ArticleIntensive care medicine2012
Impact of an intensive communication strategy on end-of-life practices in the intensive care unit.
Article in Intensive care medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Palliative care interventions in intensive care unit patients.Intensive care medicine · 2021Pooled it
- Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.Critical care (London, England) · 2016Pooled it
- Global variability in withholding and withdrawal of life-sustaining treatment in the intensive care unit: a systematic review.Intensive care medicine · 2015Pooled it
- Trial
- Quality of dying in the ICU: is it worse for patients admitted from the hospital ward compared to those admitted from the emergency department?Intensive care medicine · 2014Trial
- Patient Information and Consent for Care in the Intensive Care Unit.Healthcare (Basel, Switzerland) · 2023Review
- ICU stays that are judged to be non-beneficial: A qualitative study of the perception of nursing staff.PloS one · 2023Article
- Team-family conflicts over end-of-life decisions in ICU: A survey of French physicians' beliefs.PloS one · 2023Article
- Primary palliative care recommendations for critical care clinicians.Journal of intensive care · 2022Review
- Article
- Non-readmission decisions in the intensive care unit: A qualitative study of physicians' experience in a multicentre French study.PloS one · 2021Article
- [Nonbeneficial care-a burden for clinicians and relatives].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2019Review
- Non-readmission decisions in the intensive care unit under French rules: A nationwide survey of practices.PloS one · 2018Article
- What are the ethical aspects surrounding the collegial decisional process in limiting and withdrawing treatment in intensive care?Annals of translational medicine · 2017Review
- What are the ethical questions raised by the integration of intensive care into advance care planning?Annals of translational medicine · 2017Review
- What are the ethical dimensions in the profession of intensive care specialist?Annals of translational medicine · 2017Review
- Intensive care unit strain should not rush physicians into making inappropriate decisions, but merely reduce the time to the right decisions being made.Annals of translational medicine · 2016Article
- Effect of ICU strain on timing of limitations in life-sustaining therapy and on death.Intensive care medicine · 2016Article
- Withholding or withdrawal of treatment under French rules: a study performed in 43 intensive care units.Annals of intensive care · 2015Article
- Tell me where the patient comes from.Intensive care medicine · 2014Article
Corrections and comments
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeSince the 2005 French law on end of life and patients' rights, it is unclear whether practices have evolved. We investigated whether an intensive communication strategy based on this law would influence practices in terms of withholding and withdrawing treatment (WWT), and outcome of patients hospitalised in intensive care (ICU).
methodsThis was a single-centre, two-period study performed before and after the 2005 law. Between these periods, an intensive strategy for communication was developed and implemented, comprising regular meetings and modalities for WWT. We examined medical records of all patients who died in the ICU or in hospital during both periods.
resultsIn total, out of 2,478 patients admitted in period 1, 678 (27%) died in the ICU and 823/2,940 (28%) in period 2. In period 1, among patients who died in the ICU, 45% died subsequent to a decision to WWT versus 85% in period 2 (p < 0.01). Among these, median time delay between ICU admission and initiation of decision-making process was significantly different (6-7 days in period 1 vs. 3-5 days in period 2, p < 0.05). Similarly, median time from admission to actual WWT decision was significantly shorter in period 2 (11-13 days in period 1 vs. 4-6 days in period 2, p < 0.05). Finally, median time from admission to death in the ICU subsequent to a decision to WWT was 13-15 days in period 1 versus 7-8 days in period 2, p < 0.05. Reasons for WWT were not significantly different between periods.
conclusionIntensive communication brings about quicker end-of-life decision-making in the ICU. The new law has the advantage of providing a legal framework.
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