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Realistic Survival Outcomes After Vasopressor Use in the Intensive Care Unit
Daniel T Farkas1, Amir A Rahnemai-Azar2, Shameem Shah Kunhammed2
1Department of Surgery, Bronx-Lebanon Hospital Center, Albert Einstein College of Medicine, Bronx, NY, USA dfarkas@bronxleb.org.
The American Journal of Hospice & Palliative Care
|June 27, 2015
Summary
Patients requiring vasopressors in the intensive care unit (ICU) have drastically lower survival rates. This study highlights the critical need for accurate outcome prognostication in ICU patient care discussions.
Area of Science:
- Critical Care Medicine
- Clinical Outcomes Research
Background:
- Intensive care unit (ICU) patients face high mortality rates.
- Clinical decisions regarding care aggressiveness require realistic outcome expectations.
- Vasopressor use indicates a critical patient state.
Purpose of the Study:
- To investigate survival rates and outcomes for ICU patients initiated on vasopressors.
- To provide data for informed discussions about end-of-life care and treatment intensity.
Main Methods:
- A cohort study included 1023 ICU patients admitted between January and June 2011.
- Patients were categorized into two groups: those started on vasopressors (VP+) and those not (VP-).
- Survival rates and clinical outcomes were compared between the VP+ and VP- groups.
Main Results:
- The vasopressor group (VP+) had a significantly lower survival rate of 29.6% compared to 92.0% in the non-vasopressor group (VP-).
- This difference in survival was both clinically and statistically significant (P < .001).
- Initiation of vasopressors is a strong indicator of poor prognosis in the ICU.
Conclusions:
- Patients requiring vasopressors in the ICU experience extremely poor outcomes.
- Quantifying these outcomes accurately is crucial for clinicians when discussing care options with families.
- The findings underscore the importance of prognostication in critical care decision-making.
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