20% of Terminally Ill Die in ICU

A study has found that more than 20% of terminally ill patients in the United States die while in intensive care. The finding was reported in the March 2004 issue of Critical Care Medicine.

Researchers analyzed discharge data on more than 500,000 deaths, finding that 38.3% occurred in the hospital and 22.4% occurred following admission to an intensive care unit (ICU). End-of-life care was highest (43%) among infants, and ranged from 18-26% among older children and adults, falling to 14% for people older than 85. However, researchers are concerned that hospitals and ICUs are not prepared to deliver end-of-life care to people over 65, a population that is rapidly expanding.

"We have an enormous social and medical imperative to take very seriously our efforts to make sure critical care is only provided when appropriate and provided in a way that has all the elements of compassion and humanism necessary to treat and manage end-of-life care with dignity,” said Derek C. Angus, M.D., M.P.H., professor of critical care medicine at the University of Pittsburgh School of Medicine (PA, USA; www.medschool.pitt.edu).

Dr. Angus recommends improving prediction models, which would help reduce ICU admission at the end of life for patients with poor prognosis. He suggests that critical care doctors partner with referring doctors to consider risk prevention models before admitting terminally ill patients who cannot benefit from critical care. "Better awareness of what ICU care can offer, and better a priori discussions between patients and their healthcare providers might promote more efficient use of intensive care services.”




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