Crisis Care Scoring System Highlights Racial Inequities – Medscape – DC Initiative on Racial Equity
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Approximately twice as many Black patients as patients of other ethnicities scored in the lowest priority group for allocation of critical care resources, as determined from data from nearly 500 patients treated at six hospitals during a COVID-19 surge.

Regional surges in critically ill patients during the COVID-19 pandemic prompted concerns about the allocation of critical care resources, such as ventilators and available intensive care unit (ICU) beds, write Elisabeth D. Riviello, MD, of Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, and colleagues. Crisis standard of care (CSOC) plans developed in response to the pandemic focused on the greatest number of lives saved and life-years saved, but whether CSOC triage scores exacerbated racial inequities has not been thoroughly explored, they say.

In a study published online March 15 in JAMA Network Open, the researchers retrospectively analyzed scoring data from a regional surge in COVID-19 cases between April 13, 2020, and May 22, 2020, at six hospitals in a single healthcare network in greater Boston, Massachusetts.

The study population included 498 adults admitted to the ICU, 225 of whom had COVID-19. Patients were scored by acute severity of illness using the Sequential Organ Failure Assessment score and by chronic severity of illness using scores for comorbidity and life expectancy. The median age of the patients was 67 years; 38.4% were women, and 15.9% were Black patients.

Overall, Black patients wer

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