SciELO - Scientific Electronic Library Online

 
vol.31 número2La adjudicación de recursos en los pacientes con mal pronóstico: la necesidad de un debateMecanismos biofísicos, celulares y modulación de la lesión pulmonar inducida por la ventilación mecánica índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Medicina Intensiva

versão impressa ISSN 0210-5691

Resumo

IRIBARREN-DIARASARRI, S. et al. Limitation of therapeutic effort after ICU admission: Analysis of related factors. Med. Intensiva [online]. 2007, vol.31, n.2, pp.68-72. ISSN 0210-5691.

Objective. To analyze the limitation of therapeutic effort (LTE) in our Intensive Care Unit (ICU) and the variables associated with that decision. Design. Prospective cohort study with a follow up of one year after discharge. Setting. ICU of a second level hospital. Patients. Four hundred and nine patients admitted during a two-year period. Main variables. APACHE II, NEMS, SOFA, quality of life (PAEEC) and mortality. Results. LTE was performed in 49 (12%) patients. This decision was made by general agreement among the care team in 88% of cases and with the family in 73.5%. It was made on day 8 (4-20) with a SOFA score of 9 (4-13). Mortality in the LTE group was 69.4% in ICU, 92% in hospital, and 96% at 6 and 12 months. A logistic regression model showed that the variables associated with LTE were the following: NEMS score ≥30.7 (OR 12; 95% CI 3.7-39, p < 0.001), NEMS 26.6-30.6 (OR 8; 95% CI 2.5-25.6, p = 0.001), APACHE II > 30 (OR 7.6; 95% CI 2-29, p = 0.003), quality of life ≥ 7 (OR 4.2; 95% CI 1.1-15, p = 0.03), age ≥ 80 (OR 3.7, 95% CI 1.4-9.5, p = 0.007) and medical patient condition (OR 3.5; 95% CI 1.5-8, p = 0.003). Conclusions. LTE is a common practice and is usually performed among the care team and the patient's surrogates. The main variables associated with LSC are those related to the severity of illness, previous quality of life, medical disease and patient's age.

Palavras-chave : critical care; bioethics; quality of life; mortality; withholding treatment; withdrawing care.

        · resumo em Espanhol     · texto em Espanhol

 

Creative Commons License Todo o conteúdo deste periódico, exceto onde está identificado, está licenciado sob uma Licença Creative Commons