Perceived Inappropriateness of Intensive Care Treatment Among Clinicians: A Cross-Sectional Nationwide Survey on the Prevalence, Associated Factors, and Outcomes
Authors' conclusion
PIC is common in the ICU, inversely associated with a supportive ethical work environment, and should be regarded as a legitimate concern that warrants team reflection, as it is a prognostic marker of poor patient outcomes.
Study context
- Population
- Physicians and nurses from 47 Dutch ICUs and patients treated in the ICU on the survey dayphysicians and nurses (response rate 72%)
- Participants
- 1,058 physicians
- Outcome
- Clinicians reporting PIC for at least one patient
Methodological detailssingle-day survey, nationwide, supplemented with follow-up data
- Single-day survey
- Nationwide
- Supplemented with follow-up data
Main finding
As reported in the abstract
Clinicians reporting perceived inappropriateness of care (PIC) for ≥1 patient
276
26%
Observational data: associations, not effects.
Further findings
Factors associated with PIC
| aOR (95% CI) | P value | ||
|---|---|---|---|
| Being a nurse | 1.78 (1.37–2.33) | P < 0.001 | |
| Culture that avoids end-of-life decisions | 1.92 (1.51–2.45) | P < 0.001 | |
| Larger ICU bed capacity | 0.97 (0.94–0.99) | P = 0.004 | |
| Mutual respect within interdisciplinary teams | 0.84 (0.70–1.00) | P = 0.045 | |
| 0.512Adjusted odds ratio (log scale) |
Patient outcomes with PIC reported by multiple clinicians · 6 months post-ICU
| aOR (95% CI) | P value | ||
|---|---|---|---|
| PIC by multiple cliniciansDeath | 3.86 (1.23–12.16) | P = 0.02 | |
| PIC by multiple clinicians | 2.91 (1.14–7.42) | P = 0.03 | |
| 0.050.21520Adjusted odds ratio (log scale) |
- Patient outcomes with PIC reported by multiple clinicians: combined outcome: death, severely frail, or not living at home anymore
- Patient outcomes with PIC reported by multiple clinicians: 215 of the 397 eligible patients (54.2%) completed the survey
Reasons for PIC
- Distributive injustice
- n = 181; 70%
- Disproportionality of care
- 66%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Perceived Inappropriateness of Intensive Care Treatment Among Clinicians: A Cross-Sectional Nationwide Survey on the Prevalence, Associated Factors, and Outcomes. Crit Care Med. Published 12 June 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →