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  1. The low frequency of futility in an adult intensive care unit setting.

    Article - En anglais

    Background 

    It is widely assumed that « futile » treatment consumes significant health care resources.

    This is a prospective cohort study

    Setting :

    The setting was the medical intensive care unit of Ben Taub General Hospital, a large public hospital in Houston, Tex.

    Objective 

    To assess the frequency of intensive care unit patients meeting any of three broad definitions of futility.

    Subjects 

    Subjects consisted of 129 consecutive patients admitted to the study intensive care unit during a 6-week period in the fall of 1993.

    Main Outcome Measures 

    Operational definitions for three types of futility described in the literature were developed : Imminent demise futility, death imminent regardless of intervention, was assessed by using the APACHE II (Acute Physiology and Chronic Health Evaluation II) scoring system to determine the likelihood of mortality at more than the 90%, 95%, and 99% probabilities.

    Lethal condition futility, conditions incompatible with long-term survival, included five separate disease processes.

    Qualitative futility, conditions with an unacceptable quality of life, was assessed as a persistent vegetative state or as meeting criteria for poor prognosis due to a hypoxic ischemic coma.

    Results 

    Only 2 bed-days (0.3%) were used by patients with more than 90% predicted mortality ; 22 bed-days (3.6%) were used by patients with poor prognosis due to hypoxic ischemic coma ; and 101 bed-days (16.4%) were used by patients satisfying criteria f...

    Mots-clés Pascal : Urgence, Service hospitalier, Médicament, Prescription médicale, Confort, Coût spécifique, Economie santé, Attitude, Homme, Amérique du Nord, Amérique

    Mots-clés Pascal anglais : Emergency, Hospital ward, Drug, Medical prescription, Comfort, Specific cost, Health economy, Attitude, Human, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0143082

    Code Inist : 002B30A05. Création : 199608.