Withholding and withdrawal of life-sustaining therapy in 8569 trauma patients: A multicentre, analytical registry study.
Eur J Anaesthesiol
; 39(5): 418-426, 2022 05 01.
Article
en En
| MEDLINE
| ID: mdl-35166244
ABSTRACT
BACKGROUND:
This study aimed to determine the prevalence of withholding or withdrawal of life-sustaining therapy (WLST) decisions in trauma ICU patients, using a large registry. We hypothesised that this prevalence is similar to that of the general population admitted to an ICU. As secondary aims, it sought to describe the trauma patients for whom the decision was made for WLST and the factors associated with this decision.DESIGN:
This observational study assessed data from 14 French centres listed in the TraumaBaseTM registry. All trauma patients hospitalised for more than 48âh were pro-spectively included.RESULTS:
Data from 8569 trauma patients, obtained from January 2016 to December 2018, were included in this study. A WLST decision was made in 6% of all cases. In the WLST group, 67% of the patients were older men (age 62 versus 36, Pâ <â0.001); more often they had a prior medical history and higher median severity scores than the patients in the no WLST decision group; SAPS II 58 (46 to 69) versus 21 (13 to 35) and ISS 26 (22 to 24) versus 12 (5 to 22), Pâ <â0.001. Neurological status was strongly associated with WLST decisions. The geographic area of the ICUs affected the rate of the WLST decisions. The ICU mortality was 11% (nâ=â907) of which 47% (nâ=â422) were preceded by WLST decisions. Fourteen percent of WLST orders were not associated to the death.CONCLUSION:
Among 8569 patients, medical history, trauma severity criteria, notably neurological status and geographical areas were associated with WLST. These regional differences deserve to be investigated in future studies.
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Privación de Tratamiento
/
Unidades de Cuidados Intensivos
Tipo de estudio:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Límite:
Aged
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Eur J Anaesthesiol
Asunto de la revista:
ANESTESIOLOGIA
Año:
2022
Tipo del documento:
Article