Skip to main content
main-content

01.08.2010 | Research | Ausgabe 4/2010 Open Access

Critical Care 4/2010

Retrospective agreement and consent to neurocritical care is influenced by functional outcome

Zeitschrift:
Critical Care > Ausgabe 4/2010
Autoren:
Ines C Kiphuth, Martin Köhrmann, Joji B Kuramatsu, Christoph Mauer, Lorenz Breuer, Peter D Schellinger, Stefan Schwab, Hagen B Huttner
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​cc9210) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

ICK and HBH designed the study and wrote the manuscript. ICK, JBK, LB, and CM obtained clinical data by reviewing institutional databases and the patient's medical charts. ICK and MK obtained outcome data by mailed questionnaires and telephone interviews. MK, PDS, and SS co-interpreted the data and critically reviewed the manuscript. All authors approved the final version of the manuscript.

Abstract

Introduction

Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care--given by patients or their relatives--depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care.

Methods

We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent.

Results

High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent.

Conclusions

Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy, neurocritical care physicians should balance the expected burdens and benefits of treatment to meet the patients' putative wishes. Efforts should be undertaken to identify predictors for severe disability after neurocritical care.
Zusatzmaterial
Literatur
Über diesen Artikel

Weitere Artikel der Ausgabe 4/2010

Critical Care 4/2010 Zur Ausgabe

Neu im Fachgebiet AINS

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update AINS und bleiben Sie gut informiert – ganz bequem per eMail.

Bildnachweise