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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