SynthesisJournal of hospital medicine2019
Limitation of Life-Sustaining Care in the Critically Ill: A Systematic Review of the Literature.
Synthesis in Journal of hospital medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 2 of them syntheses that pooled 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.
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
28 citing papers in PubMed, 2 syntheses or guidelines pooled it, 64 citations in OpenAlex.
- Sex-related differences in end-of-life decision-making in patients with traumatic brain injury: a systematic review and meta-analysis.BMC palliative care · 2026Pooled it
- Assessing palliative care practices in intensive care units and interpreting them using the lens of appropriate care concepts. An umbrella review.Intensive care medicine · 2024Pooled it
- Timing matters: sex differences in treatment limitation decisions in intensive care.Critical care (London, England) · 2026Article
- Age-related sex differences in intensive care treatment and outcomes: a nationwide cohort study.British journal of anaesthesia · 2026Article
- Impact of treatment goals on outcomes in critically ill nonagenarians: a retrospective observational study.BMC geriatrics · 2026Observational
- Trends, Predictors, and Outcomes of Monitored Acute Care Unit Admissions in Older Adults: 10-Year Retrospective Analysis.Interactive journal of medical research · 2026Article
- Factors associated with an unfavorable outcome according to age in patients with COVID-19 admitted to intensive care in mainland France during the first three periods of the pandemic: a nationwide cohort study.Frontiers in medicine · 2026Article
- Life-Supporting Treatment Limitations in Patients Who Die Within 48 Hours After ICU Admission: A French, Multicenter, Observational, Exploratory Study.Critical care explorations · 2025Observational
- 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
- The impact of the CERTAIN clinical decision support tool for structured intensive care unit admission and rounding is patient sex-independent: a secondary analysis of CERTAIN.Critical care science · 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
- Why Are Men More Restrained in the Intensive Care Unit?Annals of the American Thoracic Society · 2024Article
- Navigating shared decision-making after the Life-Sustaining Treatment Decision Act: a qualitative study of in-depth interviews with terminal cancer patients, families, and healthcare professionals.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Differences between women and men in prolonged weaning.Respiratory research · 2024Article
- Limitations of life-sustaining treatments in intensive care units in Croatia: a multicenter retrospective study.Croatian medical journal · 2024Article
- Sex differences in the SOFA score of ICU patients with sepsis or septic shock: a nationwide analysis.Critical care (London, England) · 2024Article
- Sex differences in the use of mechanical ventilation in a neurointensive care population: a retrospective study.BMC pulmonary medicine · 2024Article
- Sex-Related Differences in Mortality, Delayed Cerebral Ischemia, and Functional Outcomes in Patients with Aneurysmal Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2024Review
- Long-stay ICU patients with frailty: mortality and recovery outcomes at 6 months.Annals of intensive care · 2024Article
- Limitation of life sustaining measures in neurocritical care: sex, timing, and advance directive.Journal of intensive care · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 1 country.
Funding
Abstract
When life-sustaining treatments (LST) are no longer effective or consistent with patient preferences, limitations may be set so that LSTs are withdrawn or withheld from the patient. Many studies have examined the frequency of limitations of LST in intensive care unit (ICU) settings in the past 30 years. This systematic review describes variation and patient characteristics associated with limitations of LST in critically ill patients in all types of ICUs in the United States. A comprehensive search of the literature was performed by a medical librarian between December 2014 and April 2017. A total of 1,882 unique titles and abstracts were reviewed, 113 were selected for article review, and 36 studies were fully reviewed. Patient factors associated with an increased likelihood of limiting LST included white race, older age, female sex, poor preadmission functional status, multiple comorbidities, and worse illness severity score. Based on several large, multicenter studies, there was a trend toward a higher frequency of limitation of LST over time. However, there is large variability between ICUs in the proportion of patients with limitations and on the proportion of deaths preceded by a limitation. Increases in the frequency of limitations of LST over time suggests changing attitudes about aggressive end-of-life-care. Limitations are more common for patients with worse premorbid health and greater ICU illness severity. While some differences in the frequency of limitations of LST may be explained by personal factors such as race, there is unexplained wide variability between units.
Indexed as
Identifiers
What OpenQuestion holds
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.