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Oldest Patients Least Likely to Get ICU Care

Medicare study finds those over 90 a third as likely to get critical care

FRIDAY, May 28 , 2004 (HealthDayNews) -- The older the patient, the less likely he or she will receive care in an intensive or critical care unit, according to a U.S. study.

People over age 90 were only a third as likely as people ages 68 to 70 of the same race, gender, income and illness category to be treated in an intensive care unit (ICU), said the nationwide study of more than 1 million Medicare beneficiaries.

"The concern this study raises is whether some older people are not getting care that might help them," lead researcher Dr. Theodore Iwashyna, of the Hospital of the University of Pennsylvania in Philadelphia, said in a prepared statement.

"While previous studies have shown that older people are more likely to have 'Do Not Resuscitate' orders, it may be that physicians or family members assume that older people don't want aggressive care in general, and that may not be true. It also suggests that younger patients may be getting more aggressive care than they might really want," Iwashyna said.

The study found that 47.6 percent of lung cancer patients aged 68-70 used the ICU at some point, compared with 25 percent of those aged 86-90 and 20.7 percent of those over age 90. That pattern was similar for other health problems, including heart attack, stroke, hip fracture, congestive heart failure, leukemia and lymphoma.

Iwashyna said it's vital that everyone talk with their doctor and family about the kind of care they desire if they become seriously ill.

"Otherwise, you'll be making your family members and physicians guess what you want, and they may guess wrong," Iwashyna said.

The study was presented this week at the American Thoracic Society International Conference in Orlando.

More information

The American Cancer Society has information about the Patient's Bill of Rights.

SOURCE: American Thoracic Society, news release, May 24, 2004
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