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Treatment in Critical Care Often Perceived As Futile

Care perceived as futile by critical care physicians costs $2.6 million during a three-month period

TUESDAY, Sept. 10 (HealthDay News) -- Intensive care unit (ICU) treatment is frequently perceived as futile by critical care specialists, and entails considerable costs, according to a study published online Sept. 9 in JAMA Internal Medicine.

Thanh N. Huynh, M.D., from the University of California Los Angeles, and colleagues quantified the prevalence and cost of treatment perceived to be futile in adult critical care. Critical care specialists in five ICUs were surveyed on a daily basis for three months to identify patients the physicians believed were receiving futile treatment.

During the three-month period, a total of 6,916 assessments of 1,136 patients were performed by 36 critical care specialists. Eighty percent of these patients were never perceived to be receiving futile treatment, while 8.6, 11, and 1 percent, respectively, were perceived to be receiving probably futile treatment, receiving futile treatment, and receiving futile treatment on the day they transitioned to palliative care. A total of 464 days of treatment perceived to be futile were received by patients with futile treatment assessments, accounting for 6.7 percent of all assessed patient days. Of the 123 patients perceived as receiving futile care, 84 died before hospital discharge and 20 died within six months of ICU care; survivors persisted in severely compromised states. The estimated cost of futile treatment was $2.6 million during the three-month study period.

"In our health system, critical care physicians frequently perceive that they are providing futile treatment, and the cost is substantial," the authors write. "Identifying and quantitating ICU treatment that is perceived as futile is a first step toward refocusing care on treatments that are more likely to benefit patients."

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