Death in the ICU: does the patient predict his own demise?

Critically ill patients who fear impending death may die suddenly. We studied prospectively the incidence of death in critically ill surgical patients who articulated the fear that they were about to die. Physiologic, environmental, and behavioral correlates which might influence perceptions of impending death were examined for both the study group and age- and diagnosis-matched control patients. Thirteen (2%) of 643 patients expressed the conviction that they were about to die. Five (38%) of 13 subjects and four (29%) of 13 controls died, an insignificant difference. The overall death rate in the ICU during the study period was 10%. We conclude that patients expressing fear of imminent death were no more likely to die than matched controls, but that they were among the most severely ill conscious patients in the ICU.