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

Estudio ADENI-UCI: Análisis de las decisiones de no ingreso en UCI como medida de limitación de los tratamientos de soporte vital.
Calidad de vida Denial of income Futilidad Futility Limitación de los tratamientos de soporte vital Limitation of life support treatments Negación de ingreso Quality of life

Journal

Medicina intensiva
ISSN: 2173-5727
Titre abrégé: Med Intensiva (Engl Ed)
Pays: Spain
ID NLM: 101717568

Informations de publication

Date de publication:
29 Dec 2020
Historique:
received: 07 09 2020
revised: 23 10 2020
accepted: 07 11 2020
entrez: 2 1 2021
pubmed: 3 1 2021
medline: 3 1 2021
Statut: aheadofprint

Résumé

To analyze the variables associated with ICU refusal decisions as a life support treatment limitation measure. Prospective, multicentrico SCOPE: 62 ICU from Spain between February 2018 and March 2019. Over 18 years of age who were denied entry into ICU as a life support treatment limitation measure. None. 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. 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). 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.

Identifiants

pubmed: 33386143
pii: S0210-5691(20)30342-9
doi: 10.1016/j.medin.2020.11.003
pii:
doi:

Types de publication

Journal Article

Langues

eng spa

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2020 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

Auteurs

P Escudero-Acha (P)

Hospital Universitario Marqués de Valdecilla, Santander, España.

O Leizaola (O)

Hospital Universitario Central de Asturias, Asturias, España.

N Lázaro (N)

Hospital 12 de Octubre, Madrid, España.

M Cordero (M)

Hospital Universitario de Álava, Vitoria, España.

A M Cossío (AM)

Hospital Universitario Virgen Macarena, Sevilla, España.

D Ballesteros (D)

Hospital Puerta de Hierro, Madrid, España.

P Recena (P)

Hospital Universitario de Cabueñes, Gijón, España.

A I Tizón (AI)

Complexo Hospitalario Universitario de Ourense, Ourense, España.

M Palomo (M)

Hospital de Sagunto, Valencia, España.

M M Del Campo (MM)

Hospital Universitario Germans Trias i Pujol, Badalona, España.

S Freita (S)

Complexo Hospitalario Universitario Alvaro Cunqueiro, Vigo, España.

J Duerto (J)

Hospital Clínico San Carlos, Madrid, España.

N M Bilbao (NM)

Hospital Galdakao-Usansolo, Bizkaia, España.

B Vidal (B)

Hospital Universitario de Castellón, Castellón, España.

D González-Romero (D)

Complejo Universitario Insular Materno Infantil, Las Palmas, España.

F Diaz-Dominguez (F)

Complejo Asistencial Universitario de León, León, España.

J Revuelto (J)

Hospital Universitario Puerta del Mar, Cádiz, España.

M L Blasco (ML)

Hospital Clínico de Valencia, Valencia, España.

M Domezain (M)

Hospital Universitario de Cruces, Bilbao, España.

Mª de la Concepción Pavía-Pesquera (M)

Hospital San Pedro, Logroño, España.

O Rubio (O)

Fundació Althaia Xarxa Universitaria Assistencial de Manresa, Manresa, España.

A Estella (A)

Hospital de Jerez, Jerez, España.

A Pobo (A)

Hospital Joan XXIII de Tarragona, Tarragona, España.

I Gomez-Acebo (I)

Departamento de Preventiva y Salud Pública. Facultad de Medicina. Universidad de Cantabria, Santander, España.

A González-Castro (A)

Hospital Universitario Marqués de Valdecilla, Santander, España. Electronic address: jandro120475@hotmail.com.

Classifications MeSH