Factors associated with non-beneficial treatments in end of life hospital admissions: a multicentre retrospective cohort study in Australia.
adult intensive and critical care
adult palliative care
clinical audit
health and safety
medical ethics
quality in health care
Journal
BMJ open
ISSN: 2044-6055
Titre abrégé: BMJ Open
Pays: England
ID NLM: 101552874
Informations de publication
Date de publication:
04 11 2019
04 11 2019
Historique:
entrez:
7
11
2019
pubmed:
7
11
2019
medline:
24
10
2020
Statut:
epublish
Résumé
To quantitatively assess the factors associated with non-beneficial treatments (NBTs) in hospital admissions at the end of life. Retrospective multicentre cohort study. Three large, metropolitan tertiary hospitals in Australia. 831 adult patients who died as inpatients following admission to the study hospitals over a 6-month period in 2012. Odds ratios (ORs) of NBT derived from logistic regression models. Overall, 103 (12.4%) admissions involved NBTs. Admissions that involved conflict within a patient's family (OR 8.9, 95% CI 4.1 to 18.9) or conflict within the medical team (OR 6.5, 95% CI 2.4 to 17.8) had the strongest associations with NBTs in the all subsets regression model. A positive association was observed in older patients, with each 10-year increment in age increasing the likelihood of NBT by approximately 50% (OR 1.5, 95% CI 1.2 to 1.9). There was also a statistically significant hospital effect. This paper presents the first statistical modelling results to assess the factors associated with NBT in hospital, beyond an intensive care setting. Our findings highlight potential areas for intervention to reduce the likelihood of NBTs.
Identifiants
pubmed: 31690607
pii: bmjopen-2019-030955
doi: 10.1136/bmjopen-2019-030955
pmc: PMC6858125
doi:
Types de publication
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e030955Informations de copyright
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
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