1 in 5 ICU Patients Get 'Futile' Care

Cheryl Clark, for HealthLeaders Media , September 10, 2013

"That's our suspicion, that there hasn't been enough discussion even before the patient got to the ICU, and perhaps afterwards."

Wenger says the researchers asked these critical care specialists to assess the patients they were caring for that day, and there were few disagreements when different doctors were assigned to the same patients on subsequent days.

Sometimes when a new doctor rotated on to an ICU, however, "the new doctor would frequently not rate the care as being futile on the first or second day. They said it took them a few days to get to know the patient well enough to make a statement."

As evidence of how futile the care was, of the 123 patients said by physicians to be receiving futile care, 84 died during hospitalization and another 20 died within six months of their ICU stay. The rest were described as having irreversible illnesses including severe cognitive impairment, end stage dementia, anoxic brain injury, persistent vegetative state, or multi-organ failure.

Wenger says that the $2.6 million estimated of cost of care for these 123 patients is probably greatly underestimated, because the estimated $4,004 cost per day of futile care was only calculated on days that physicians described the care as futile. The cost estimate did not include care for patients said to be "probably futile."

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