TITLE

Withholding/Withdrawal of Life Support in Trauma Patients: Is There an Age Bias?

AUTHOR(S)
Plaisier, Brian R.; Blostein, Paul A.; Hurt, Karla J.; Malangoni, Mark A.
PUB. DATE
February 2002
SOURCE
American Surgeon;Feb2002, Vol. 68 Issue 2, p159
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Our objective was to examine patterns of withholding/withdrawal (WH/WD) of life support in trauma patients and to determine whether WD/WH of life support is used more frequently in elderly patients. This is a retrospective cohort study of injured elderly (≥65 years) and young patients (<65 years) from 1994 through 1998 treated at a surgical intensive care unit in a community tertiary-care hospital. We studied the cases of 82 patients (30 elderly and 52 young patients) with WH/WD of life support after injury. Our main outcome measures were demographic and clinical characteristics of elderly and young patients undergoing WH/WD of life support after injury with an association between age and WH/WD of life support. Of 102 total trauma patient deaths 82 had WH/WD of life support. This mode was chosen in 52 (80%) patients under the age of 65 and in 30 (81%) patients age 65 or greater. Patients in the younger cohort had a higher mean Injury Severity Score and Abbreviated Injury Score of 5 (P < 0.05). The elderly cohort had a higher incidence of pre-existing disease (<0.001). Length of stay was similar between the populations. We conclude that the elderly were no more likely to have WH/WD of life support than were younger patients. However, the older patients were less severely injured as measured by Injury Severity Score and percentage with Abbreviated Injury Score head of 5. Other factors such as the presence of pre-existing disease may influence the decision to withhold or withdraw life support to a greater degree than the actual severity of injuries.
ACCESSION #
6596447

 

Related Articles

  • Resus Sim 98.  // Internet Journal of Space Medicine;Jan2002, Vol. 1 Issue 1, p7 

    ResusSim 98 is a PC-based simulator of Advanced Life Support (ALS) aimed at doctors, medical students, nurses, paramedics, and other health care personnel. The program provides the user with a thorough evaluation of the treatment given, along with suggestions of the currently recommended...

  • Resus Sim 98.  // Internet Journal of Advanced Nursing Practice;2003, Vol. 5 Issue 2, p8 

    ResusSim 98 is a personal computer-based simulator of advanced life support aimed at doctors, medical students, nurses, paramedics, and other health care personnel. ResusSim contains 21 different patients wherein each situation may develop differently from time to time because of underlying...

  • Resus Sim 98.  // Internet Journal of Tropical Medicine;2002, Vol. 1 Issue 1, p6 

    ResusSim 98 is a PC-based simulator of Advanced Life Support (ALS) aimed at doctors, medical students, nurses, paramedics, and other health care personnel. The program provides the user with a thorough evaluation of the treatment given, along with suggestions of the currently recommended...

  • Resus Sim 98.  // Internet Journal of Plastic Surgery;2003, Vol. 1 Issue 2, p1 

    ResusSim 98 is a PC-based simulator of Advanced Life Support (ALS) aimed at doctors, medical students, nurses, paramedics, and other health care personnel. A real-time ECG is shown on the screen along with pictures of the relevant resuscitation situation. ResusSim contains 21 different patients...

  • Controlled trial of automated external defibrillators in the London Ambulance Service. Walters, Geraldine; D'Auria, D.; Glucksman, E. E. // Journal of the Royal Society of Medicine;Sep1990, Vol. 83 Issue 9, p563 

    This controlled trial was performed in London and compared outcomes of patients treated by ambulance staff using either basic life support alone or an automated external defibrillator (AED) as an adjunct to basic life support. Five of the 212 (2%) patients were successfully resuscitated by crews...

  • Direct mail improves knowledge of basic life support guidelines in general practice: a randomised study. Secher, Niels; Marie Mikkelsen, Mette; Adelborg, Kasper; Mikkelsen, Ronni; Lerkevang Grove, Erik; Mørch Rubak, Jens; Vedsted, Peter; Løfgren, Bo // Scandinavian Journal of Trauma, Resuscitation & Emergency Medici;2012, Vol. 20 Issue 1, p72 

    Background: Implementation of new guidelines into clinical practice is often incomplete. Direct mail is a simple way of providing information to physicians and may improve implementation of new guidelines on basic life support (BLS). The aim of this study was to describe knowledge of the most...

  • The Limits of Dispute Resolution.  // Hastings Center Report;Nov/Dec2001, Vol. 31 Issue 6, p10 

    Presents a case of a patient with multiple diseases who was maintained on life-sustaining treatments due to the insistence of his wife. Suggestions made by the medical care providers of the patient; How the providers attempted to solve the dispute; Result of a medical ethics mediation.

  • Advanced Hazmat Life Support (AHLS): Development and Demographics from 1999 through 2003. Walter, Frank G.; Meislin, Harvey; Munger, Benson; Crounse, Danielle // Internet Journal of Rescue & Disaster Medicine;2005, Vol. 5 Issue 1, p14 

    This is a prospective, descriptive, feasibility study to determine whether an interdisciplinary group of healthcare experts could design and successfully deliver an international, life support, continuing education program that teaches the medical management of hazmat patients. The...

  • Home Care for Life-Supported Persons: the French System of Quality Control, Technology Assessment, and Cost Containment. Goldberg, Allen I. // Public Health Reports;Jul/Aug89, Vol. 104 Issue 4, p329 

    Home care for persons who require the prolonged use of life-supportive medical technology is a reality in several nations. France has had more than a quarter of a century of experience with providing home care for patients with chronic respiratory insufficiency and with a system to evaluate the...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics