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A Useful Allocation of Medical Resources

Robert D. Madoff, MD; Steven M. Sharpe, MD; John J. Fath, MD; Richard L. Simmons, MD; Frank B. Cerra, MD

Arch Surg. 1985;120(6):698-702.

Abstract
• To determine factors related to outcome following prolonged stays in the surgical intensive care unit (ICU), we reviewed the charts of all 59 patients who required surgical ICU stays of one week or longer during 1982 (63 admissions). Overall ICU survival was 58.7% and varied inversely with acute illness severity, length of ICU stay, and hospital cost. The need for renal dialysis and prolonged mechanical ventilatory support were associated with bad outcomes. Age did not affect ICU survival. Follow-up survival was 33% of the original group or 56.8% of ICU survivors. Poor chronic health was associated with a high late mortality. The functional status of surviving patients was satisfactory, with 18 of 21 patients living independently. We conclude that there is significant survival following prolonged ICU therapy, and that, although identifiable factors related to outcome exist, none alone permit the discontinuation of therapy on an individual basis.

(Arch Surg 1985;120:698-702)

Author Affiliations
From the Department of Surgery, University of Minnesota Hospitals, Minneapolis.

Footnotes
Accepted for publication Feb 4, 1985.

Read before the 92nd annual meeting of the Western Surgical Association, Colorado Springs, Colo, Nov 13, 1984.

Reprint requests to Box 344 Mayo, University of Minnesota Hospitals, 420 Delaware St SE, Minneapolis, MN 55455 (Dr Madoff).

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