Intended for healthcare professionals


Deciding who to admit to a critical care unit

BMJ 2007; 335 doi: (Published 29 November 2007) Cite this as: BMJ 2007;335:1103
  1. Eddy Fan, instructor,
  2. Dale M Needham, assistant professor
  1. Johns Hopkins Medical Institutions, Division of Pulmonary and Critical Care Medicine, Baltimore, MD 21205, USA
  1. dale.needham{at}

    Scarce resources may cause doctors to be pessimistic about prognosis and refuse critical care admissions

    Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. The incidence of COPD is rising, and the World Health Organization estimates that it will be the fourth leading cause of death globally by 2030.1 In this week's BMJ, Wildman and colleagues report the differences between actual survival and survival predicted by a doctor in people with asthma or COPD admitted to intensive care.2 This is an important matter to investigate, because people with asthma and COPD who have acute exacerbations that require admission to intensive care have high short term mortality.3 4

    Using data from 832 admissions for asthma or COPD in 95 intensive care units and high dependency units in the United Kingdom, the authors found that predicted …

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