Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital
U A López González1, D Bautista Rentero1, M Crespo Gómez2
1Servicio de Medicina Preventiva, Hospital Universitario Doctor Peset, Valencia, Spain.
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.
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