Factors associated with limitation of life support: Post-ICU mortality case study of a tertiary hospital

Abstract

BackgroundLife-sustaining treatment limitation (LSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it. ObjectiveTo determine factors related to LSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU. DesignRetrospective longitudinal study. AmbitIntensive care unit of a tertiary hospital. PatientsPeople who died in the hospitalization ward after ICU treatment between January 2014 and December 2019. InterventionsNone. This is an observational study. Variables of interestAge, sex, probability of death, type of admission, LSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays. ResultsOf 114 patients who died outside the ICU, 49 had LSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LSV (OR 1,03 and 1,08, respectively). Patients without LSV had a higher post-ICU stay, while it was lower for male patients. ConclusionsOur results support that LSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.