Evidence map›Paper›PMID 40055260›Full record

ArticleAnnals of intensive care2025

End-of-life decision disparities according to the gross national income in critically ill patients: a secondary analysis of the ETHICUS-2 study.

Ignacio Martin-Loeches, Charles L Sprung, Eric Wolsztynski, Rachael Cusack, Suzana Margareth Lobo, Alessandro Protti, Alexander Avidan

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Article in Annals of intensive care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

The trial behind it

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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

4 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

7 authors.

Ignacio Martin-LoechesDepartment of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James' Hospital, Dublin, D08 NHY1, Ireland. drmartinloeches@gmail.com.ORCID http://orcid.org/0000-0002-5834-4063
Charles L SprungDepartment of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.
Eric WolsztynskiSchool of Mathematical Sciences, University College Cork, Western Gateway Building, Western Road, Cork, T12 XF62, Ireland.
Rachael CusackDepartment of Intensive Care Medicine, Multidisciplinary Intensive Care Research Organization (MICRO), St James' Hospital, Dublin, D08 NHY1, Ireland.
Suzana Margareth LoboUnidade de Terapia Intensiva, Hospital de Base, Faculdade de Medicina de São José Do Rio Preto, São José do Rio Preto, SP, Brasil.
Alessandro ProttiIRCCS Humanitas Research Hospital, Rozzano, Milano, Italy.
Alexander AvidanDepartment of Anesthesiology, Critical Care and Pain Medicine, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel.

Funding

Science Foundation Ireland 12/RC/2289-P2
6 · The paper itself

Abstract

aimThis study aimed to evaluate the association of end-of-life decisions and time to death in a global cohort of critically ill patients who participated in the international study on end-of-life practices in intensive care units (ICU) (Ethicus-2 study).

methodsA post hoc analysis was conducted on data from a worldwide observational study that prospectively recruited adult ICU patients who died between September 1, 2015, and September 30, 2016, from 199 ICUs in 36 countries.

resultsThe end-of-life pathways of 10,547 ICU non-survivors were s analysed. Patients in high-income countries exhibited a significantly shorter time to death compared to those from middle-income countries. Additionally, therapeutic decisions were found to have a significant but varied association with the length of ICU stay across gross national income (GNI) groups. Specifically, patients in high-income countries with no decision had the shortest length of stay (LOS) overall. However, withdrawing or withholding life-sustaining treatment led to longer LOS in both middle and high GNI countries.

conclusionThis study's findings highlight the need for uniformity in global end-of-life decision-making. Outcomes are significantly associated with gross national income (GNI). Moreover, patients in high-income nations tend to have shorter ICU stays before death.

Indexed as

End-of-lifeGross national incomeHospital mortalityIntensive careLife-sustaining measures

Identifiers

PMID40055260
PMCPMC11889315

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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.