Institutional Variation in Life-Sustaining Treatments and Mortality Among Older Patients

Does use of life-sustaining treatments vary for older patients (age ≥80 years) among intensive care units (ICUs), and is higher treatment intensity associated with improved in-hospital survival?In this cohort study of 60 713 patients aged 80 years or older across 127 ICUs in Japan, use of life-sustaining treatment varied widely among institutions after case-mix adjustment. Higher institutional treatment intensity was not associated with better in-hospital survival after adjustment for patient- and institution-level factors.In this study, greater institutional use of life-sustaining treatments was not associated with better survival among older patients, highlighting the need for better identification of older patients most likely to benefit from intensive treatment.

Corresponding Author: Yusuke Sasabuchi, MD, MPH, PhD, Department of Real-World Evidence, Graduate School of Medicine, University of Tokyo, Hongo, 7-3-1, Bunkyo-ward, Tokyo, 113-8654, Japan (rhapsody77777@gmail.com).

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