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Table 3 Main variables of the case report form

From: Designing and conducting a cluster-randomized trial of ICU admission for the elderly patients: the ICE-CUB 2 study

Item

% missing

Inclusion criteria

 Katz Index of Independence in Activities of Daily Living

16.63

 Age at inclusion

0.00

 Preserved nutritional status (defined as the absence of cachexia, subjectively assessed by physician at bedside)

0.00

 Main reason for ED visit

0.13

 Social security coverage

0.00

 No known active cancer

0.00

Main variables

 Date of inclusion

0.03

 SAPS III

6.03

 Gender

0.00

 Referring emergency physician’s seniority

1.61

 Referring ICU physician’s seniority

33.86

 Full ICU

41.63

 Primary referent

6.52

 Identified general practitioner

1.15

 Invalidating illness

2.37

 Living place

1.05

 Home support

5.90

 Physicians sought patient’s opinion regarding ICU admission

40.74

 Patient’s opinion about ICU admission

0.10

 Physicians seek primary referent’s/family’s opinion regarding ICU admission

49.47

 Primary referent’s/family’s opinion

0.23

 Perceived burden for primary referent/family

63.24

 Surgical status at ED visit

0.30

 Glasgow Coma Scale

12.02

 Emergency physician proposal for an ICU admission

3.29

 Reason for not proposing ICU

22.69

 Patient wishes about ICU admission

42.42

 ICU physician proposal for an ICU admission

20.55

 Reason for not proposing ICU

4.42