Neuroanesthesia & neurocritical care
Reporting practices and impact of withdrawal of life-sustaining treatment on outcomes in acute brain injury clinical trials: a literature review and simulation study
Authors' conclusion
WLST is poorly reported in contemporary ABI trials. Misclassification of WLST-related deaths leads to important bias in trial-reported treatment effects, potentially yielding underpowered studies and erroneous trial conclusions.
Study context
- Population
- Two-arm randomised superiority trials of adults with acute brain injury (TBI, intracranial hemorrhage, SAH, ischemic stroke, post-cardiac arrest brain injury) in 10 high-impact journals, 1 January 2015 to 19 December 2024
- Participants
- 69 trials
- Outcome
- Reporting of WLST in acute brain injuries (ABI) trials
Methodological detailsliterature review of RCTs, simulation-based analysis, blinded and unblinded trial scenarios, binary and ordinal neurologic outcomes
- Literature review of RCTs
- Simulation-based analysis
- Blinded and unblinded trial scenarios
- Binary and ordinal neurologic outcomes
Main finding
As reported in the abstract
- Withdrawal of life-sustaining treatment (WLST) frequency reported
- 17 trials (24.6%)
- WLST timing reported
- 9 (13.0%)
- WLST reasons reported
- 10 (14.5%)
- Standardised neuro-prognostication criteria reported
- 7 (10.1%)
- WLST misclassification reversed statistical conclusions, median % of trials across all simulations (IQR 17.4-32.4%)
- 22.1%
Original publication
Reporting practices and impact of withdrawal of life-sustaining treatment on outcomes in acute brain injury clinical trials: a literature review and simulation study. Crit Care. Published 8 March 2026. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →