ArticleIntensive care medicine2018
Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit.
Article in Intensive care medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT07035951 (The VIP-3), which is not on this map. Cited by 79 papers.
What it found
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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.
The VIP-3 (Very Old Intensive Care Patients) Study: Decision-making in the Older Intensive Care Unit (ICU) Patient: How Are Family Meetings Implemented Across Diverse Cultures in Europe?
Who cites it
79 citing papers in PubMed, 215 citations in OpenAlex.
- Sublingual microcirculatory assessment on admission independently predicts the outcome of old intensive care patients suffering from shock.Scientific reports · 2024Trial
- Direct assessment of microcirculation in shock: a randomized-controlled multicenter study.Intensive care medicine · 2023Trial
- Critical care of the very old, what needs to be done?European geriatric medicine · 2026Review
- End-of-life decision-making in very old critically ill patients.European geriatric medicine · 2026Review
- Review
- Extracorporeal Cytokine Hemadsorption with oXirisJournal of clinical medicine · 2026Article
- Determinants of ICU Admission Care Limitation in Patients Younger Than 65 Years: A Prospective, Observational, Multicenter Study.Critical care explorations · 2026Observational
- Influence of Age in End-of-Life Practices in Worldwide ICUs (ETHICUS-2): A Prospective Observational Study.Critical care medicine · 2026Observational
- Impact of treatment goals on outcomes in critically ill nonagenarians: a retrospective observational study.BMC geriatrics · 2026Observational
- Life-sustaining therapy limitation in critical illness: unequal weights of demographics, disease severity, and comorbidities.Critical care science · 2026Article
- Frailty and Outcomes in Elderly ICU Patients: Insights from a Portuguese Cohort.Healthcare (Basel, Switzerland) · 2025Article
- Intensive care of the very old - questioning the relationship between illness severity and the moral imperative to deliver life-saving care.Philosophy, ethics, and humanities in medicine : PEHM · 2025Article
- Status epilepticus in older adults: A critical review.Epilepsia · 2025Review
- Determinants of Limiting Life-Sustaining Treatment in Critically Ill COVID-19 Patients: A Multicenter Study in Korean Intensive Care Units.Tuberculosis and respiratory diseases · 2025Article
- Prognosis of Nonagenarian ICU Patients A Bayesian analysis of prospective European studies.Annals of intensive care · 2025Article
- Observational
- End-of-life decision disparities according to the gross national income in critically ill patients: a secondary analysis of the ETHICUS-2 study.Annals of intensive care · 2025Article
- Regional differences in triage decisions affect hospital mortality among frail COVID-19 patients in the COvid MEdicaTion study.BMC infectious diseases · 2025Observational
- Goals of care discussions and treatment limitation decisions in European acute geriatric units: a one-day cross-sectional study.Age and ageing · 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
19 more citing papers are in PubMed but not listed here.
Corrections and comments
- Erratum issued
Authors and funding
24 authors at 19 institutions in 15 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU.
methodsThis prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up.
resultsLST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU length of stay. The ICU and 30-day mortality were, respectively, 29.1 and 53.1% in the withholding group and 82.2% and 93.1% in the withdrawal group. LST was less frequently limited in eastern and southern European countries than in northern Europe. The patient-independent factors associated with LST limitation were: acute ICU admission (OR 5.77, 95% CI 4.32-7.7), Clinical Frailty Scale (CFS) score (OR 2.08, 95% CI 1.78-2.42), increased age (each 5 years of increase in age had a OR of 1.22 (95% CI 1.12-1.34) and SOFA score [OR of 1.07 (95% CI 1.05-1.09 per point)]. The frequency of LST limitation was higher in countries with high GDP and was lower in religious countries.
conclusionsThe most important patient variables associated with the instigation of LST limitation were acute admission, frailty, age, admission SOFA score and country.
trial registrationClinicalTrials.gov (ID: NTC03134807).
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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.