Intensive Care Unit Overuse Common in Patients With Heart Disease

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Examination of over 1 million Medicare records found that the intensive care unit was overused for patients with heart and lung conditions.
Examination of over 1 million Medicare records found that the intensive care unit was overused for patients with heart and lung conditions.

HealthDay News — Admission to the intensive care unit (ICU) is not associated with a survival benefit for patients with uncertain ICU needs hospitalized with exacerbation of chronic obstructive pulmonary disease (COPD), exacerbation of heart failure, or acute myocardial infarction (MI), according to a study published online in the Annals of the American Thoracic Society.

Thomas Valley, MD, of the University of Michigan Medical School in Ann Arbor, and colleagues examined 1.5 million Medicare records to determine outcomes for patients with COPD, acute MI, and worsening heart failure.

The researchers observed no difference in 30-day mortality rates between patients in the ICU and those who received regular inpatient care in another type of hospital unit. However, ICU care was almost $5,000 more for patients with worsening heart failure and $2,600 more for acute MI patients, compared to those in regular care. There was no difference in cost for COPD patients in the ICU or regular care. The investigators also found that ICU patients were more likely to undergo invasive procedures and be exposed to infections.

"These findings suggest that the ICU may be overused for some patients with these conditions," the authors write. "Identifying patients most likely to benefit from ICU admission may improve health care efficiency while reducing costs."

Reference

Valley TS, Sjoding ME, Ryan AM, Iwashyna TJ, Cooke CR. Intensive care unit admission and survival among older patients with chronic obstructive pulmonary disease, heart failure, or myocardial infarction [published online February 17, 2017]. Ann Am Thorac Soc. doi: 10.1513/AnnalsATS.201611-847OC 

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