Cardiac arrest & resuscitation
Early and late withdrawal of life-sustaining treatment after out-of-hospital cardiac arrest in the United Kingdom: Institutional variation and association with hospital mortality
Authors' conclusion
Significant variability exists between UK ICUs in WLST frequency and timing. This matters because unexplained higher-than-expected WLST frequency is associated with higher hospital mortality independently of timing, potentially signalling prognostic pessimism and lower healthcare quality.
Study context
- Population
- Adults admitted to United Kingdom (UK) Intensive Care Units (ICUs) after Out-of-Hospital Cardiac Arrest (OHCA), 2010–2017
- Participants
- 28,438 adults · 204 ICUs
- Exposure
- ICU-level O/E ratio of early and late Withdrawal of Life-Sustaining Treatment (WLST) frequency
- Early-WLSTn = 6,397
- Outcome
- Between-ICU variation in early and late WLST and association of ICU O/E ratio of WLST with patients' hospital mortality
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
WLST frequency and between-ICU variation
EstimateP value
Early-WLSTunexplained between-ICU variation after adjustment; CrI
Median OR 1.59(95% CrI 1.49–1.71)
Late-WLSTunexplained between-ICU variation after adjustment; CrI
Median OR 1.39(95% CrI 1.31–1.50)
Early-WLSThospital mortality per higher ICU O/E ratio of early-WLST
OR 1.29(95% CI 1.21–1.38)
P < 0.001Late-WLSThospital mortality per higher ICU O/E ratio of late-WLST
OR 1.39(95% CI 1.31–1.48)
P < 0.001Each row per its own increment, as printed
- Patients with WLST
- 10,775 (37.9%)
- Early-WLST among WLST
- 6397 (59.4%)
Observational data: associations, not effects.
Original publication
Early and late withdrawal of life-sustaining treatment after out-of-hospital cardiac arrest in the United Kingdom: Institutional variation and association with hospital mortality. Resuscitation. Published 1 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →