Balancing care decisions for gravely ill patients

ROCHESTER, Minn. -- Mayo Clinic researchers studying gravely ill intensive care unit (ICU) patients found that unrealistic family expectations resulted in the increased use of health care resources without a significant improvement in survival rate among these patients.

The February Mayo Clinic Proceedings study is important for patients who have a high likelihood of death in a hospital. Early, accurate identification of these patients when they arrive at the hospital might limit potentially futile, aggressive ICU care to such patients. However, limiting such aggressive care based on inaccurate tools might shorten potentially productive lives, says Keith Berge, M.D., a Mayo Clinic anesthesiologist who was the lead researcher.

In this study, researchers used the Acute Physiology and Chronic Health Evaluation III (APACHE III), a computerized system that is designed to prospectively predict mortality rates in "real time" for ICU patients, to identify a group of patients with a very low predicted likelihood of survival. This group of extremely ill patients was then looked at in more detail.

The researchers compared a group of these patients in which the families had unrealistic expectations of survival with a group of patients whose families' expectations were deemed appropriate. They found that patients whose families had unrealistic expectations used substantially more ICU resources. The median number of days in ICU for all patients was four, while the median number of days in ICU for patients whose families had unrealistic expectations was 11 days. While these patients survived to hospital discharge at a higher rate than others (33 percent versus 17 percent), their survival one year later did not differ much from those without documentation of unrealistic expectations (11 percent versus 6 percent). Nearly all survivors were severely disabled at discharge and at one year.

"Perhaps the best way to avoid vast expenditures of resources on


Page: 1 2 3

Related medicine news :

1. Accountability in Clinical Research: Balancing Risk and Benefit
2. How the stories of ordinary people could give them more say over planning decisions
3. Web-based tool to help clinicians make schizophrenia treatment decisions
4. Fair decisions more important when hospitals face crisis like SARS
5. Concerns about fertility affect treatment decisions in one-third of young breast cancer patients
6. European study highlights frequency of medical end-of-life decisions in terminally ill pts
7. Brain imaging study reveals interplay of thought and emotion in economic decisions
8. Peer pressure matters in young adults smoking decisions
9. Computerized tool predicts sarcoma outcome and improves ability to make better treatment decisions
10. Hormonal treatment improves survival in high-risk prostate cancer patients
11. Study finds that coordinating care of chronically ill patients does not increase liability

Post Your Comments:

(Date:10/13/2015)... ... October 13, 2015 , ... The American Institutes for ... campus health staff caring for students who have experienced sexual assault and other trauma. ... White House during the Violence Against Women Act's 21st anniversary. , ...
(Date:10/13/2015)... ... October 13, 2015 , ... Califia Farms , one ... the release of its limited edition holiday seasonal flavors: Almondmilk Holiday Nog, new ... the unique flavor combinations and delicious taste Califia Farms’ beverages are known for, ...
(Date:10/13/2015)... ... October 13, 2015 , ... Altec ... their sponsorship of the Microsoft Dynamics AXUG, GPUG and NAVUG Summits to take ... and NAVUG Summit are independent user conferences designed and led by users to ...
(Date:10/13/2015)... , ... October 13, 2015 , ... Dr. Poneh Ghasri, ... New Today on September 18, 2015. The research, which was conducted at the Dental ... Sabbah and colleagues, show connections between stress during pregnancy and future dental health in ...
(Date:10/13/2015)... ... 2015 , ... Protein is essential to good health. You need it to ... how much protein does the average man need in order to stay healthy? ... 2015 issue of Harvard Men's Health Watch . Most Americans get about 15% ...
Breaking Medicine News(10 mins):
(Date:10/13/2015)... -- Families across the country have filed product ... pharmaceutical company,s blockbuster anti-nausea drug Zofran and congenital ... their fraudulent misrepresentations to prescribing physicians about the ...   Due to the large number of Zofran birth ... Panel on Multidistrict Litigation (JPML) has ordered that ...
(Date:10/13/2015)... LAS VEGAS , Oct. 13, 2015 ... field of vascular medicine and intervention through education and ... its annual conference,  VIVA 2015 . Sixteen trial results, ... be released for the first time on Monday and ... Vegas. --> --> ...
(Date:10/13/2015)... , Oct. 13, 2015   Generational Equity , ... businesses, is pleased to announce the acquisition of its ... Largo, Florida , by Meridian Biomedical, ... September 11, 2015. Florida ... --> Florida . To learn more, ...
Breaking Medicine Technology:
Cached News: