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Center, gestational age, and race impact end-of-life care practices at regional neonatal intensive care units

FRY, Jessica T. ; MATOBA, Nana ; DATTA, Ankur ; DIGERONIMO, Robert ; COGHILL, Carl H. ; NATARAJAN, Girija ; BROZANSKI, Beverly ; LEUTHNER, Steven R. ; NIEHAUS, Jason Z. ; SCHLEGEL, Amy Brown ; SHAH, Anita ; ZANILETTI, Isabella ; BARTMAN, Thomas ; MURTHY, Karna ; SULLIVAN, Kevin M. ; CHILDREN'S HOSPITAL NEONATAL CONSORTIUM (CHNC)
The journal of pediatrics, 09/12/2019, Pagination inconnue

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Trends in hospital-based specialty palliative care in the United States from 2013 to 2017

SCHOENHERR, Laura A. ; BISCHOFF, Kara E. ; MARKS, Angela K. ; O'RIORDAN, David L. ; PANTILAT, Steven Z.
JAMA network open, 02/12/2019, vol.2, n°12, p. 1-11

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Update in hospice and palliative care

HYDEN, Karen ; GELFMAN, Laura ; DIONNE-ODOM, J. Nicholas ; SMITH, Cardinale B. ; COATS, Heather
JOURNAL OF PALLIATIVE MEDICINE, 05/12/2019, Pagination inconnue

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Intégration de la démarche palliative à la médecine intensive-réanimation - de la théorie à la pratique

NOIZET-YVERNEAU, O. ; BORDET, F. ; PILLOT, J. ; EON, B. ; GONZALEZ, F. ; DRAY, S. ; BOYER, A. ; BLONDIAUX, I. ; QUENTIN, B. ; ROLANDO, S. ; JARS-GUINCESTRE, M.-C. ; LAURENT, A. ; QUENOT, J.-P. ; BOULAIN, T. ; SOUFIR, L. ; SÉRIE, M. ; PENVEN, G. ; SAINT-BLANQUAT, L. De ; VANDERLINDEN, T. ; RIGAUD, J.-P. ; REIGNIER, J.
Médecine intensive réanimation, 01/09/2019, vol.28, n°5, p. 398-407

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An evaluation of an advanced practice role in palliative radiation therapy

JOB, Mary ; HOLT, Tanya ; BERNARD, Anne
Journal of medical radiation sciences, 06/2019, vol.66, n°2, p. 96-102

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Thème : Médecine.

FIN VIE ; EUROPE ; SOIN INTENSIF ; PRATIQUE MEDICALE ; LIMITATION TRAITEMENT

Importance: End-of-life decisions occur daily in intensive care units (ICUs) around the world, and these practices could change over time.
bjective To determine the changes in end-of-life practices in European ICUs after 16 years.
Design, Setting, and Participants: Ethicus-2 was a prospective observational study of 22 European ICUs previously included in the Ethicus-1 study (1999-2000). During a self-selected continuous 6-month period at each ICU, consecutive patients who died or had any limitation of life-sustaining therapy from September 2015 until October 2016 were included. Patients were followed up until death or until 2 months after the first treatment limitation decision.
Exposures: Comparison between the 1999-2000 cohort vs 2015-2016 cohort.
Main Outcomes and Measures: End-of-life outcomes were classified into 5 mutually exclusive categories (withholding of life-prolonging therapy, withdrawing of life-prolonging therapy, active shortening of the dying process, failed cardiopulmonary resuscitation [CPR], brain death). The primary outcome was whether patients received any treatment limitations (withholding or withdrawing of life-prolonging therapy or shortening of the dying process). Outcomes were determined by senior intensivists.
Results: Of 13 625 patients admitted to participating ICUs during the 2015-2016 study period, 1785 (13.1%) died or had limitations of life-prolonging therapies and were included in the study. Compared with the patients included in the 1999-2000 cohort (n = 2807), the patients in 2015-2016 cohort were significantly older (median age, 70 years [interquartile range {IQR}, 59-79] vs 67 years [IQR, 54-75]; P < .001) and the proportion of female patients was similar (39.6% vs 38.7%; P = .58). Significantly more treatment limitations occurred in the 2015-2016 cohort compared with the 1999-2000 cohort (1601 [89.7%] vs 1918 [68.3%]; difference, 21.4% [95% CI, 19.2% to 23.6%]; P < .001), with more withholding of life-prolonging therapy (892 [50.0%] vs 1143 [40.7%]; difference, 9.3% [95% CI, 6.4% to 12.3%]; P < .001), more withdrawing of life-prolonging therapy (692 [38.8%] vs 695 [24.8%]; difference, 14.0% [95% CI, 11.2% to 16.8%]; P < .001), less failed CPR (110 [6.2%] vs 628 [22.4%]; difference, -16.2% [95% CI, -18.1% to -14.3%]; P < .001), less brain death (74 [4.1%] vs 261 [9.3%]; difference, -5.2% [95% CI, -6.6% to -3.8%]; P < .001) and less active shortening of the dying process (17 [1.0%] vs 80 [2.9%]; difference, -1.9% [95% CI, -2.7% to -1.1%]; P < .001).
Conclusions and Relevance: Among patients who had treatment limitations or died in 22 European ICUs in 2015-2016, compared with data reported from the same ICUs in 1999-2000, limitations in life-prolonging therapies occurred significantly more frequently and death without limitations in life-prolonging therapies occurred significantly less frequently. These findings suggest a shift in end-of-life practices in European ICUs, but the study is limited in that it excluded patients who survived ICU hospitalization without treatment limitations.

Origine : PubMed

General practice physicians' and nurses' self-reported multidisciplinary end-of-life care - a systematic review

SENIOR, Hugh ; GRANT, Matthew ; RHEE, Joel J. ; AUBIN, Michèle ; MAC VEY, Peta ; JOHNSON, Claire ; MONTEROSSO, Leanne ; NWACHUKWU, Harriet ; FALLON-FERGUSON, Julia ; YATES, Patsy ; WILLIAMS, Briony ; MITCHELL, Geoffrey
BMJ supportive and palliative care, 29/08/2019, Pagination inconnue

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Palliative care in the neuro-ICU - perceptions, practice patterns, and preferences of neurointensivists

BAR, Barak ; CREUTZFELDT, Claire J. ; RUBIN, Michael A.
Neurocritical care, 29/08/2019, p. 1-4

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Off-label-prescriptions in daily clinical practice - a cross-sectional national survey of palliative medicine physicians

HAGEMANN, Vera ; BAUSEWEIN, Claudia ; REMI, Constanze
PROGRESS IN PALLIATIVE CARE, 2019, vol.27, n°4, p. 154-159

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Continuity of physicians' dedication to inpatient hospice and palliative care - a 14-year nationwide survey in Taiwan

CHENG, Bo-Ren ; LIN, Ming-Hwai ; CHANG, Hsiao-Ting ; WANG, Yi-Jen ; CHEN, Tzeng-Ji ; CHOU, Li-Fang ; HWANG, Shinn-Jang
International journal of environmental research and public health, 15/08/2019, vol.16, n°16, p. 1-9

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National consensus project clinical practice guidelines for quality palliative care guidelines, 4th edition

FERRELL, Betty R. ; TWADDLE, Martha L. ; MELNICK, Amy ; MEIER, Diane E.
JOURNAL OF PALLIATIVE MEDICINE, 12/2018, vol.21, n°12, p. 1684-1689

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Questionnaire survey on medical futility and termination of resuscitation in cardiac arrest patients among emergency physicians in Hong Kong

SO, C. W. ; LUI, C. T. ; TSUI, K. L. ; CHAN, K. L. ; LAW, A. K. K. ; WONG, Y. K. ; LI, T. ; WONG, C. L. ; LEUNG, S. C.
Hong Kong medical journal, 06/2019, vol.25, n°3, p. 183-191

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Allied health clinicians' understanding of palliative care as it relates to patients, caregivers, and health clinicians - a cross-sectional survey

MORGAN, Deidre ; RAWLINGS, Deb ; BUTTON, Elizabeth ; TIEMAN, Jennifer
Journal of allied health, 2019, vol.48, n°2, p. 127-133

A survey of hospice professionals regarding medical cannabis practices

COSTANTINO, Ryan C. ; FELTEN, Natalee ; TODD, Marisa ; MAXWELL, Terri ; McPHERSON, Mary Lynn
JOURNAL OF PALLIATIVE MEDICINE, 16/05/2019, p. 1-5

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Description of continuous palliative sedation practices in a large health region and comparison with clinical practice guidelines

ABDUL-RAZZAK, Amane ; LEMIEUX, Laurie ; SNYMAN, Maggie ; PEREZ, Grace ; SINNARAJAH, Aynharan
JOURNAL OF PALLIATIVE MEDICINE, 09/2019, vol.22, n°9, p. 1052-1064

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Screening for opioid misuse in the nonhospitalized seriously ill patient

MITCHELL, Julie L. ; BLACKHALL, Leslie J. ; BARCLAY, Joshua S.
JOURNAL OF PALLIATIVE MEDICINE, 09/2019, vol.22, n°9, p. 1115-1119

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Palliative intent treatment for head and neck cancer - an analysis of practice and outcomes

BEGBIE, F. D. ; DOUGLAS, C. M. ; FINLAY, F. ; MONTGOMERY, J.
The journal of laryngology and otology, 01/04/2019, vol.133, n°4, p. 313-317

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Ethical and clinical considerations in treating infections at the end of life

VAUGHAN, Leigh ; DUCKETT, Ashley A. ; ADLER, Mary ; CAIN, Joan
JOURNAL OF HOSPICE AND PALLIATIVE NURSING, 04/2019, vol.21, n°2, p. 110-115

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Evaluation of the interrater reliability of end-of-life medical orders in the physician orders for life-sustaining treatment form

LOVADINI, Gustavo Bigaton ; FUKUSHIMA, Fernanda Bono ; SCHOUERI, Joao Francisco Lindenberg ; DOS REIS, Roberto ; FONSECA, Cecilia Guimarães Ferreira ; RODRIGUEZ, Jahaira Jeanainne Casanova ; COELHO, Cauana Silva ; NEVES, Adriele Ferreira ; RODRIGUES, Aniela Maria ; MARQUES, Marina Almeida ; JACINTO, Alessandro Ferrari ; HARRISON DENING, Karen ; BASSETT, Rick ; MOSS, Alvin H. ; STEINBERG, Karl E. ; VIDAL, Edison Iglesias de Oliveira
JAMA network open, 05/04/2019, vol.2, n°4, 11 p.

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Individual, clinical and system factors associated with the place of death - a linked national database study

TAN, Woan Shin ; BAJPAI, Ram ; LOW, Chan Kee ; HO, Andy Hau Yan ; WU, Huei Yaw ; CAR, Josip
Plos one, 2019, vol.14, n°4, 13 p.

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