We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Death in emergency departments: a multicenter cross-sectional survey with analysis of withholding and withdrawing life support.
- Authors
Le Conte, Philippe; Riochet, David; Batard, Eric; Volteau, Christelle; Giraudeau, Bruno; Arnaudet, Idriss; Labastire, Laetitia; Levraut, Jacques; Thys, Frédéric; Lauque, Dominique; Piva, Claude; Schmidt, Jeannot; Trewick, David; Potel, Gilles
- Abstract
To describe the characteristics of patients who die in emergency departments and the decisions to withhold or withdraw life support. We undertook a 4-month prospective survey in 174 emergency departments in France and Belgium to describe patients who died and the decisions to limit life-support therapies. Of 2,512 patients enrolled, 92 (3.7%) were excluded prior to analysis because of missing data; 1,196 were men and 1,224 were women (mean age 77.3 ± 15 years). Of patients, 1,970 (81.4%) had chronic underlying diseases, and 1,114 (46%) had a previous functional limitation. Principal acute presenting disorders were cardiovascular, neurological, and respiratory. Life-support therapy was initiated in 1,781 patients (73.6%). Palliative care was undertaken for 1,373 patients (56.7%). A decision to withhold or withdraw life-sustaining treatments was taken for 1,907 patients (78.8%) and mostly concerned patients over 80 years old, with underlying metastatic cancer or previous functional limitation. Decisions were discussed with family or relatives in 58.4% of cases. The decision was made by a single ED physician in 379 cases (19.9%), and by at least two ED physicians in 1,528 cases (80.1%). Death occurring in emergency departments mainly concerned elderly patients with multiple chronic diseases and was frequently preceded by a decision to withdraw and/or withhold life-support therapies. Training of future ED physicians must be aimed at improving the level of care of dying patients, with particular emphasis on collegial decision-taking and institution of palliative care.
- Subjects
HOSPITAL emergency services; LIFE support systems in critical care; PALLIATIVE treatment; CHRONIC diseases; HOSPICE care
- Publication
Intensive Care Medicine, 2010, Vol 36, Issue 5, p765
- ISSN
0342-4642
- Publication type
Article
- DOI
10.1007/s00134-010-1800-1