U.A. López González , D. Bautista Rentero , M. Crespo Gómez , P. Cárcamo Ibarra , A.M. Míguez Santiyán
{"title":"限制生命支持的相关因素:一家三级医院重症监护室后死亡病例研究。","authors":"U.A. López González , D. Bautista Rentero , M. Crespo Gómez , P. Cárcamo Ibarra , A.M. Míguez Santiyán","doi":"10.1016/j.redare.2024.02.007","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Life-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it.</p></div><div><h3>Objective</h3><p>To determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU.</p></div><div><h3>Design</h3><p>Retrospective longitudinal study.</p></div><div><h3>Ambit</h3><p>Intensive care unit of a tertiary hospital.</p></div><div><h3>Patients</h3><p>People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019.</p></div><div><h3>Interventions</h3><p>None. This is an observational study.</p></div><div><h3>Variables of interest</h3><p>Age, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays.</p></div><div><h3>Results</h3><p>Of 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients.</p></div><div><h3>Conclusions</h3><p>Our results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.</p></div>","PeriodicalId":94196,"journal":{"name":"Revista espanola de anestesiologia y reanimacion","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital\",\"authors\":\"U.A. López González , D. Bautista Rentero , M. Crespo Gómez , P. Cárcamo Ibarra , A.M. Míguez Santiyán\",\"doi\":\"10.1016/j.redare.2024.02.007\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Life-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it.</p></div><div><h3>Objective</h3><p>To determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU.</p></div><div><h3>Design</h3><p>Retrospective longitudinal study.</p></div><div><h3>Ambit</h3><p>Intensive care unit of a tertiary hospital.</p></div><div><h3>Patients</h3><p>People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019.</p></div><div><h3>Interventions</h3><p>None. This is an observational study.</p></div><div><h3>Variables of interest</h3><p>Age, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays.</p></div><div><h3>Results</h3><p>Of 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients.</p></div><div><h3>Conclusions</h3><p>Our results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.</p></div>\",\"PeriodicalId\":94196,\"journal\":{\"name\":\"Revista espanola de anestesiologia y reanimacion\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Revista espanola de anestesiologia y reanimacion\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2341192924000271\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Revista espanola de anestesiologia y reanimacion","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2341192924000271","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital
Background
Life-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it.
Objective
To determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU.
Design
Retrospective longitudinal study.
Ambit
Intensive care unit of a tertiary hospital.
Patients
People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019.
Interventions
None. This is an observational study.
Variables of interest
Age, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays.
Results
Of 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients.
Conclusions
Our results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.