Early Decision Effect of Withholding and/or Withdrawing Life-sustaining Treatment on Emergency Department Patients' Short- and Long-term Outcomes: a Retrospective Analysis.
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 发起方
- 入组人数
- 354
- 试验地点
- 1
- 主要终点
- all-cause mortality
研究概览
简要总结
Background In France, a significant proportion of end-of-life (EOL) decisions occur in emergency departments (EDs), where time constraints and limited resources may hinder optimal care. Although withholding or withdrawing life-sustaining treatments (WHWD) is common in this context, the impact of timing on patient outcomes remains unclear.
Objective:
To assess how the timing of WHWD decisions influences short- and long-term outcomes among ED patients.
Methods:
We conducted a retrospective, observational study at Beaujon Hospital's ED (Paris, France) between January 2020 and December 2021. We included 354 adult patients admitted to the observation unit with a WHWD decision. Patients were categorized into early (eWHWD) and late (lWHWD) groups based on the median time to decision. The primary endpoint was 28-day all-cause mortality. Cox regression was used for survival analysis, adjusting for age, sex, comorbidities, functional status, and severity of illness.
研究设计
- 研究类型
- Observational
- 观察模型
- Cohort
- 时间视角
- Retrospective
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •To be included, patients hospitalised after their ED visit must be admitted to the observation unit (OU) in association with a mention of a withholding/withdrawing of the life-sustaining treatment in the ED medical record.
排除标准
- 未提供
结局指标
主要结局
all-cause mortality
时间窗: 28-days
次要结局
未报告次要终点
研究者
Prabakar VAITTINADA AYAR
doctor
Beaujon Hospital