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‘Futile’ ICU treatments affect access to care for other patients
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Administering critical care treatment to prolong life without achieving a meaningful benefit to the patient, or “futile” treatment, delays care for other patients, according to researchers at UCLA’s David Geffen School of Medicine.
Critical care physicians at five ICUs in a 466-bed academic medical center and a 266-bed academic community hospital were surveyed over a 3-month period. Researchers identified incidents when the unit was full and at least one patient was receiving futile treatment. Next, they identified patients who waited more than 4 hours in the ED or for more than 1 day at an outside hospital.
During the study period, 36 critical care specialists evaluated 1,136 patients, 123 of whom were identified as having received futile care. Researchers reported that ICUs with available beds were more likely to contain patients receiving futile treatments, compared with full ICUs (P<.001). However, at least one patient received futile treatment at a full ICU for 38% of the study period (72 days). On these days, researchers reported that 33 ED patients waited for more than 4 hours, nine waited longer than one 1 day to be transferred appropriately, 15 canceled their transfer request after waiting more than 1 day and two patients died while waiting to be transferred.
“Many people do not realize that there is a tension between what medicine is able to do and what medicine should do,” UCLA professor of medicine, Neil S. Wenger, MD, said in a press release. “Even fewer realize that medicine is commonly used to achieve goals that most people, and perhaps most of society, would not value, such as prolonging the dying process in the intensive care unit when a patient cannot improve. But almost no one recognizes that these actions affect other patients, who might receive delayed care — or, worse, not receive needed care at all because futile medical treatment was provided to someone else.”
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