End-of-Life Practices in an Intensive Care Unit of a Private Hospital in Mexico

Abstract

Background: Many factors, such as religion, geography, and customs, influence end-of-life practices. This variability exists even between different physicians.

Objective: To observe and describe the end-of-life actions of patients in the intensive care unit (ICU) and document the variables that might influence decision-making at the end of life.

Materials and methods: This is a cross-sectional study performed in the ICU patients of a private hospital from March 2017 to March 2022. We used the Philips Tasy Electronic Medical Record database of clinical records; 298 patients were included in the study during these five years (2017-2022). The data analysis was done with the statistical package SPSS version 23 for Windows.

Results: A total of 297 patients were included in this study, of which more than half were men. About 60% of our sample had private health insurance, whereas the remaining paid out of pocket. Most patients had withholding treatment, followed by failed cardiopulmonary resuscitation, withdrawal treatment, and brain death, and none of the patients had acceleration of the dying process. The main cause of admission to the ICU in our center was respiratory complications. Most of our samples were Catholics.

Conclusions: Decision-making at the end of life is a complex process. Active participation of the patient, when possible, the patient's family, doctors, and nurses, can give different perspectives and a more compassionate and individualized approach to end-of-life care.

Keywords: End-of-life practices; ICU; active shortening of the dying process.; cardiopulmonary resuscitation; critical care medicine; withdrawal treatment; withholding treatment.