ArticleCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2019
Factors influencing decisions by critical care physicians to withdraw life-sustaining treatments in critically ill adult patients with severe traumatic brain injury.
Open access · goldAbstract read
In one paragraph
Article in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
3.4field-weighted citation impact, top 8% of its field
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
18 citing papers in PubMed, 33 citations in OpenAlex.
- Review
- Serial measurements of neuron specific enolase, glial fibrillary acidic protein and neurofilament light for mortality prediction in patients with severe acute brain injury in the ICU.Clinical chemistry and laboratory medicine · 2026Article
- Reporting practices and impact of withdrawal of life-sustaining treatment on outcomes in acute brain injury clinical trials: a literature review and simulation study.Critical care (London, England) · 2026Review
- Disorders of consciousness diagnosis, interventions, and prognostication for the intensivist: Report of the 2025 ISICEM roundtable.Intensive care medicine · 2026Review
- Patterns in withdrawal of life-sustaining treatment in trauma patients with and without moderate to severe traumatic brain injury: an ACS-TQIP retrospective cohort study.Trauma surgery & acute care open · 2026Article
- Estimating bias from withdrawal of life sustaining treatment in clinical trials.Critical care (London, England) · 2025Review
- Redirection of Care after Traumatic Brain Injury in Intensive Care: Sex and Social Determinants of Health.Neurotrauma reports · 2025Article
- Recovery Potential in Patients Who Died After Withdrawal of Life-Sustaining Treatment: A TRACK-TBI Propensity Score Analysis.Journal of neurotrauma · 2024Article
- Multimodal Prediction of 3- and 12-Month Outcomes in ICU Patients with Acute Disorders of Consciousness.Neurocritical care · 2024Article
- Ethics and the 2018 Practice Guideline on Disorders of Consciousness: A Framework for Responsible Implementation.Neurology · 2022Article
- Prognostic Research in Traumatic Brain Injury: Markers, Modeling, and Methodological Principles.Journal of neurotrauma · 2021Review
- Proceedings of the First Curing Coma Campaign NIH Symposium: Challenging the Future of Research for Coma and Disorders of Consciousness.Neurocritical care · 2021Article
- Inside the lived perspective of life after spinal cord injury: a qualitative study of the desire to live and not live, including with assisted dying.Spinal cord · 2021Article
- Inter-physician variability in strategies linked to treatment limitations after severe traumatic brain injury; proactivity or wait-and-see.BMC medical ethics · 2021Article
- Early discrimination of cognitive motor dissociation from disorders of consciousness: pitfalls and clues.Journal of neurology · 2021Article
- Association of age with death and withdrawal of life-sustaining therapy after severe traumatic brain injury.Canadian journal of surgery. Journal canadien de chirurgieArticle
- Pain perception and attitudes toward life-sustaining treatment in pediatric patients with disorders of consciousness: a survey of Chinese healthcare professionals.Frontiers in neurologyArticle
- Factors influencing withdrawal of life-sustaining treatments in patients with severe acquired brain injuries: a scoping review.Frontiers in neurologyReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 4 institutions in 1 country.
Alexis F TurgeonCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont. alexis.turgeon@fmed.ulaval.ca.
Kristin DorranceCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Patrick ArchambaultCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
François LauzierCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
François LamontagneCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Ryan ZarychanskiCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Robert FowlerCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Lynne MooreCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Jacques LacroixCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Shane EnglishCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Amélie BoutinCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
John MuscedereCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Karen E A BurnsCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Donald GriesdaleCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Lauralyn A McIntyreCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Damon ScalesCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Francis BernardCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Janet YamadaCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Janet E SquiresCHU de Québec - Université Laval Research Centre (Turgeon, Archambault, Lauzier, Moore, Boutin), Population Health and Optimal Health Practices Research Unit, Trauma - Emergency - Critical Care Medicine, and Division of Critical Care Medicine (Turgeon, Archambault, Lauzier), Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Université Laval, Québec, Que.; Clinical Epidemiology Program (Dorrance, English, McIntyre, Squires), Ottawa Hospital Research Institute, Ottawa, Ont.; Departments of Family and Emergency Medicine (Archambault), and Medicine (Lauzier), Faculty of Medicine, Université Laval, Québec, Que.; Department of Medicine (Lamontagne), Université de Sherbrooke; Centre de recherche du CHU de Sherbrooke (Lamontagne), Sherbrooke, Que.; Department of Internal Medicine (Zarychanski), Sections of Critical Care Medicine, Haematology and Medical Oncology, Faculty of Medicine, University of Manitoba, Winnipeg, Man.; Sunnybrook Research Institute (Fowler, Scales), Sunnybrook Health Sciences Centre, Toronto, Ont.; Department of Social and Preventive Medicine (Moore), Université Laval, Québec, Que.; CHU Ste-Justine Research Centre (Lacroix), CHU Ste-Justine and Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Division of Critical Care (English, McIntyre), Department of Medicine, University of Ottawa, Ottawa, Ont.; Department of Critical Care Medicine (Muscedere) and Kingston Health Sciences Centre, Queen's University, Kingston, Ont.; Interdepartmental Division of Critical Care Medicine (Burns), University of Toronto; Li Ka Shing Knowledge Institute (Burns), St. Michael's Hospital, Toronto, Ont.; Division of Critical Care Medicine (Griesdale), Department of Medicine, and Department of Anesthesiology, Pharmacology and Therapeutics (Griesdale), University of British Columbia, Vancouver, BC; Department of Medicine (Bernard), Université de Montréal, Montréal, Que.; Daphne Cockwell School of Nursing (Yamada), Ryerson University, Toronto, Ont.; School of Nursing (Squires), University of Ottawa, Ottawa, Ont.
Canadian Traumatic Brain Injury Research Consortium and the Canadian Critical Care Trials Group
Université de Sherbrooke · CAUniversity of Toronto · CAUniversité Laval · CAUniversity of British Columbia · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMost deaths in critically ill patients with severe traumatic brain injury are associated with a decision to withdraw life-sustaining treatments. We aimed to identify the behavioural determinants that influence recommendations by critical care physicians to consider the withdrawal of life-sustaining treatments in this population.
methodsWe conducted a descriptive qualitative study based on the Theoretical Domains Framework of critical care physicians caring for patients with severe traumatic brain injury across Canada. We stratified critical care physicians by regions and used a purposive sampling strategy. We conducted semistructured phone interviews using a piloted and pretested interview guide. We transcribed the interviews verbatim and verified the content for accuracy. We performed the analysis using a 3-step approach: coding, generation of specific beliefs and generation of specific themes.
resultsWe recruited 20 critical care physicians across 4 geographic regions. After reaching saturation, we identified 7 core themes across 4 Theoretical Domains Framework domains for factors relevant to the decision to withdraw life-sustaining treatments. Four factors (i.e., clinical triggers, social triggers, interaction with families and intentions with medical decisions) were identified before the decision is made and 3 were identified during the decision-making process (i.e., considerations, priorities and knowledge needs). We identified multiple themes reflecting internal (
interpretationWe identified several core themes and domains considered by critical care physicians in Canada in the decision to withdraw life-sustaining treatments in critically ill patients with severe traumatic brain injury. Future research should aim at identifying the factors influencing surrogate decision-makers in the decision to withdraw life-sustaining treatments in these patients.
Indexed as
Brain Injuries, TraumaticClinical Decision-MakingCritical CarePhysiciansWithholding TreatmentCanadaCritical IllnessFemaleHumansMaleQualitative ResearchTrauma Severity Indices
Identifiers
What OpenQuestion holds
Textmetadata
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.