Triage decisions for intensive care in terminally ill patients

Sprung, Charles L.; Eidelman, Leonid A.

doi:10.1007/s001340050449

Cited by 16 publications

(11 citation statements)

References 51 publications

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“…mortality in terms of ICU mortality, hospital mortality, long term mortality; severity of illness with use of the Acute Physiology Score-APS; hospital costs for patients receiving intensive care and mechanical ventilation, quality of life after intensive care etc.) did not come to any solid recommendation (Chelluri, Grenvik and Silverman, 1995;Sprung and Eidelman, 1997). Various studies have suggested that increasing APS, premorbid functional status, coexisting chronic illness and organ system dysfunction could affect morality, but local data were lacking.…”

Section: E Intensive Care For the Elderlymentioning

confidence: 94%

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Critical Care Ethics in Hong Kong: Cross-Cultural Conflicts as East Meets West

Cheng

Wong

et al. 1998

The Journal of Medicine and Philosophy

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The practice of critical care medicine has long been a difficult task for most critical care physicians in the densely populated city of Hong Kong, where we face limited resources and a limited number of intensive care beds. Our triage decisions are largely based on the potential of functional reversibility of the patients. Provision of graded care beds may help to relieve some of the demands on the intensive care beds. Decisions to forego futile medical treatment are frequently physician-guided family-based decisions, which is quite contrary to the Western focus on patient autonomy. However, as people acquire knowledge about health care and they become more aware of individual rights, our critical care doctors will be able to narrow the gaps between the different concepts of medical ethics among our professionals as well as in our society. An open and caring attitude from our intensivists will be important in minimizing the cross-cultural conflict on the complex issue of medical futility.

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Section: E Intensive Care For the Elderlymentioning

confidence: 94%

“…Age alone has not been found to be a good predictor for survival or quality of life after intensive care (CastilloLorente et al, 1997;Parillo, 1997;Sprung and Eidelman, 1997). Different studies, performed mostly in Europe and the USA, looking at different parameters (e.g.…”

Section: E Intensive Care For the Elderlymentioning

confidence: 96%

Critical Care Ethics in Hong Kong: Cross-Cultural Conflicts as East Meets West

Cheng

Wong

et al. 1998

The Journal of Medicine and Philosophy

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“…Characteristics of patients that influence admission to intensive care are age, severity of illness, and reason for admission 5 6. Availability of beds has been inconsistently associated with triage decisions 6 7.…”

Section: Introductionmentioning

confidence: 99%

National questionnaire survey on what influences doctors' decisions about admission to intensive care

Escher

Perneger

Chevrolet

2004

BMJ

110

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“…4 It has been shown that an intensivist, and not the primary service provider, is best positioned to allocate intensive care unit resources. 5 The intensivist is removed from the conflict of interest that many primary service providers face when forced to make decisions about the discharge of their patients from the intensive care unit. [6][7][8][9] In addition, the intensivist has the most knowledge about the most recent clinical status of the patient, and can modify disposition decisions in real time, as opposed to the frequently "snapshot" view of the clinical condition of the patient by the primary team.…”

Section: Discussionmentioning

confidence: 99%