ICU sedation, delirium & recovery
Factors Associated With Quality-of-Dying-and-Death Classes Among Critically Ill Patients
Authors' conclusion
In this cohort study of critically ill patients and their family surrogates, modifiable end-of-life ICU-care characteristics played a more significant role in associations with patient QODD class than did immutable family demographics, preexisting family health conditions, patient demographics, and patient clinical characteristics
Study context
- Population
- Primary family surrogates of critically ill patients at high risk of death (APACHE II score >20) who survived >3 days after intensive care unit (ICU) admission, medical ICUs of 2 Taiwanese medical centers, 2018–2020
- Participants
- 309 family surrogates
- Exposure
- Factors associated with membership in quality of dying and death (QODD) classes vs high QODD class
- Outcome
- QODD class membership (23-item ICU-QODD questionnaire; 4 previously determined classes)
Methodological detailsmulticentre, latent class modeling (3-step approach), Follow-up through December 2022; data analysis July to September 2023
- Multicentre
- Latent class modeling (3-step approach)
- Follow-up through December 2022; data analysis July to September 2023
Main finding
As reported in the abstract
Factors associated with QODD class (vs high QODD class)
Each group vs high QODDAdjusted odds ratio (95% CI)
Poor to uncertain QODDgreater perceived social support of surrogates
0.89(0.83–0.94)
Worst QODDgreater perceived social support of surrogates
0.92(0.87–0.96)
Poor to uncertain QODDfamily meetings
8.61(2.49–29.74)
Worst QODDfamily meetings
7.28(1.37–38.71)
Worst QODDdeath with CPR
7.51(1.12–50.25)
Moderate QODDfamily presence at patient death
0.16(0.05–0.54)
Poor to uncertain QODDfamily presence at patient death
0.21(0.05–0.82)
Worst QODDfamily presence at patient death
0.08(0.02–0.38)
Poor to uncertain QODDhigher family satisfaction with ICU care
0.93(0.87–0.98)
Worst QODDhigher family satisfaction with ICU care
0.86(0.81–0.92)
Observational data: associations, not effects.
Original publication
Factors Associated With Quality-of-Dying-and-Death Classes Among Critically Ill Patients. JAMA Netw Open. Published 1 July 2024. doi:10.
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