Table 1. Characteristics of Patients that died on the intensive care unit between August 2008 and September 2010.
All | No EOLD | DNR | p* 1 | WH/WDLS | p* 2 | |||||
n = 224 | n = 58 | n = 166 | n = 153 | |||||||
Age, years, mean (±SD) | 70.5 | (±12.7) | 69.5 | (±9.9) | 70.8 | (±13.6) | 0.229 | 71.0 | (±13.4) | 0.236 |
Gender, male, n (%) | 136 | (60.7) | 39 | (67.2) | 97 | (58.4) | 0.237 | 86 | (56.2) | 0.145 |
Source of admission, n (%) | ||||||||||
Sugical | 170 | (75.9) | 48 | (82.8) | 122 | (73.5) | 0.156 | 113 | (73.9) | 0.175 |
Medical + Others * 3 | 54 | (24.1) | 10 | (17.2) | 44 | (26.5) | 40 | (26.1) | ||
Comorbidities, n (%) | ||||||||||
Liver cirrhosis | 20 | (8.9) | 4 | (6.9) | 16 | (9.6) | 0.789 | 16 | (10.5) | 0.600 |
Portal hypertension | 12 | (5.4) | 3 | (5.2) | 9 | (5.4) | 1.000 | 9 | (5.9) | 1.000 |
Status post oesophageal bleeding | 9 | (4.0) | 2 | (3.4) | 7 | (4.2) | 1.000 | 7 | (4.6) | 1.000 |
Hepatic encelopathy | 4 | (1.8) | 1 | (1.7) | 3 | (1.8) | 1.000 | 3 | (2.0) | 1.000 |
Cardiac insufficiency NYHA IV | 42 | (18.8) | 9 | (15.5) | 33 | (19.9) | 0.464 | 31 | (20.3) | 0.432 |
Chronic pulmonary disease | 55 | (24.6) | 10 | (17.2) | 45 | (27.1) | 0.133 | 42 | (27.5) | 0.124 |
Chronic obstructive pulmonary disease (COPD) | 47 | (21.0) | 8 | (13.8) | 39 | (23.5) | 0.118 | 36 | (23.5) | 0.120 |
Lung fibrosis | 3 | (1.3) | 0 | (0.0) | 3 | (1.8) | 0.570 | 3 | (2.0) | 0.563 |
Terminal renal insufficiency | 24 | (10.7) | 6 | (10.3) | 18 | (10.8) | 0.916 | 18 | (11.8) | 0.772 |
Steroid medication | 12 | (5.4) | 2 | (3.4) | 10 | (6.0) | 0.736 | 10 | (6.5) | 0.518 |
Chemotherapy | 12 | (5.4) | 3 | (5.2) | 9 | (5.4) | 1.000 | 9 | (5.9) | 1.000 |
Immunosuppression therapy | 7 | (3.1) | 3 | (5.2) | 4 | (2.4) | 0.379 | 4 | (2.6) | 0.396 |
AIDS | 0 | (0.0) | 0 | (0.0) | 0 | 0 | 1.000 | 0 | 0 | 1.000 |
Leukemia | 2 | (0.9) | 0 | (0.0) | 2 | (1.2) | 1.000 | 2 | (1.3) | 1.000 |
Lymphoma | 5 | (2.2) | 0 | (0.0) | 5 | (3.0) | 0.331 | 5 | (3.3) | 0.326 |
Metastasing cancer | 23 | (10.3) | 4 | (6.9) | 18 | (10.8) | 0.454 | 18 | (11.8) | 0.449 |
Severity Scores, mean (± SD) | ||||||||||
SAPS II Admission | 61.6 | ±17.4 | 64.6 | ±18.0 | 60.5 | ±17.0 | 0.176 | 60.9 | ±17.0 | 0.232 |
SOFA Admission | 9.5 | ±3.6 | 10.0 | ±3.3 | 9.4 | ±3.7 | 0.363 | 9.4 | ±3.7 | 0.395 |
SOFA day before EOLD/death | 10.6 | ±3.7 | 11.1 | ±3.4 | 10.5 | ±3.7 | 0.312 | 10.4 | ±3.7 | 0.233 |
SOFA 2 days before EOLD/death | 10.2 | ±3.4 | 10.7 | ±3.6 | 10.0 | ±3.5 | 0.218 | 10.1 | ±3.4 | 0.289 |
ICU LOS, days, median (IQR) | 5.5 | (2–16) | 3 | (1–8) | 7 | (3–22) | <0.001 | 7 | (3–23) | <0.001 |
Organ replacement, n (%) | ||||||||||
Ventilation | 201 | (89.7) | 51 | (87.9) | 151 | (91.0) | 0.250 | 137 | (89.5) | 0.165 |
+5* 4 | (8.6) | |||||||||
Tracheostomy | 50 | (22.3) | 7 | (12.1) | 43 | (25.9) | 0.029 | 40 | (26.1) | 0.028 |
Dialysis | 143 | (63.8) | 37 | (63.8) | 106 | (63.9) | 0.993 | 96 | (62.7) | 0.888 |
IABP | 49 | (21.9) | 20 | (34.5) | 28 | (16.9) | 0.005 | 23 | (15.0) | 0.002 |
VAD | 22 | (9.8) | 7 | (12.1) | 15 | (9.0) | 0.504 | 15 | (9.8) | 0.631 |
ECMO/ECLS | 14 | (6.3) | 1 | (1.7) | 13 | (7.8) | 0.122 | 13 | (8.5) | 0.119 |
Vasopressors | 202 | (90.2) | 55 | (94.8) | 145 | (87.3) | 0.142 | 134 | (87.6) | 0.205 |
Blood products, n, median (Min-Max) | 11.5 | (0–225) | 10 | (0–125) | 12 | (0–225) | 0.409 | 12 | (0–225) | 0.372 |
Advance directive with living and therapeutic will, n, (%) | 21 | (9.4) | 6 | (10.3) | 15 | (9.0) | 0.768 | 14 | (9.2) | 0.791 |
Advance directive with patient´s surrogate decision maker, n, (%) | 20 | (8.9) | 5 | (8.6) | 15 | (9.0) | 1.000 | 13 | (8.5) | 1.000 |
Patients with an attorney during ICU stay, n, (%) | 90 | (40.2) | 16 | (27.6) | 74 | (44.6) | 0.023 | 69 | (45.1) | 0.021 |
Documentation in PDMS special section * 5, n, (%) | 67 | (29.9) | 2 | (3.4) | 65 | (39.2) | <0.001 | 62 | (40.5) | <0.001 |
EOLD = End-of-life-decision; DNR = Do-not-resuscitate order; WH/WDLS = Withhold/Withdraw-life-support order;
1 = between Patients with a DNR and those without an EOLD;
2 = between Patients with a WH/WDLS order and those without an EOLD; SD = Standarddeviation; LOS = length of stay; IQR = interquartile range; Min = Minimum; Max = Maximum;
3 = Including Dermatology and Emergency Room;
4 = patients ventilated in the process of cardiopulmonary resuscitation; IABP = intra-aortic balloon pump; VAD = ventricular assist device; ECMO/ECLS = extracorporal membrane oxygenation/life system;
5 = special section of patientś main chart in the Patient data management system (PDMS) for documentation of social history and family conferences.