Evidence map›Paper›PMID 34930420›Full record

Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2021

Limitation of life-sustaining treatment and patient involvement in decision-making: a retrospective study of a Danish COVID-19 patient cohort.

Hanne Irene Jensen, Sevim Ozden, Gitte Schultz Kristensen, Mihnaz Azizi, Siri Aas Smedemark, Christian Backer Mogensen

Open access · goldAbstract readObservational Study
In one paragraph

Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.8field-weighted citation impact, top 25% 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

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Article
  2. 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

6 authors at 4 institutions in 1 country.

Hanne Irene JensenDepartment of Anaesthesiology and Intensive Care, Kolding Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark. hanne.irene.jensen@rsyd.dk.ORCID http://orcid.org/0000-0001-9323-4284
Sevim OzdenDepartment of Anaesthesiology and Intensive Care, Kolding Hospital, University Hospital of Southern Denmark, Sygehusvej 24, 6000, Kolding, Denmark.
Gitte Schultz KristensenDepartment of Emergency, Hospital Sønderjylland, University Hospital of Southern Denmark, Aabenraa, Denmark.
Mihnaz AziziEmergency Medicine, Hospital of South West Jutland, University Hospital of Southern Denmark, Esbjerg, Denmark.
Siri Aas SmedemarkDepartment of Geriatric Medicine, Kolding Hospital, University Hospital of Southern Denmark, Kolding, Denmark.
Christian Backer MogensenDepartment of Regional Health Research, University of Southern Denmark, Odense, Denmark.
Kolding Hospital · DKUniversity of Southern Denmark · DKHospital South West Jutland · DKSygehus Sønderjylland · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe coronavirus (COVID-19) pandemic and the risk of an extensive overload of the healthcare systems have elucidated the need to make decisions on the level of life-sustaining treatment for patients requiring hospitalisation. The purpose of the study was to investigate the proportion and characteristics of COVID-19 patients with limitation of life-sustaining treatment decisions and the degree of patient involvement in the decisions.

methodsA retrospective observational descriptive study was conducted in three Danish regional hospitals, looking at all patients ≥ 18 years of age admitted in 2020 with COVID-19 as the primary diagnosis. Lists of hospitalised patients admitted due to COVID-19 were extracted. The data registration included age, gender, comorbidities, including mental state, body mass index, frailty, recent hospital admissions, COVID-19 life-sustaining treatment, ICU admission, decisions on limitations of life-sustaining treatment before and during current hospitalisation, hospital length of stay, and hospital mortality.

resultsA total of 476 patients were included. For 7% (33/476), a decision about limitation of life-sustaining treatment had been made prior to hospital admission. At the time of admission, one or more limitations of life-sustaining treatment were registered for 16% (75/476) of patients. During the admission, limitation decisions were made for an additional 11 patients, totaling 18% (86/476). For 40% (34/86), the decisions were either made by or discussed with the patient. The decisions not made by patients were made by physicians. For 36% (31/86), no information was disclosed about patient involvement.

conclusionsLife-sustaining treatment limitation decisions were made for 18% of a COVID-19 patient cohort. Hereof, more than a third of the decisions had been made before hospital admission. Many records lacked information on patient involvement in the decisions.

Indexed as

COVID-19DenmarkHumansPatient ParticipationRetrospective StudiesSARS-CoV-2COVID-19End-of-lifeLife-sustaining treatmentPatient involvementShared decision-making

Identifiers

PMID34930420
PMCPMC8686092
OpenAlexW4200295284

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.