ArticleStroke2021
Withdrawal of Life-Sustaining Treatment Mediates Mortality in Patients With Intracerebral Hemorrhage With Impaired Consciousness.
Article in Stroke, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
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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.
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Who cites it
30 citing papers in PubMed, 42 citations in OpenAlex.
- Impact of a Specialized Care Pathway for ICU Patients With Disorders of Consciousness: Observational Insights From an Expert Center.European journal of neurology · 2026Observational
- Early care limitation after ICH in a population-based study: what drives clinicians' decisions?European stroke journal · 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
- The Impact of Intervention Modality on Mortality Outcomes in Patients With Hemorrhagic Strokes: A Meta-Analysis.Cureus · 2025Review
- Association of the ICH Score With Withdrawal of Life-Sustaining Treatment Over a 10-Year Period.Annals of clinical and translational neurology · 2025Article
- Detecting Pain Correlates With Recovery in Acute Brain Injury Patients With Disorders of Consciousness.Critical care explorations · 2025Observational
- Challenges with Formulating Accurate Prognosis for Patients with Severe Acute Brain Injury.Neurocritical care · 2025Review
- A Survey of Surrogates and Health Care Professionals Indicates Support of Cognitive Motor Dissociation-Assisted Prognostication.Neurocritical care · 2025Observational
- Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury.Nature medicine · 2025Observational
- Timing of neuroprognostication in the ICU.Current opinion in critical care · 2025Review
- Factors Related to Nonachievement of Intensive Blood Pressure-Lowering Target in Patients with Intracerebral Hemorrhage.Neurocritical care · 2025Article
- Social Determinants of Health and Limitation of Life-Sustaining Therapy in Neurocritical Care: A CHoRUS Pilot Project.Neurocritical care · 2024Article
- Resting-State EEG Signature of Early Consciousness Recovery in Comatose Patients with Traumatic Brain Injury.Neurocritical care · 2024Article
- Predictors of In-Hospital Mortality in Spontaneous Intracerebral Hemorrhage in a Tertiary Hospital in Ghana: A Retrospective Analysis.Neurosurgery practice · 2024Article
- Toward a More Culture-centered, Humane, Ethical, and Inclusive Care of Persons with Disorders of Consciousness.Neurocritical care · 2024Article
- Recovery of consciousness after acute brain injury: a narrative review.Journal of intensive care · 2024Review
- The risk and burden of thromboembolic and hemorrhagic events in patients with malignant gliomas receiving bevacizumab.Journal of neuro-oncology · 2024Article
- Covert Tracking to Immersive Stimuli in Traumatic Brain Injury Subjects With Disorders of Consciousness.Journal of neurotrauma · 2024Article
- A Novel Approach to Screen for Somatosensory Evoked Potentials in Critical Care.Neurocritical care · 2024Article
- Prognostication or predestination?Brain & spine · 2024Article
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Authors and funding
16 authors at 3 institutions in 1 country.
Funding
Abstract
background and purposeImpaired level of consciousness (LOC) on presentation at hospital admission in patients with intracerebral hemorrhage (ICH) may affect outcomes and the decision to withhold or withdraw life-sustaining treatment (WOLST).
methodsPatients with ICH were included across 121 Florida hospitals participating in the Florida Stroke Registry from 2010 to 2019. We studied the effect of LOC on presentation on in-hospital mortality (primary outcome), WOLST, ambulation status on discharge, hospital length of stay, and discharge disposition.
resultsAmong 37 613 cases with ICH (mean age 71, 46% women, 61% White, 20% Black, 15% Hispanic), 12 272 (33%) had impaired LOC at onset. Compared with cases with preserved LOC, patients with impaired LOC were older (72 versus 70 years), more women (49% versus 45%), more likely to have aphasia (38% versus 16%), had greater ICH score (3 versus 1), greater risk of WOLST (41% versus 18%), and had an increased in-hospital mortality (32% versus 12%). In the multivariable-logistic regression with generalized estimating equations accounting for basic demographics, comorbidities, ICH severity, hospital size and teaching status, impaired LOC was associated with greater mortality (odds ratio, 3.7 [95% CI, 3.1-4.3],
conclusionsIn this large multicenter stroke registry, a third of ICH cases presented with impaired LOC. Impaired LOC was associated with greater in-hospital mortality and worse disposition at discharge, largely influenced by early decision to withhold or WOLST.
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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.