Table 1.
Patient characteristics according to whether therapy was limited or not (n = 177)
| Characteristics | All (n = 177) |
WH/WD (n = 54) |
WH (n = 43) |
WD (n = 11) |
|---|---|---|---|---|
| Age, years (mean ± SD) | 47 ± 17.5 | 57.7 ± 2.31 | 58 ± 17 | 56.9 ± 5 |
| Gender, n (%) | ||||
| Male | 100(56.5) | 30(55.6) | 24(55.8) | 6(54.5) |
| Female | 77(43.5) | 24(44.4) | 19(44.2) | 5(45.5) |
| Prior health condition: CCI | ||||
| 0 | 89(50.3) | 13(24.1) | 12(27.9) | 1(9.1) |
| 1 | 45(25.4) | 12(22.2) | 10(23.3) | 2(18.2) |
| > 2 | 43(24.3) | 29(53.7) | 21(48.8) | 8(72.7) |
| APACHE II (mean ± SD) | 17 ± 7.5 | 20.3 ± 1 | 21 ± 7.6 | 17.5 ± 5 |
| Acute medical disorders, n (%) | ||||
| Cardiac | 49(27.7) | 10(18.5) | 9(20.9) | 1(9.1) |
| Respiratory | 15(8.5) | 6(11.1) | 3(7) | 3(27.3) |
| Neurological | 25(14.1) | 17(31.5) | 15(34.9) | 2(18.2) |
| Infectious | 30(16.9) | 6(11.1) | 5(11.6) | 1(9.1) |
| Metabolic | 15(8.5) | 3(5.6) | 2(4.7) | 1(1.9) |
| Digestive | 18(10.2) | 8(14.8) | 5(11.6) | 3(27.3) |
| Traumatic | 25(14.1) | 4(7.4) | 4(9.3) | 0 |
| Chronic underlying diseases, n (%) | ||||
| Heart failure | 35(19.7) | 21(38.9) | 17(39.5) | 4(36.1) |
| Chronic respiratory disease | 21(11.9) | 4(7.4) | 3(7) | 1(9.1) |
| Malignancy | 14(7.9) | 10(18.5) | 7(16.3) | 3(27.3) |
| Liver disease | 9(5.1) | 5(9.2) | 2(4.7) | 3(27.3) |
| Time interval from ED admission to death (hours) median [IQR] | 24[8-48] | 24[12-48] | 12[4-34] | 12[4-29] |
| Time interval from ED admission to the decision WH/WD (hours) median [IQR] | ---- | 8[3-24] | 7[2-24] | 12[6-24] |
| Time interval from decision WH/WD to death (hours) median [IQR] | ---- | 12[4-34] | 24[12-48] | 12[12-76] |
| Documentation of decision WH/WD in medical record, n (%) | ---- | 1(1.85) | 1(5.3) | 0 |
| Initiation of the decision-making process WH/WD, n (%) | ||||
| Single ED physician | ---- | 23(42.6) | 19(44.2) | 4(36.4) |
| Single ED physician with Nursing staff Single ED physician without Nursing staff |
---- ---- |
18 (78.3) 5 (21.7) |
14(73.7) 5(26.3) |
4(100) 0 |
| Medical staff | ---- | 31(57.4) | 24(55.8) | 7(63.6) |
| Involvement in the decision-making process WH/WD*, n (%) | ||||
| Nursing staff | ---- | 48(88.9) | 37(86) | 11(100) |
| Patient | ---- | 6(11.1) | 5(11.7) | 1(9.1) |
| Families | ---- | 38(70.4) | 29(67.5) | 9(81.8) |
| Moment of decision WH/WD making, n (%) | ||||
| From 8 h to 14 h | ---- | 24(44.4) | 19(44.2) | 5(45.5) |
| From 14 h to20 h | ---- | 14(26) | 11(25.6) | 3(27.3) |
| Night and weekend | ---- | 16(29.6) | 13(30.2) | 3(27.3) |
CCI: Charlson Index of Comorbidities; APACHE II: Acute Physiology and Chronic Health Evaluation; WH: withholding; WD: withdrawal of life-sustaining treatment. *Several individuals can be involved in the decision making process WH/WD for the same patient.