ArticleCritical care explorations2021
Frequency of Withdrawal of Life-Sustaining Therapy for Perceived Poor Neurologic Prognosis.
Article in Critical care explorations, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed, 49 citations in OpenAlex.
- Impact of Mandatory Clinical Ethics Consultation for Neurocritically Ill Patients.Journal of bioethical inquiry · 2026Article
- Clinicians' Approaches to Prognostication After Traumatic Brain Injury and Cardiac Arrest: A Multi-Hospital, Qualitative Study.Neurocritical care · 2026Article
- Wolf Creek XVIII Part 8: Wolf Creek Innovator in Cardiac Arrest and Resuscitation Science Award.Resuscitation plus · 2026Article
- Disorders of consciousness diagnosis, interventions, and prognostication for the intensivist: Report of the 2025 ISICEM roundtable.Intensive care medicine · 2026Review
- Withdrawal of life-sustaining therapies after cardiac arrest.Current opinion in critical care · 2025Review
- Communicating with Families after Severe Acute Brain Injury.Neurocritical care · 2025Review
- Super-Refractory Status Epilepticus Diagnosis, Management, and Prognostication: An International Survey Study.Neurology. Clinical practice · 2025Article
- Status epilepticus in older adults: A critical review.Epilepsia · 2025Review
- Impact of Country Income Level on Outcomes in Patients with Acute Brain Injury Requiring Invasive Mechanical Ventilation: A Secondary Analysis of the ENIO Study.Neurocritical care · 2025Article
- Challenges with Formulating Accurate Prognosis for Patients with Severe Acute Brain Injury.Neurocritical care · 2025Review
- Recovery Potential in Patients After Cardiac Arrest Who Die After Limitations or Withdrawal of Life Support.JAMA network open · 2025Article
- Social Determinants of Health and Limitation of Life-Sustaining Therapy in Neurocritical Care: A CHoRUS Pilot Project.Neurocritical care · 2024Article
- Machine learning-based diagnostic model for stroke in non-neurological intensive care unit patients with acute neurological manifestations.Scientific reports · 2024Article
- Recovery Potential in Patients Who Died After Withdrawal of Life-Sustaining Treatment: A TRACK-TBI Propensity Score Analysis.Journal of neurotrauma · 2024Article
- Limitation of life sustaining therapy in disorders of consciousness: ethics and practice.Brain : a journal of neurology · 2024Review
- A multicenter, randomized, doubleblind, placebo-controlled trial of amantadine to stimulate awakening in comatose patients resuscitated from cardiac arrest.Clinical and experimental emergency medicine · 2024Article
- Simple approach to quantify hypoxic-ischemic brain injury severity from computed tomography imaging files after cardiac arrest.Resuscitation · 2024Article
- Computational Prognostic Modeling in Traumatic Brain Injury.Advances in experimental medicine and biology · 2024Review
- Disambiguating Consciousness in Clinical Settings.Neurology · 2023Article
- Impact of Receiving Hospital on Out-of-Hospital Cardiac Arrest Outcome: Racial and Ethnic Disparities in Texas.Journal of the American Heart Association · 2023Article
Corrections and comments
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Authors and funding
13 authors at 4 institutions in 1 country.
Funding
Abstract
To measure the frequency of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis among decedents in hospitals of different sizes and teaching statuses.
designWe performed a multicenter, retrospective cohort study.
settingFour large teaching hospitals, four affiliated small teaching hospitals, and nine affiliated nonteaching hospitals in the United States. PATIENTS: We included a sample of all adult inpatient decedents between August 2017 and August 2019. MEASUREMENTS AND MAIN
resultsWe reviewed inpatient notes and categorized the immediately preceding circumstances as withdrawal of life-sustaining therapy for perceived poor neurologic prognosis, withdrawal of life-sustaining therapy for nonneurologic reasons, limitations or withholding of life support or resuscitation, cardiac death despite full treatment, or brain death. Of 2,100 patients, median age was 71 years (interquartile range, 60-81 yr), median hospital length of stay was 5 days (interquartile range, 2-11 d), and 1,326 (63%) were treated at four large teaching hospitals. Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis occurred in 516 patients (25%) and was the sole contributing factor to death in 331 (15%). Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis was common in all hospitals: 30% of deaths at large teaching hospitals, 19% of deaths in small teaching hospitals, and 15% of deaths at nonteaching hospitals. Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis happened frequently across all hospital units. Withdrawal of life-sustaining therapy for perceived poor neurologic prognosis contributed to one in 12 deaths in patients without a primary neurologic diagnosis. After accounting for patient and hospital characteristics, significant between-hospital variability in the odds of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis persisted.
conclusionsA quarter of inpatient deaths in this cohort occurred after withdrawal of life-sustaining therapy for perceived poor neurologic prognosis. The rate of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis occurred commonly in all type of hospital settings. We observed significant unexplained variation in the odds of withdrawal of life-sustaining therapy for perceived poor neurologic prognosis across participating hospitals.
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