Variation in decisions to forgo life-sustaining therapies in US ICUs.

ABSTRACT:

Background

The magnitude and implication of variation in end-of-life decision-making among ICUs in the United States is unknown.

Methods

We reviewed data on decisions to forgo life-sustaining therapy (DFLSTs) in 269,002 patients admitted to 153 ICUs in the United States between 2001 and 2009. We used fixed-effects logistic regression to create a multivariable model for DFLST and then calculated adjusted rates of DFLST for each ICU.

Results

Patient factors associated with increased odds of DFLST included advanced age, female sex, white race, and poor baseline functional status (all P < .001). However, associations with several of these factors varied among ICUs (eg, black race had an OR for DFLST from 0.18 to 2.55 across ICUs). The ICU staffing model was also found to

SUBMITTER: Quill CM 

PROVIDER: S-EPMC4151359 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature