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Doctors differ on life-support decisions for patients in septic shock

NEWS IN BRIEF — Posted Aug. 3, 2009

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A study in the journal Critical Care found that physicians presented with identical clinical scenarios about patients with septic shock differed greatly in predicting the patients' outcomes and whether to recommend stopping supportive care (link).

"This study uncovered an alarming variation in predicted prognoses among physicians with experience treating septic shock," said lead author and principal investigator James O'Brien, MD, a pulmonologist and critical care specialist at Ohio State University Medical Center.

Nearly 300 members of the Critical Care Assembly of the American Thoracic Society responded to the survey. Though they were given the same objective measure of patients' illness severity, doctors were more likely to predict poor recovery and counsel ending life support for patients who were obese or had lung cancer, according to the study, published in late June.

The findings raise concerns that some end-of-life decisions "may be influenced by the individual physician as much as the patient's status," Dr. O'Brien said.

The study's authors recommended looking for more objective tools to help doctors achieve consistency in making these difficult calls without letting their biases interfere.

Note: This item originally appeared at http://www.ama-assn.org/amednews/2009/08/03/prbf0803.htm.

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