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Withholding or with...
Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit
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- Guidet, Bertrand (author)
- Paris-Sorbonne University
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- Flaatten, Hans (author)
- Haukeland University Hospital
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- Boumendil, Ariane (author)
- Hospital Saint-Antoine
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- Morandi, Alessandro (author)
- Hospital Ancelle di Cremona
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- Andersen, Finn H (author)
- Norwegian University of Science and Technology
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- Artigas, Antonio (author)
- Autonomous University of Barcelona
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- Bertolini, Guido (author)
- Mario Negri Institute for Pharmacological Research
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- Cecconi, Maurizio (author)
- St George's Hospital, London
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- Christensen, Steffen (author)
- Aarhus University Hospital
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- Faraldi, Loredana (author)
- Niguarda Hospital
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- Fjølner, Jesper (author)
- Aarhus University Hospital
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- Jung, Christian (author)
- University Hospital of Düsseldorf
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- Marsh, Brian (author)
- Mater Misericordiae University Hospital
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- Moreno, Rui (author)
- Centro Hospitalar Universitário de Lisboa Central,NOVA University Lisbon
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- Oeyen, Sandra (author)
- Ghent University Hospital
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- Öhman, Christina Agwald (author)
- Karolinska University Hospital
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- Pinto, Bernardo Bollen (author)
- Geneva University Hospital
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- Soliman, Ivo W (author)
- University Medical Center Utrecht
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- Szczeklik, Wojciech (author)
- Jagiellonian University
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- Valentin, Andreas (author)
- Cardinal Schwarzenberg Hospital
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- Watson, Ximena (author)
- St George's Hospital, London
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- Zafeiridis, Tilemachos (author)
- University Hospital of Larissa
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- De Lange, Dylan W (author)
- University Medical Center Utrecht
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- Spångfors, Martin (creator_code:cre_t)
- Lund University,Lunds universitet,Anestesiologi och intensivvård,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Centrum för hjärtstopp,Forskargrupper vid Lunds universitet,SWECRIT,Anesthesiology and Intensive Care,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Center for cardiac arrest,Lund University Research Groups
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- Brorsson, Camilla (contributor)
- Umeå University Hospital, Sweden
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(creator_code:org_t)
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- 2018-05-17
- 2018
- English 12 s.
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In: Intensive Care Medicine. - : Springer Science and Business Media LLC. - 0342-4642 .- 1432-1238. ; 44:7, s. 1027-1038
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http://dx.doi.org/10...
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Abstract
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- PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU.METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up.RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries.CONCLUSIONS: The most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country.TRIAL REGISTRATION: ClinicalTrials.gov (ID: NTC03134807).
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Aged, 80 and over
- Decision Making
- Europe
- Humans
- Intensive Care Units
- Life Support Care
- Male
- Prospective Studies
- Withholding Treatment
- Elderly
Publication and Content Type
- art (subject category)
- ref (subject category)
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Guidet, Bertrand
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Flaatten, Hans
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Boumendil, Arian ...
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Morandi, Alessan ...
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Andersen, Finn H
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Artigas, Antonio
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Bertolini, Guido
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Cecconi, Maurizi ...
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Christensen, Ste ...
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Faraldi, Loredan ...
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Fjølner, Jesper
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Jung, Christian
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Marsh, Brian
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Moreno, Rui
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Oeyen, Sandra
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Öhman, Christina ...
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Pinto, Bernardo ...
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Soliman, Ivo W
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Szczeklik, Wojci ...
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Valentin, Andrea ...
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Watson, Ximena
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Zafeiridis, Tile ...
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De Lange, Dylan ...
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Spångfors, Marti ...
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Brorsson, Camill ...
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Anesthesiology a ...
- Articles in the publication
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Intensive Care M ...
- By the university
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Lund University
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Umeå University