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Age, SAPS 3 and female sex are associated with decisions to withdraw or withhold intensive care

Artikel i vetenskaplig tidskrift
Författare Linda Block
Max Petzold
Anna Nordenskjöld Syrous
B. Lindqvist
Helena Odenstedt Hergès
Silvana Naredi
Publicerad i Acta Anaesthesiologica Scandinavica
ISSN 0001-5172
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Språk en
Länkar dx.doi.org/10.1111/aas.13411
Ämnesord age, ethics, life-sustaining care, SAPS 3, sex
Ämneskategorier Anestesi och intensivvård

Sammanfattning

Background: Intensive care treat critically ill patients. When intensive care is not considered beneficial for the patient, decisions to withdraw or withhold treatments are made. We aimed to identify independent patient variables that increase the odds for receiving a decision to withdraw or withhold intensive care. Methods: Registry study using data from the Swedish Intensive Care Registry (SIR) 2014-2016. Age, condition at admission, including co-morbidities (Simplified Acute Physiology Score version 3, SAPS 3), diagnosis, sex, and decisions on treatment limitations were extracted. Patient data were divided into a full care (FC) group, and a withhold or withdraw (WW) treatment group. Results: Of all 97 095 cases, 47.1% were 61-80 years old, 41.9% were women and 58.1% men. 14 996 (15.4%) were allocated to the WW group and 82 149 (84.6%) to the FC group. The WW group, compared with the FC group, was older (P < 0.001), had higher SAPS 3 (P < 0.001) and were predominantly female (P < 0.001). Compared to patients 16-20 years old, patients >81 years old had 11 times higher odds of being allocated to the WW group. Higher SAPS 3 (continuous) increased the odds of being allocated to the WW group by odds ratio [OR] 1.085, (CI 1.084-1.087). Female sex increased the odds of being allocated to the WW group by 18% (1.18; CI 1.13- 1.23). Conclusion: Older age, higher SAPS 3 at admission and female sex were found to be independent variables that increased the odds to receive a decision to withdraw or withhold intensive care. © 2019 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd

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