ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2023
End-of-life practices in 11 German intensive care units : Results from the ETHICUS-2 study.
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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.
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.
Who cites it
11 citing papers in PubMed.
- [Documentation of changes in goals of care in intensive care units - retrospective medical record analysis of deceased patients].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- [Controlled Donation after Circulatory determination of Death (cDCD) : A position paper by the DCD working group of the German Interdisciplinary Association for Intensive Care and Emergency Medicine (DIVI)].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- [Ethically challenging determination of treatment goals in the intensive care unit: reasons, frequency and possible solutions].Die Anaesthesiologie · 2026Review
- [Change in goal-of-care in a cardiological intensive care unit-retrospective medical record analysis].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Article
- Invasive ventilation and mortality in critically ill nonagenarians: a retrospective cohort study.European journal of medical research · 2026Article
- Potential for donation after circulatory death in Germany: a multicenter retrospective study at seven university hospitals.Transplant international : official journal of the European Society for Organ Transplantation · 2026Article
- Patient Characteristics and Different Decision Paths for Establishing Palliative Care for Patients Admitted via the Emergency Department.Journal of clinical medicine · 2025Article
- Intensive care clinicians' experiences of palliative withdrawal of mechanical ventilation: a qualitative study.BMJ open · 2025Article
- [Opportunities and risks of advance directives : An appraisal of the practice in Germany after legal regulation in 2009].Schmerz (Berlin, Germany) · 2025Review
- [Frequency and barriers to the patient advanced directive and lasting power of attorney: findings from a prospective observation study in palliative care services].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Observational
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnd-of-life care is common in German intensive care units (ICUs) but little is known about daily practice.
objectivesTo study the practice of end-of-life care.
methodsProspectively planned, secondary analysis comprising the German subset of the worldwide Ethicus‑2 Study (2015-2016) including consecutive ICU patients with limitation of life-sustaining therapy or who died.
resultsAmong 1092 (13.7%) of 7966 patients from 11 multidisciplinary ICUs, 967 (88.6%) had treatment limitations, 92 (8.4%) died with failed CPR, and 33 (3%) with brain death. Among patients with treatment limitations, 22.3% (216/967) patients were discharged alive from the ICU. More patients had treatments withdrawn than withheld (556 [57.5%] vs. 411 [42.5%], p < 0.001). Patients with treatment limitations were older (median 73 years [interquartile range (IQR) 61-80] vs. 68 years [IQR 54-77]) and more had mental decision-making capacity (12.9 vs. 0.8%), advance directives (28.6 vs. 11.2%), and information about treatment wishes (82.7 vs 33.3%, all p < 0.001). Physicians reported discussing treatment limitations with patients with mental decision-making capacity and families (91.3 and 82.6%, respectively). Patient wishes were unknown in 41.3% of patients. The major reason for decision-making was unresponsiveness to maximal therapy (34.6%).
conclusionsTreatment limitations are common, based on information about patients' wishes and discussion between stakeholders, patients and families. However, our findings suggest that treatment preferences of nearly half the patients remain unknown which affects guidance for treatment decisions.
Indexed as
Identifiers
What OpenQuestion holds
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.