Prolonged surgical intensive care. A useful allocation of medical resources
R. D. Madoff, S. M. Sharpe, J. J. Fath, R. L. Simmons and F. B. Cerra
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.
