ArticleJournal of internal medicine2022
Variations in end-of-life care practices in older critically ill patients with COVID-19 in Europe.
Article in Journal of internal medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- End-of-life decision-making in very old critically ill patients.European geriatric medicine · 2026Review
- The experiences and opinions of Polish medical personnel regarding limitations of futile treatment in intensive care units - A questionnaire study.Palliative & supportive care · 2025Article
- End-of-life decision disparities according to the gross national income in critically ill patients: a secondary analysis of the ETHICUS-2 study.Annals of intensive care · 2025Article
- Regional differences in triage decisions affect hospital mortality among frail COVID-19 patients in the COvid MEdicaTion study.BMC infectious diseases · 2025Observational
- Challenges of using body bags for COVID-19 deaths from the healthcare provider perspective - a qualitative study.BMJ open quality · 2024Article
- Predictors of outcomes of patients ≥ 80 years old admitted to intensive care units in Poland - a post-hoc analysis of the VIP2 prospective observational study.Anaesthesiology intensive therapy · 2024Observational
- Limiting life-sustaining treatment for very old ICU patients: cultural challenges and diverse practices.Annals of intensive care · 2023Article
- Article
- Variations in end-of-life care practices in older critically ill patients with COVID-19 in Europe.Journal of internal medicine · 2022Article
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Authors and funding
27 authors at 19 institutions in 15 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious studies reported regional differences in end-of-life care (EoLC) for critically ill patients in Europe.
objectivesThe purpose of this post-hoc analysis of the prospective multicentre COVIP study was to investigate variations in EoLC practices among older patients in intensive care units during the coronavirus disease 2019 pandemic.
methodsA total of 3105 critically ill patients aged 70 years and older were enrolled in this study (Central Europe: n = 1573; Northern Europe: n = 821; Southern Europe: n = 711). Generalised estimation equations were used to calculate adjusted odds ratios (aORs) to population averages. Data were adjusted for patient-specific variables (demographic, disease-specific) and health economic data (gross domestic product, health expenditure per capita). The primary outcome was any treatment limitation, and 90-day mortality was a secondary outcome.
resultsThe frequency of the primary endpoint (treatment limitation) was highest in Northern Europe (48%), intermediate in Central Europe (39%) and lowest in Southern Europe (24%). The likelihood for treatment limitations was lower in Southern than in Central Europe (aOR 0.39; 95% confidence interval [CI] 0.21-0.73; p = 0.004), even after multivariable adjustment, whereas no statistically significant differences were observed between Northern and Central Europe (aOR 0.57; 95%CI 0.27-1.22; p = 0.15). After multivariable adjustment, no statistically relevant mortality differences were found between Northern and Central Europe (aOR 1.29; 95%CI 0.80-2.09; p = 0.30) or between Southern and Central Europe (aOR 1.07; 95%CI 0.66-1.73; p = 0.78).
conclusionThis study shows a north-to-south gradient in rates of treatment limitation in Europe, highlighting the heterogeneity of EoLC practices across countries. However, mortality rates were not affected by these results.
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