دورية أكاديمية
Practices of end-of-life decisions in 66 southern French ICUs 4years after an official legal framework: A 1-day audit
| العنوان: | Practices of end-of-life decisions in 66 southern French ICUs 4years after an official legal framework: A 1-day audit |
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| المؤلفون: | Roger, Claire, Morel, Jérôme, Molinari, Nicolas, Orban, Jean Christophe, Jung, Boris, Futier, Emmanuel, Desebbe, Olivier, Friggeri, Arnaud, Silva, Stein, Bouzat, Pierre, Ragonnet, Benoit, Allaouchiche, Bernard, Constantin, Jean-Michel, Ichai, Carole, Jaber, Samir, Leone, Marc, Lefrant, Jean-Yves, Rimmelé, Thomas |
| المساهمون: | Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Caractéristiques féminines des dysfonctions des interfaces cardio-vasculaires (EA 2992), Université Montpellier 1 (UM1)-Université de Montpellier (UM), Hémostase, Inflammation et sepsis, Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Institut Montpelliérain Alexander Grothendieck (IMAG), Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Physiologie & médecine expérimentale du Cœur et des Muscles U 1046 (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Réanimation Médico-Chirurgicale, Service d'Anésthésie Réanimation CHU Clermont-Ferrand, CHU Estaing Clermont-Ferrand, CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service d'anesthésiologie et de soins intensifs, Hospices Civils de Lyon (HCL)-Hôpital Louis Pradel CHU - HCL, Hospices Civils de Lyon (HCL), Hospices Civils de Lyon, Pôle Anesthésie Réanimation CHU de Toulouse, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), ANTE-INSERM U836, équipe 5, Neuroimagerie fonctionnelle et perfusion cérébrale, Grenoble Institut des Neurosciences (GIN), Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Joseph Fourier - Grenoble 1 (UJF)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service d'anesthésie-réanimation, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, Service d’Anesthésie et de Réanimation, Service de Réanimation, Hospices Civils de Lyon (HCL)-Hôpital E. Herriot, Service de réanimation, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital St Roch, Unité de Recherche sur les Maladies Infectieuses Tropicales Emergentes (URMITE), Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes (URMITE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS)-Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR48, Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Institut des sciences biologiques - CNRS Biologie (INSB-CNRS)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Lyon Sud CHU - HCL (CHLS) |
| المصدر: | ISSN: 2352-5568 ; Anaesthesia Critical Care & Pain Medicine ; https://hal.umontpellier.fr/hal-01759479Test ; Anaesthesia Critical Care & Pain Medicine, 2015, 34 (2), pp.73 - 77. ⟨10.1016/j.accpm.2014.10.001⟩. |
| بيانات النشر: | HAL CCSD Elsevier Masson |
| سنة النشر: | 2015 |
| المجموعة: | Hospices Civils de Lyon (HCL): HAL |
| مصطلحات موضوعية: | end-of-life, family communication, withdrawing, withholding, [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; Since the implementation of two French laws in 2002 and 2005 and the implementation of guidelines about End-of-Life (EoL) decisions, few studies concerning EoL practices in French intensive care units (ICUs) have been reported. This study was aimed at assessing compliance with recommendations and current legislation concerning EoL decisions. Prospective observational study based on 1-day audit conducted from January to May 2009 in 66 southern French ICUs. Six hundred and twenty-five patients were included (median age: 63 [52-76] years, median SAPS II: 46 [34-58]). The written designation of a surrogate decision-maker was reported for 87 (15%) patients. Advance directives were completed for only 4% of patients. The EoL decision-making process consisted in a multidisciplinary approach for 99 (47%) patients and was recorded in the medical chart for 63 (64%) cases. Families were informed about medical decisions in 58% of cases. This proportion was higher (87%) if a decision to forego life-sustaining therapy was made. EoL decisions consisted of withholding treatments for 72 (94%) patients and withdrawal of treatments for 5 (6%) patients. In the multivariate stepwise logistic regression, four variables were independently associated with a decision to forego life support: preexisting dependence on others (P<0.0001), advance directives (P=0.01), age (P=0.008) and the SAPS 2 score (P=0.009). The major finding of the present study is the existence of a gap between the widely approved EoL recommendations made by scientific societies and the daily practice of southern French ICUs. Even if EoL decisions are mostly shared with relatives, their written documentation in medical charts remains insufficient. Concerning EoL practices, the withdrawal of treatment remains an uncommon decision. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/25862305; hal-01759479; https://hal.umontpellier.fr/hal-01759479Test; https://hal.umontpellier.fr/hal-01759479/documentTest; https://hal.umontpellier.fr/hal-01759479/file/2015%20Roger%20et%20al.,%20Anaesthesia%20Critical%20Care%20%26%20Pain%20Medicine_2.pdfTest; PRODINRA: 336381; PUBMED: 25862305; WOS: 000361568300002 |
| DOI: | 10.1016/j.accpm.2014.10.001 |
| الإتاحة: | https://doi.org/10.1016/j.accpm.2014.10.001Test https://hal.umontpellier.fr/hal-01759479Test https://hal.umontpellier.fr/hal-01759479/documentTest https://hal.umontpellier.fr/hal-01759479/file/2015%20Roger%20et%20al.,%20Anaesthesia%20Critical%20Care%20%26%20Pain%20Medicine_2.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.1F9BA4FF |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.accpm.2014.10.001 |
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