Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2009 Apr;35(4):623-30.
doi: 10.1007/s00134-008-1310-6. Epub 2008 Oct 10.

End-of-life practices in 282 intensive care units: data from the SAPS 3 database

Elie Azoulay  1 , Barbara Metnitz, Charles L Sprung, Jean-François Timsit, François Lemaire, Peter Bauer, Benoît Schlemmer, Rui Moreno, Philipp Metnitz; SAPS 3 investigators
Affiliations

End-of-life practices in 282 intensive care units: data from the SAPS 3 database

Elie Azoulay et al. Intensive Care Med. 2009 Apr.

Abstract

Objective: To report incidence and characteristics of decisions to forgo life-sustaining therapies (DFLSTs) in the 282 ICUs who contributed to the SAPS3 database.

Methods: We reviewed data on DFLSTs in 14,488 patients. Independent predictors of DFLSTs have been identified by stepwise logistic regression.

Results: DFLSTs occurred in 1,239 (8.6%) patients [677 (54.6%) withholding and 562 (45.4%) withdrawal decisions]. Hospital mortality was 21% (3,050/14,488); 36.2% (1,105) deaths occurred after DFLSTs. Across the participating ICUs, hospital mortality in patients with DFLSTs ranged from 80.3 to 95.4% and time from admission to decisions ranged from 2 to 4 days. Independent predictors of decisions to forgo LSTs included 13 variables associated with increased incidence of DFLSTs and 7 variables associated with decrease incidence of DFLST. Among hospital and ICU-related variables, a higher number of nurses per bed was associated with increased incidence of DFLST, while availability of an emergency department in the same hospital, presence of a full time ICU-specialist and doctors presence during nights and week-ends were associated with a decreased incidence of DFLST.

Conclusion: This large study identifies structural variables that are associated with substantial variations in the incidence and the characteristics of decisions to forgo life-sustaining therapies.

PubMed Disclaimer

References

    1. N Engl J Med. 2003 Sep 18;349(12):1123-32 - PubMed
    1. Crit Care Med. 1998 Feb;26(2):245-51 - PubMed
    1. Am J Respir Crit Care Med. 1998 Oct;158(4):1163-7 - PubMed
    1. N Engl J Med. 1988 Jan 7;318(1):25-30 - PubMed
    1. N Engl J Med. 2007 Feb 1;356(5):469-78 - PubMed

Publication types