ICU sedation, delirium & recovery
Predictors and outcomes of withholding and withdrawal of life-sustaining treatments in intensive care units in Singapore: a multicentre observational study
Authors' conclusion
Differences in the independent predictors of withholding and withdrawal of LST exist. Even after accounting for baseline characteristics, both withholding and withdrawal of LST independently predict hospital mortality.
Study context
- Population
- Patients admitted to 21 adult intensive care unit (ICUs) across 9 public hospitals in Singapore, average of three months per year, 2014 to 2019
- Participants
- 8,907 patients · 9,723 admissions
- Exposure
- LST withholding vs LST withdrawal vs no LST limitation
- Outcome
- Withholding and withdrawal of LST (CPR, invasive mechanical ventilation, vasopressors/inotropes)
Methodological details21 adult ICUs across 9 public hospitals, multivariable generalised mixed model analysis
- 21 adult ICUs across 9 public hospitals
- Multivariable generalised mixed model analysis
Main finding
As reported in the abstract
Withholding and withdrawal of LST
Observational data: associations, not effects.
Secondary outcomes
| Outcome | No limitation | Withholding | Withdrawal | OR (95% CI) | |
|---|---|---|---|---|---|
| Hospital mortalityWithholding vs No limitation · multivariable analysis | 10.6% | 82.1% | 91.8% | 13.822 (9.987–19.132) | |
| Hospital mortalityWithdrawal vs No limitation · multivariable analysis | 38.319 (24.351–60.298) | ||||
| 0.050.21520Odds ratio (log scale) |
- Hospital mortality: p < 0.001 across three groups
Original publication
Predictors and outcomes of withholding and withdrawal of life-sustaining treatments in intensive care units in Singapore: a multicentre observational study. J Intensive Care. Published 26 March 2024. doi:10.
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