ICU Critical Care: Costs and Perceived Futility

Thanh N. Huynh, MD, MSHS Clinical Instructor UCLA Division of Pulmonary Critical CareMedicalResearch.com Interview with:
Thanh N. Huynh, MD, MSHS
Clinical Instructor
UCLA Division of Pulmonary Critical Care

MedicalResearch.com: What are the main findings of the study?

Dr. Huynh: Our study shows that it is common for ICU doctors to recognize that futile treatment is provided to patients who cannot benefit from it.  In our study, 11% of ICU patients were perceived as receiving futile treatment.  The outcomes of these 123 patients were uniformly poor, with 85% dying within 6 months.  Advances in critical care medicine has allowed us to save lives, but it has also allowed us provide aggressive life-sustaining treatments that may not benefit all patients.  When aggressive treatment is poorly matched with a patient’s prognosis, doctors will consider such treatment as futile and our study shows that this is not an uncommon occurrence in our health system.


MedicalResearch.com: Were any of the findings unexpected?

Dr. Huynh: We think futile treatment occurs in every hospital, but this study is the first of its kind to empirically quantify it.

MedicalResearch.com: What should clinicians and patients take away from your report?

Dr. Huynh: I think clinicians and patients should realize that not all aggressive treatments are beneficial to the patient.  The intensity and aggressiveness of medical care should be matched with a patient’s prognosis so that so that suffering can be minimized and health care resources be redirected to treatments that do benefit the patient.  We need to realize that intensive critical care is not always the best treatment plan for all patients, and both the clinician and patient (and their loved ones) need to be involved in these difficult discussions.

MedicalResearch.com: What recommendations do you have for future research as a result of this study?

Dr. Huynh: Future research will focus on identifying the patient and clinician factors that lead to futile treatment.  In identifying these factors, we also hope to develop interventions that will decrease futile treatment.

Citation:

Huynh TN, Kleerup EC, Wiley JF, et al. The Frequency and Cost of Treatment Perceived to Be Futile in Critical Care. JAMA Intern Med. 2013;():-. doi:10.1001/jamainternmed.2013.10261.

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