Friday, October 07, 2005

Beware of dementia bias

All other things being equal, patients with dementia who are admitted to the ICU do just as well as those without dementia according to this study in the June issue of Critical Care Medicine. A higher percentage of patients in the dementia group (46% vs. 11%) were from nursing homes.

Although there may be legitimate reasons to withhold ICU care in some demented patients (such as advance directives) we can’t base the decision on a presumption of poor clinical outcome.


DR. Srinivas said...

I am a Chennai (india) based Geriatrician, who works two months evry year in the UK. I fully agree with your view that dementia should not be a good reason for refusal of ICU care. if the acute problem is reversible and if the patient has a reasonble chance of getting back to his premorbid status, we should do that. In Chennai I do that -but in UK , NHS poloicies based on cost considerations forbid it!

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