Withholding and withdrawing treatment in patients admitted in an Internal Medicine ward

Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial
R García CaballeroV Castilla

Abstract

Many of the patients admitted to a general medical ward have a compromised quality of life, or short life expectancy, so they are potential candidates for withhold/withdraw (WH/WD) treatment. The first objectif was to describe which measures were WH/WD among patients who died during their admission in a general medical ward from a tertiary hospital in Madrid. Secondly, to define the clinical characteristics of this population. A cross-sectional descriptive study during 6 months from 2011 and 2012 of all the patients dead while their admission in the Internal Medicine Department. 2007 patients were admitted, 211 died (10.5%). 121 (57%) were female, with 85±9 years of mean age. 103 (48.8%) came from a residential facility and 105 fulfilled terminality criteria (49.8%). One decision to WH/WD treatment was made in 182 patients (86.3%, CI 95%: 81.4-91.1), two in 99 cases (46.9%, CI 95%: 39.9-53.9) and 3 or more in 31 subjects (14.7%, CI 95%: 9.6-19.7). The most frequent decisions involved do-not-resuscitate orders (154, 73.0%), rejection of «aggressive treatment measures» (80, 38.0%), use of antibiotics (19, 9.0%), admission in ICU (18, 8.5%), and/or surgical treatment (11, 5.2%). WH/WD treatment is very frequent among patients who ...Continue Reading

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Citations

Jan 23, 2016·Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial·M A Sánchez-González
Jul 28, 2016·Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial·E Ameneiros-LagoJ A Garrido-Sanjuán
May 18, 2020·Revista clínica española·R García CaballeroB Herreros
May 18, 2021·Revista Clínica Espanõla·R García-CaballeroB Herreros

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