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Dying in the Intensive Care Unit
Francisco Del Olmo1, Yomayra Otero1, Juan Flores1
1VA Caribbean Healthcare System, San Juan, Puerto Rico.
Puerto Rico Health Sciences Journal
|March 30, 2019
Summary
Few intensive care unit (ICU) patients had advance directives despite advanced age and chronic illnesses. Early palliative care (PS) referral is crucial for high-risk patients in the ICU.
Area of Science:
- Medical Research
- Critical Care Medicine
- Palliative Care
Background:
- Palliative care services (PS) aim to improve quality of life for patients with serious illnesses.
- Understanding the profile of patients who die in the intensive care unit (ICU) is essential for optimizing care.
Purpose of the Study:
- To document the characteristics of patients who received palliative care services and died in the medicine ICU.
- To identify patterns in demographics, comorbidities, and end-of-life care among ICU decedents.
Main Methods:
- Retrospective record review of patients who died in the ICU between January 1, 2012, and December 31, 2014.
- Data collected included demographics, comorbidities, cause of death, length of stay, PS involvement, and life support withdrawal.
Main Results:
- 200 patients met criteria, predominantly males, many over 79 years old.
- 73% were on mechanical ventilation; fewer than 15% had advance directives.
- Most patients died within the first week; PS was involved in 56% of those surviving over 24 hours.
Conclusions:
- A low percentage of ICU decedents had advance directives, despite significant comorbidities and advanced age.
- Findings highlight the need for earlier palliative care (PS) referral for high-risk ICU patients.
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