Postoperative undertriage increases risk for high-acuity patients, prompting new goals of care.

• Undertriaged patients had higher unplanned intubation rates (12.1% vs. 7.1%) and in-hospital mortality (7% vs. 1.1%).
• New DNR status orders were issued for 7.2% of undertriaged patients compared to 2.8% in the ICU cohort.

Surgeons should reevaluate triage practices to mitigate these risks and improve patient outcomes.

• Similar overall costs suggest no financial benefit in undertriaging.