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Longer ICU stay associated with better patient satisfaction

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Families are more satisfied with withdrawal of intensive care support for relatives if the process is longer, a study has shown.

Findings were based on medical charts and family questionnaires for more than 500 patients who had died at the ICU or within 24 hours of discharge in 15 US hospitals.

Families were asked about their satisfaction using a scoring system. When patients were left for three days in ICU, the satisfaction score averaged 0.9.

But if they stayed in ICU for 16 days, the average satisfaction score was 14.5.

Authors said an explanation for the higher rate of satisfaction was that the slower decision making process associated with a prolonged ICU stay allowed families more time to come to terms with the deterioration in a relative’s condition.

‘The take home message is not to prolong the withdrawal of life-sustaining therapies to the possible detriment of the patient, but to facilitate better communication between ICU clinicians and patients’ families.

‘When physicians make a decision to withdraw support, they have often not prepared the family sufficiently and physicians may consequently embark on ‘stuttering’ withdrawal of life support in order to have more time to prepare the family.’

American Journal of Respiratory and Critical Care Medicine (2008) 178: 798-804.

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