Developing Consensus-Based Criteria for Intensive Care Unit Admission Prioritization During Mass Casualty Incidents: A Delphi Study in Iran
学术急诊医学档案,
卷 14 编号 1 (2026),
1 十月 2025
,
第 e56 页
https://doi.org/10.22037/aaem.v14i1.3112
摘要
Introduction: Mass casualty incidents create sudden surges in critical care demand that can overwhelm hospital capacity. This study aimed to develop consensus-based ICU admission criteria for mass casualty incidents. Methods: This methodological study employed a two-stage sequential design to identify, refine, and prioritize ICU admission criteria for mass casualty incidents (MCIs). First, an expert panel of 15 specialists in critical care, emergency medicine, and disaster management refined a preliminary checklist derived from a scoping review. Then, a two-round Delphi survey was conducted with 20 experts to assess consensus, and the study was reported in accordance with the CREDES recommendations. Consensus was predefined as a mean score of at least 4.0 on a five-point Likert scale. The response rate was 100%. Results: The initial checklist, which consisted of 46 criteria, was expanded to 51 items after the expert panel review. Following a two-round Delphi survey, consensus was reached on 18 criteria across six components: respiratory, cardiovascular, neurological, trauma and bleeding, multisystem, and special clinical considerations. The mean scores for these criteria ranged from 4.00 to 4.55, with the highest score being for respiratory rate at 4.55. Additionally, all retained items had an interquartile range of 1.00 to 1.25, indicating strong agreement among the experts. Conclusions: The proposed framework may serve as a preliminary decision-support tool for ICU triage in mass casualty incidents, based on expert consensus rather than clinical outcome validation. It may support equitable resource allocation and disaster preparedness, but external validation in other healthcare settings is required before broader application.
- Mass Casualty Incidents
- Intensive Care Unit
- ICU Admission
- Patient Prioritization
- Triage
- Delphi Study
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