دورية
Withholding or withdrawing life-sustaining treatments in the COVID-19 pandemic: adherence to legal standards
| العنوان: | Withholding or withdrawing life-sustaining treatments in the COVID-19 pandemic: adherence to legal standards |
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| المؤلفون: | Guastella, Virginie, Lambert, Céline, Lafforgue, Aurore, Metretin, Pauline, Verstreate, Aude, Watelet, Sophie, Perceau-Chambard, Élise, Lautrette, Alexandre |
| المصدر: | Supportive & Palliative Care; 20240101, Vol. 14 Issue: 0 pe549-e553, 5p |
| مستخلص: | ObjectivesIn France, when the patient is unable to express his wishes, the decision to withhold or withdraw life-sustaining treatment (WWLST) is made following a collegial procedure described by a law. The aim of our study was to assess how closely this WWLST decision-making procedure in end of life patients was maintained during the COVID-19 pandemic.MethodsThis retrospective observational multicentre study compared the rate of non-compliance with WWLST decision-making procedures during the pandemic period from March to June 2020 with control period in 2019, in Clermont-Ferrand and Lyon Hospitals. Secondary objectives were to determine the factors associated with non-compliance.ResultsIn 430 deceased patients included (176 in 2019 and 254 in 2020), the rate of non-compliance was 61.4% in 2019 and 59.1% in 2020 (p=0.63). In multivariable analysis, non-compliance was associated with immunosuppression status (OR 1.69, 95% CI (1.12 to 2.54), p=0.01) but was lower in intensive care unit (OR 0.54, 95% CI (0.36 to 0.82), p=0.003) and when the patient had visits from relatives (OR 0.41, 95% CI (0.22 to 0.75), p=0.004).ConclusionIn France, more than half of WWLST decisions do not comply with the law. The COVID-19 pandemic did not increase this non-compliance rate. Further studies are needed for a better understanding of the mechanisms underlying non-compliance with WWLST decision-making procedure.Trial registration numberNCT04452487. |
| قاعدة البيانات: | Supplemental Index |
| تدمد: | 2045435X 20454368 |
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| DOI: | 10.1136/spcare-2023-004504 |