models.