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Abstract

Background and aims: Treatment of an individual critically ill patient during intensive care treatment may at some point become hopeless. Aims: To determine characteristics of end-of-life decision making (EOLDM) in the Slovene Pediatric and Adult Intensive Care Units (ICUs). Methods: Prospective clinical study in the three-month period in 2013 was performed in all 34 Slovene ICUs. The study was approved by the Slovene National Medical Ethics Committee. IBM® SPSS® Statistics 20 (IBM Corp., Somers, NY, USA) was used for statistical analysis; p value significance level was determined at p≤0.001. Results: Completed forms were obtained from 33 out of 34 ICUs. 4226 patients were included in the study. Overall mortality rate in patients admitted was 10.8%. In 112 patients (2.7% of all admitted patients and 24.6% of those who died in the ICU) an EOLDM process have been made. No differences were found in EOLDMs between adult (medical or surgical) and paediatric ICUs. The advance directive in adult ICUs was used in 2.2%. Initiative for EOLDMs was taken by the physicians in 96.2% and relatives were actively involved in 61.8%. Two and a half days passed from the EOLDMs to the death in ICU. Do-not-resuscitate order was most commonly used during withholding of treatment, and inotropes/vasopresors were most commonly withdrawn. In 72.3% of the cases palliative care was included. Conclusions: EOLDM was regularly applied in the Slovene ICUs, but not as frequently as in some other European countries. Among adult medical or surgical and pediatric ICUs we haven’t found any significant difference in EOLDMs.