ADENI-UCI Study: Analysis of non-income decisions in ICU as a measure of limitation of life support treatments

被引：5

作者：

Escudero-Acha, P. ^{[1
]}

Leizaola, O. ^{[2
]}

Lazaro, N. ^{[3
]}

Cordero, M. ^{[4
]}

Cossio, A. M. ^{[5
]}

Ballesteros, D. ^{[6
]}

Recena, P. ^{[7
]}

Tizon, A., I ^{[8
]}

Palomo, M. ^{[9
]}

del Campo, M. M. ^{[10
]}

Freita, S. ^{[11
]}

Duerto, J. ^{[12
]}

Bilbao, N. M. ^{[13
]}

Vidal, B. ^{[14
]}

Gonzalez-Romero, D. ^{[15
]}

Diaz-Dominguez, F. ^{[16
]}

Revuelto, J. ^{[17
]}

Blasco, M. L. ^{[18
]}

Domezain, M. ^{[19
]}

Pavia-Pesquera, Ma de la Concepcion ^{[20
]}

Rubio, O. ^{[21
]}

Estella, A. ^{[22
]}

Pobo, A. ^{[23
]}

Gomez-Acebo, I ^{[24
]}

Gonzalez-Castro, A. ^{[1
]}

机构：

[1] Hosp Univ Marques de Valdecilla, Santander, Spain

[2] Hosp Univ Cent Asturias, Asturias, Spain

[3] Hosp 12 Octubre, Madrid, Spain

[4] Hosp Univ Alava, Vitoria, Spain

[5] Hosp Univ Virgen Macarena, Seville, Spain

[6] Hosp Puerta de Hierro, Madrid, Spain

[7] Hosp Univ Cabuenes, Gijon, Spain

[8] Complexo Hosp Univ Ourense, Orense, Spain

[9] Hosp Sagunto, Valencia, Spain

[10] Hosp Badalona Germans Trias & Pujol, Badalona, Spain

[11] Complexo Hosp Univ Alvaro Cunqueiro, Vigo, Spain

[12] Hosp Clin San Carlos, Madrid, Spain

[13] Hosp Galdakao Usansolo, Bizkaia, Spain

[14] Hosp Univ Castellon, Castellon de La Plana, Spain

[15] Complejo Univ Insular Materno Infantil, Las Palmas Gran Canaria, Spain

[16] Complejo Asistencial Univ Leon, Leon, Spain

[17] Hosp Univ Puerta del Mar, Cadiz, Spain

[18] Hosp Clin Valencia, Valencia, Spain

[19] Hosp Univ Cruces, Bilbao, Spain

[20] Hosp San Pedro, Logrono, Spain

[21] Fundacio Althaia Xarxa Univ Assistencial Manresa, Manresa, Spain

[22] Hosp Jerez, Jerez de la Frontera, Spain

[23] Hosp Joan XXIII Tarragona, Tarragona, Spain

[24] Univ Cantabria, Dept Prevent & Salud Publ, Fac Med, Santander, Spain

来源：

MEDICINA INTENSIVA | 2022年 / 46卷 / 04期

关键词：

Futilidad; Limitation of life support treatments; Denial of income; Futility; Quality of life; INTENSIVE-CARE-UNIT; SUSTAINING TREATMENT; ADMISSION; DISCHARGE; OUTCOMES; REFUSAL; APACHE; TRIAGE;

D O I：

10.1016/j.medin.2020.11.003

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Objective: To analyze the variables associated with ICU refusal decisions as a life support treatment limitation measure.Design: Prospective, multicentricoScope: 62 ICU from Spain between February 2018 and March 2019.Patients: Over 18 years of age who were denied entry into ICU as a life support treatment limitation measure.Interventions: None.Main interest variables: Patient comorities, functional situation as measured by the KNAUS and Karnosfky scale; predicted scales of Lee and Charlson; severity of the sick person measured by the APACHE II and SOFA scales, which justifies the decision-making, a person to whom the information is transmitted; date of discharge or in-hospital death, destination for hospital discharge.Results: A total of 2312 non-income decisions were recorded as an LTSV measure of which 2284 were analyzed. The main reason for consultation was respiratory failure (1080 [47.29%]). The poor estimated quality of life of the sick (1417 [62.04%]), the presence of a severe chronic disease (1367 [59.85%]) and the prior functional limitation of patients (1270 [55.60%]) were the main reasons for denying admission. The in-hospital mortality rate was 60.33%. The futility of treatment was found as a risk factor associated with mortality (OR: 3.23; IC95%: 2.62-3.99).Conclusions: Decisions to limit ICU entry as an LTSV measure are based on the same reasons as decisions made within the ICU. The futility valued by the intensivist is adequately related to the final result of death.(c) 2020 Elsevier Espana, S.L.U. y SEMICYUC. All rights reserved.

引用

页码：192 / 200

页数：9

共 34 条

[21] Determinants and outcomes associated with decisions to deny or to delay intensive care unit admission in Morocco [J].