Futility in acute care surgery: first do no harm

Melissa Hornor; Uzer Khan; Michael W Cripps; Allyson Cook Chapman; Jennifer Knight-Davis; Thaddeus J Puzio; Bellal Joseph; AAST Geriatrics Committee

doi:10.1136/tsaco-2023-001167

Futility in acute care surgery: first do no harm

Trauma Surg Acute Care Open. 2023 Sep 25;8(1):e001167. doi: 10.1136/tsaco-2023-001167. eCollection 2023.

Authors

Melissa Hornor^{1

2}, Uzer Khan³, Michael W Cripps⁴, Allyson Cook Chapman⁵, Jennifer Knight-Davis^{2

6}, Thaddeus J Puzio⁷, Bellal Joseph^{2

8}; AAST Geriatrics Committee

Collaborators

Affiliations

¹ Surgery, Loyola University Chicago, Maywood, Illinois, USA.
² American Association for the Surgery of Trauma, AAST Geriatric Trauma Committee, Chicago, IL, USA.
³ Surgery, Texas Christian University, Fort Worth, Texas, USA.
⁴ Surgery, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
⁵ Medicine and Surgery, University of California San Francisco, San Francisco, California, USA.
⁶ Surgery, The Ohio State University College of Medicine and Public Health, Columbus, Ohio, USA.
⁷ General Surgery, University of Texas McGovern Medical School, Houston, Texas, USA.
⁸ Surgery, University of Arizona Medical Center-University Campus, Tucson, Arizona, USA.

Abstract

The consequences of the delivery of futile or potentially ineffective medical care and interventions are devastating on the healthcare system, our patients and their families, and healthcare providers. In emergency situations in particular, determining if escalating invasive interventions will benefit a frail and/or severely critically ill patient can be exceedingly difficult. In this review, our objective is to define the problem of potentially ineffective care within the specialty of acute care surgery and describe strategies for improving the care of our patients in these difficult situations.

Keywords: acute; geriatrics; multiple trauma.

Publication types

Review