Decisions at the end of live in the Intensive Care Unit. 2019-2021 triennium
Keywords:
End-of-life decisions, no resuscitation, limitation of therapeutic effort, withdrawal of life support, multiple organ dysfunctionAbstract
Introduction: Decisions at the end of life are a topic of eternal relevance in acute care units.
Objective: To describe aspects considered in decision-making at the end of life in the Intensive Care Unit.
Material y Methods: A descriptive, longitudinal, retrospective study was carried out in the Intensive Care Unit of the Arnaldo Milián Castro Hospital. A population of 1 599 patients treated in the 2019-2021 triennium was studied; 444 of them died, and at least one decision was made at the end of life in 25 cases. Documentary analysis of medical records and descriptive statistics were used in data analysis.
Results: In 2019, there were fewer deaths (104), where the decision option at the end of life prevailed (1.93 %) with a predominance of no resuscitation. Females prevailed in 2020 and the highest average age was observed in 2021 (71.8 years). There was a negative trend in the averages of length of stay, decision making and death. The main causes were multiple organ failure (62.50 %) alone or combined with bronchopneumonia and septic shock.
Conclusions: Few end-of-life decisions are made in our setting, with do not resuscitate order (DNR) being the most frequently made decision. Multiple organ failure (MOF) is the main cause.
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