Observational studyIntensive care medicine2013
The ETHICA study (part I): elderly's thoughts about intensive care unit admission for life-sustaining treatments.
Observational study in Intensive care medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
44 citing papers in PubMed.
- Trial
- Older patients and intensive care: factors that influence patients decisions on life sustaining measures.BMC geriatrics · 2026Article
- Acute kidney injury and chronic kidney disease in the aging critically ill patient.Intensive care medicine · 2026Article
- Invasive ventilation and mortality in critically ill nonagenarians: a retrospective cohort study.European journal of medical research · 2026Article
- GRACE-ICU: A multimodal nomogram-based approach for illness severity assessment of older adults in the ICU.NPJ digital medicine · 2025Article
- Observational
- Be-SNAP: the Belgian Sepsis National Action Plan.Frontiers in public health · 2025Article
- ICU Admission Preferences in the Hypothetical Event of Acute Critical Illness: A Survey of Very Old Norwegians and Their Next-of-Kins.Critical care explorations · 2024Article
- Hematologists' perspective on advance directives, a French national cross-sectional survey - the ADORE-H study.BMC medical ethics · 2024Article
- Oncologists' perspective on advance directives, a French national prospective cross-sectional survey - the ADORE study.BMC medical ethics · 2024Article
- The critically ill older patient with sepsis: a narrative review.Annals of intensive care · 2024Review
- The impact of age on intensive care.Ageing research reviews · 2023Review
- Sex-Related Differences in Acuity and Postoperative Complications, Mortality and Failure to Rescue.The Journal of surgical research · 2023Article
- A rapid scoping review of end-of-life conversations with frail older adults in Canada.Canadian family physician Medecin de famille canadien · 2021Article
- Age-Specific and Sex-Specific Trends in Life-Sustaining Care After Acute Stroke.Journal of the American Heart Association · 2021Article
- The outcome of in- and out-hospital cardiopulmonary arrest in the older population: a scoping review.European geriatric medicine · 2021Article
- Differences in end-of-life care and outcomes in palliative consultation-eligible patients with and without do-not-resuscitate orders: A propensity score-matched study.Journal of the Chinese Medical Association : JCMA · 2021Observational
- ICU-Mortality in Old and Very Old Patients Suffering From Sepsis and Septic Shock.Frontiers in medicine · 2021Article
- Noninvasive ventilation in critically ill very old patients with pneumonia: A multicenter retrospective cohort study.PloS one · 2021Article
- Impact of advance directives on the variability between intensivists in the decisions to forgo life-sustaining treatment.Critical care (London, England) · 2020Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo assess preferences among individuals aged ≥80 years for a future hypothetical critical illness requiring life-sustaining treatments.
methodsObservational cohort study of consecutive community-dwelling elderly individuals previously hospitalised in medical or surgical wards and of volunteers residing in nursing homes or assisted-living facilities. The participants were interviewed at their place of residence after viewing films of scenarios involving the use of non-invasive mechanical ventilation (NIV), invasive mechanical ventilation (IMV), and renal replacement therapy after a period of invasive mechanical ventilation (RRT after IMV). Demographic, clinical, and quality-of-life data were collected. Participants chose among four responses regarding life-sustaining treatments: consent, refusal, no opinion, and letting the physicians decide.
resultsThe sample size was 115 and the response rate 87 %. Mean participant age was 84.8 ± 3.5 years, 68 % were female, and 81 % and 71 % were independent for instrumental activities and activities of daily living, respectively. Refusal rates among the elderly were 27 % for NIV, 43 % for IMV, and 63 % for RRT (after IMV). Demographic characteristics associated with refusal were married status for NIV [relative risk (RR), 2.9; 95 % confidence interval (95 %CI), 1.5-5.8; p = 0.002] and female gender for IMV (RR, 2.4; 95 %CI, 1.2-4.5; p = 0.01) and RRT (after IMV) (RR, 2.7; 95 %CI, 1.4-5.2; p = 0.004). Quality of life was associated with choices regarding all three life-sustaining treatments.
conclusionsIndependent elderly individuals were rather reluctant to accept life-sustaining treatments, especially IMV and RRT (after IMV). Their quality of life was among the determinants of their choices.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.