NSW SCIDUA

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Really nice case reviews, I assume our government would never put something like this out. My two main takeaways, 1) aspiration is no joke and 2) the US does not have a monopoly on insane heroic care for people in their 80s and 90s!
 
@ambiturner the cases, patient populations, and mortality outcomes described are very much akin to the ones we have here. However I think it is rare to have discussions to palliate in the OR and patient dies just hours later. Here we bring them to the ICU for the full court press, talk to and argue with family about futility, and the patient dies days or weeks later never having any meaningful chance of recovery.
 
ambiturner said:
Really nice case reviews, I assume our government would never put something like this out. My two main takeaways, 1) aspiration is no joke and 2) the US does not have a monopoly on insane heroic care for people in their 80s and 90s!
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Yeah I was surprised to see rescue ECMO in the case reports.
 
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coffeebythelake said:
@ambiturner the cases, patient populations, and mortality outcomes described are very much akin to the ones we have here. However I think it is rare to have discussions to palliate in the OR and patient dies just hours later. Here we bring them to the ICU for the full court press, talk to and argue with family about futility, and the patient dies days or weeks later never having any meaningful chance of recovery.
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The way surgeon mortality is tracked and the fact that they are the primary revenue source for a hospital and can’t be made angry created that problem. If they actively lost money like hospitalists or had no mortality tracking penalties I think a lot of them would be more reasonable and not require endless nonsense in the icu until outside the 30 day window.
 
chessknt said:
The way surgeon mortality is tracked and the fact that they are the primary revenue source for a hospital and can’t be made angry created that problem. If they actively lost money like hospitalists or had no mortality tracking penalties I think a lot of them would be more reasonable and not require endless nonsense in the icu until outside the 30 day window.
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America is much more litigious and we do a lot of things despite futility to placate patients and family. But I have no doubt what you are saying plays a significant role as well. Hospitals gotta fudge those numbers about mortality rates and readmission rates.
 
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