Evidence map›Paper›PMID 34140017›Full record

ArticleBMC medical ethics2021

Consent for withholding life-sustaining treatment in cancer patients: a retrospective comparative analysis before and after the enforcement of the Life Extension Medical Decision law.

Yu Jin Chung, Incheol Park, Junho Cho, Jin Ho Beom, Ji Eun Lee

Open access · goldAbstract read
In one paragraph

Article in BMC medical ethics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.4field-weighted citation impact, top 35% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

5 authors at 1 institution in 1 country.

Yu Jin ChungDepartment of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea.
Incheol ParkDepartment of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea.
Junho ChoDepartment of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea.
Jin Ho BeomDepartment of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea. wangtiger@yuhs.ac.
Ji Eun LeeDepartment of Emergency Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu 120-752, Seoul, Republic of Korea.
Yonsei University · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Life Extension Medical Decision law enacted on February 4, 2018 in South Korea was the first to consider the suspension of futile life-sustaining treatment, and its enactment caused a big controversy in Korean society. However, no study has evaluated whether the actual implementation of life-sustaining treatment has decreased after the enforcement of this law. This study aimed to compare the provision of patient consent before and after the enforcement of this law among cancer patients who visited a tertiary university hospital's emergency room to understand the effects of this law on the clinical care of cancer patients.

methodsThis retrospective single cohort study included advanced cancer patients aged over 19 years who visited the emergency room of a tertiary university hospital. The two study periods were as follows: from February 2017 to January 2018 (before) and from May 2018 to April 2019 (after). The primary outcome was the length of hospital stay. The consent rates to perform cardiopulmonary resuscitation (CPR), intubation, continuous renal replacement therapy (CRRT), and intensive care unit (ICU) admission were the secondary outcomes.

resultsThe length of hospital stay decreased after the law was enforced from 4 to 2 days (p = 0.001). The rates of direct transfers to secondary hospitals and nursing hospitals increased from 8.2 to 21.2% (p = 0.001) and from 1.0 to 9.7%, respectively (p < 0.001). The consent rate for admission to the ICU decreased from 6.7 to 2.3% (p = 0.032). For CPR and CRRT, the consent rates decreased from 1.0 to 0.0% and from 13.9 to 8.8%, respectively, but the differences were not significant (p = 0.226 and p = 0.109, respectively).

conclusionAfter the enforcement of the Life Extension Medical Decision law, the length of stay in the tertiary university hospital decreased in patients who established their life-sustaining treatment plans in the emergency room. Moreover, the rate of consent for ICU admission decreased.

Indexed as

Life ExpectancyNeoplasmsAgedCohort StudiesHumansInformed ConsentIntensive Care UnitsRepublic of KoreaRetrospective StudiesWithholding TreatmentCardiopulmonary resuscitationContinuous renal replacement therapyIntensive care unitIntubationLength of hospital stayLife Extension Medical Decision law

Identifiers

PMID34140017
PMCPMC8210737
OpenAlexW3167959030

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.