COPD, heart failure patients may not benefit from ICU stay

A stay in the intensive care unit may not improve the chances of survival for some patients.

A stay in the intensive care unit (ICU) may not improve the chances of survival for patients who suffer from heart failure, chronic obstructive pulmonary disorder or acute myocardial infarction.

New research published in the Annals of the American Thoracic Society found that a stay in the ICU was not linked with notable decreases in 30-day mortality rates for patients with those three conditions. Instead, it was linked to increased costs.

Indeed, the study found that it cost about $9,100 to treat heart failure patients outside the ICU but nearly $12,000 when it involved a stay in the ICU. Patients treated for myocardial infarction also saw hospital costs go up, from about $14,500 to approximately $19,500. No significant increase was recorded for COPD patients, however, according to the study.

The research examined more than 1.5 million records for Medicare beneficiaries with those three conditions. Because the study only examined Medicare patients, the findings may not apply to younger patients, the researchers note.

They estimated that approximately one in six patients was admitted to the ICU only because of living closest to a hospital that places a high percentage of its patients in ICU beds.

In addition to cost increases, patients in the ICU are more likely to undergo invasive procedures when admitted to the ICU.

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Thomas Valley, M.D., the study’s lead author and a pulmonary and critical care researcher at the University of Michigan Medical School, said in an announcement of the findings that clinicians should carefully evaluate if ICU care is actually beneficial for each patient. 

While some patients clearly need such care, he said, the research "found that the ICU may not always be the answer. Now, we need to help doctors decide who needs the ICU and who doesn't."

The researchers call for additional study to better understand which patients benefit the most from intensive care.