ArticleMedizinische Klinik, Intensivmedizin und Notfallmedizin2026
[Change in goal-of-care in a cardiological intensive care unit-retrospective medical record analysis].
Article in Medizinische Klinik, Intensivmedizin und Notfallmedizin, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper 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
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6 authors.
Funding
Abstract
backgroundIntensive care units (ICU) are primarily focused on maximum therapy and life extension. Changes of goals-of-care in favor of quality of life and a dignified dying process remain a particular challenge.
objectivesTo analyze the implementation of changes of goal-of-care in a cardiology ICU.
methodsRetrospectively assessed were medical records from 40 randomly selected patients who died between July 2019 and August 2021 in the cardiology ICU at University Hospital Cologne. Descriptive statistics were performed using SPSS (IBM, Armonk, NY, USA) software.
resultsThe median age of the patients was 70.5 years; 75% were male and average length of stay was 4 days (median). Cause of death was mostly due to cardiac or pulmonary causes (30/40 medical records). Changes of goal-of-care were documented for 65% of patients; this group was generally older and had a longer stay. Changes of goal-of-care mostly occurred within the last 24 h of life (81%). Decisions were mostly made together with relatives, as patients were often no longer able to communicate (85%). Avoidance of escalation of measures was more common than de-escalation.
conclusionWe identified two groups of patients with different challenges regarding changes of goal-of-care: (1) Patients with sudden death within 72 h, for whom changes of goal-of-care is rarely possible, making resilience in dealing with dying patients and communication with relatives crucial for the treating personnel. (2) Patients with longer stays, where changes of goal-of-care are more frequently implemented. For this group, continuous re-evaluation of goal-of-care and, in this context, medical indications and patient wishes are particularly important.
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