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08/30/2014

Religiously Affiliated ICU Patients Receive More Aggressive End-of-Life Care

A study just published in the August 2014 issue of the Journal of Surgical Research finds that religiously affiliated intensive care unit patients receive more aggressive end-of-life care in the ICU. Yet this high-intensity care does not translate into any significant difference in survival.


Study Objectives
Previous studies have already demonstrated that religious patients receive more aggressive end-of-life care. In this study, the Vanderbilt surgeon authors sought to examine the effect of religious affiliation on EOL care in the ICU setting. (The lead author, Myrick Clements Shinall, Jr., earned an M.Div. concurrently with his M.D.) 


Study Itself
The authors looked at  patients admitted to any adult ICU at a tertiary academic center who required at least 2 days of mechanical ventilation and who died within 30 days of admission. This group had 334 patients, with 235 affirming a religious affiliation. The affiliated and non-affiliated patients had similar levels of acuity.


Findings
The authors used hospital charges, ventilator days, hospital days, and days until death as proxies for intensity of care among the EOL patients.  Religiously affiliated patients in the EOL group incurred:

  • 23% more hospital charges
  • 25% more ventilator days
  • 23% more hospital days
  • 30% longer time until death  

Despite this, survival did not differ significantly among affiliated and non-affiliated patients.

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