Factors associated with treatment limitations in two Swedish intensive care units: Prevalence and patient involvement

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Jonsson, NinoHalland Hospital Halmstad, Sweden (author)

Factors associated with treatment limitations in two Swedish intensive care units : Prevalence and patient involvement

Article/chapterEnglish2023

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2023-01-04
John Wiley & Sons,2023
printrdacarrier

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LIBRIS-ID:oai:DiVA.org:lnu-118832
https://urn.kb.se/resolve?urn=urn:nbn:se:lnu:diva-118832URI
https://doi.org/10.1111/aas.14185DOI
https://gup.ub.gu.se/publication/324102URI

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Language:English
Summary in:English

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SwePubSwePub

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Subject category:ref swepub-contenttype
Subject category:art swepub-publicationtype

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The aim was to study the prevalence, documentation, and patient involvement in treatment limitations (TLs) in two Swedish intensive care units (ICUs). All patients admitted to the ICUs of two Swedish regional hospitals in 2019 were screened for inclusion. Exclusion criteria included postanesthesia care < 24 h. Patients were identified using the Swedish Intensive Care Registry (SIR) and data were extracted from SIR and hospital charts. Uni- and multivariable logistic analysis was performed to investigate associations with the presence of TLs. A total of 3090 patients were admitted to the two ICUs in 2019. After exclusion, 1019 patients were included in the study. 45.5% were women and the mean age was 62.9 years. 26.5% of the patients had one or several TLs. Age (OR 1.04 per one year increase 95% confidence interval (CI) 1.02-1.05), SAPS3-score (OR 1.08 per one unit increase 95% CI 1.06-1.09) and ICU length of stay (OR 1.11 per one day increase 95% CI 1.05-1.17) were independently associated with an increased likelihood of receiving a TL. 17% of the patients were involved in the decision-making process and in > 30% of cases neither the patient nor next-of-kin were informed. Women were to a larger extent involved in the decision process than men (24.5 vs. 12.5% p < .05). When the intensivist documented why a TL was established, patient autonomy was four times more commonly stated as the motivation for the TL among women compared to men (15.5% vs. 3.8% p < .05). TLs were common in two Swedish ICUs but a substantial number of patients and next-of-kin were not involved in the decision-making process or informed of the decision. Women were more often than men engaged in the decision to establish a TL.

Subject headings and genre

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Anestesi och intensivvård hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Anesthesiology and Intensive Care hsv//eng
MEDICIN OCH HÄLSOVETENSKAP Hälsovetenskap Medicinsk etik hsv//swe
MEDICAL AND HEALTH SCIENCES Health Sciences Medical Ethics hsv//eng
ethics
intensive care unit
patient involvement
treatment limitation
Medicin
Medicine
ethics
intensive care unit
patient involvement
treatment limitation

Added entries (persons, corporate bodies, meetings, titles ...)

Pettersson, NiklasHalland Hospital Halmstad, Sweden (author)
Asplund, PeterHalland Hospital Halmstad, Sweden (author)
Bremer, Anders,Docent,1957-Linnéuniversitetet,Institutionen för hälso- och vårdvetenskap (HV),Region Kalmar County, Sweden,Ctr Interprofess Collaborat Emergency Care CICE(Swepub:lnu)gbran (author)
Lehtipalo, StefanHalland Hospital Halmstad, Sweden (author)
Hessulf, Fredrik,1986Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine(Swepub:gu)xhesfr (author)
Halland Hospital Halmstad, SwedenInstitutionen för hälso- och vårdvetenskap (HV) (creator_code:org_t)

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In:Acta Anaesthesiologica Scandinavica: John Wiley & Sons67:3, s. 339-3460001-51721399-6576

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