Evidence map›Paper›PMID 30442381›Full record

ArticleBurns : journal of the International Society for Burn Injuries2019

Predictors of withdrawal of life support after burn injury.

Colleen N Bartley, Kenisha Atwell, Bruce Cairns, Anthony Charles

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Burns : journal of the International Society for Burn Injuries, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.6field-weighted citation impact, top 16% of its field
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 17 citations in OpenAlex.

  1. Treatment Decisions in Patients With Potentially Nonsurvivable Burn Injury in Australia and New Zealand: A Registry-Based Study.Journal of burn care & research : official publication of the American Burn Association · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Colleen N BartleyDepartment of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
Kenisha AtwellDepartment of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
Bruce CairnsDepartment of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States.
Anthony CharlesDepartment of Surgery, University of North Carolina at Chapel Hill, North Carolina Jaycee Burn Center, United States. Electronic address: anthchar@med.unc.edu.
University of North Carolina at Chapel Hill · US

Funding

TRAUMA RESEARCH FELLOWSHIPT32GM008450 · NIGMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI Bruce A Cairns, Anthony G Charles · 1992 to 2026
$3.8M
NIGMS NIH HHS T32 GM008450
6 · The paper itself

Abstract

introductionDiscussions regarding withdrawal of life support after burn injury are challenging and complex. Often, providers may facilitate this discussion when the extent of injury makes survival highly unlikely or when the patient's condition deteriorates during resuscitation. Few papers have evaluated withdrawal of life support in burn patients. We therefore sought to determine the predictor of withdrawal of life support (WLS) in a regional burn center.

methodsWe conducted a retrospective analysis of all burn patients from 2002 to 2012. Patient characteristics included age, gender, burn mechanism, percentage total body surface area (%TBSA) burned, presence of inhalation injury, hospital length of stay, and pre-existing comorbidities. Patients <17years of age and patients with unknown disposition were excluded. Patients were categorized into three cohorts: Alive till discharge (Alive), death by withdrawal of life support (WLS), or death despite ongoing life support (DLS). DLS patients were then excluded from the study population. Multivariate logistic regression was used to estimate predictors of WLS.

results8,371 patients were included for analysis: 8134 Alive, 237 WLS. Females had an increased odd of WLS compared to males (OR 2.03, 95% CI 1.18-3.48; p=0.010). Based on higher CCI, patients with pre-existing comorbidities had an increased odd of WLS (OR 1.28, 95% CI 1.08-1.52; p=0.005). There was a significantly increased odds for WLS (OR 1.09, 95% CI 1.06-1.12; p<0.001) with increasing age. Similarly, there was an increased odd for WLS (OR 1.08, 95% CI 1.07-1.51; p<0.001) with increasing %TBSA. An increased odd of WLS (OR 2.47, 95% CI 1.05-5.78; p=0.038) was also found in patients with inhalation injury.

conclusionThe decision to withdraw life support is a complex and difficult decision. Our current understanding of predictors of withdrawal of life support suggests that they mirror those factors which increase a patient's risk of mortality. Further research is needed to fully explore end-of-life decision making in regards to burn patients. The role of patient's sex, particularly women, in WLS decision making needs to be further explored.

Indexed as

AdultAgedAged, 80 and overAge FactorsBlack or African AmericanBurnsBurns, InhalationComorbidityDecision MakingEthnicityFemaleHispanic or LatinoHumansLife Support CareLogistic ModelsMaleBurn injuryComfort careEnd of life decisionsWithdrawal of life support

Identifiers

PMID30442381
PMCPMC6420869
OpenAlexW2901729459

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.