Prognostication of patients in coma after cardiac arrest: Public perspectives
To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America. A web-base...
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| Veröffentlicht in: | Resuscitation 2021-12, Vol.169, p.4-10 |
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| creator | van Til, Janine Bouwers-Beens, Eline Mertens, Mayli Boenink, Marianne Groothuis-Oudshoorn, Catherina Hofmeijer, Jeannette |
| description | To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America.
A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for differences between countries.
In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37–54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p |
| doi_str_mv | 10.1016/j.resuscitation.2021.10.002 |
| format | Article |
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A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for differences between countries.
In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37–54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p < 0.001) or the Netherlands (OR = 1.74, p < 0.001) and preferring to stay alive in a conscious state with severe physical and cognitive impairments more than respondents from Italy (OR = 3.76, p < 0.001), Germany (OR = 2.21, p < 0.001), or the Netherlands (OR = 2.39, p < 0.001).
Over one-third of the respondents considered WLST unacceptable when there is any remaining prognostic uncertainty. Respondents had a more positive perspective on acceptable quality of life after coma than what is currently considered acceptable in medical literature. This indicates a need for a closer look at the practice of WLST based on prognostic information, to ensure responsible use of novel prognostic tests.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2021.10.002</identifier><identifier>PMID: 34634358</identifier><language>eng</language><publisher>Ireland: Elsevier B.V</publisher><subject>Adult ; Coma - epidemiology ; Coma - etiology ; End-of-life decisions ; Heart Arrest - epidemiology ; Heart Arrest - therapy ; Humans ; Post-anoxic coma ; Prognosis ; Prognostic tests ; Public perspective ; Quality of Life ; Withdrawal of life support ; Withholding Treatment</subject><ispartof>Resuscitation, 2021-12, Vol.169, p.4-10</ispartof><rights>2021 The Authors</rights><rights>Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3512-378721bb212f0fb0dc5ecf17ef113db03b2f42794070f4b5628bd0672b3fd2db3</citedby><cites>FETCH-LOGICAL-c3512-378721bb212f0fb0dc5ecf17ef113db03b2f42794070f4b5628bd0672b3fd2db3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.resuscitation.2021.10.002$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34634358$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>van Til, Janine</creatorcontrib><creatorcontrib>Bouwers-Beens, Eline</creatorcontrib><creatorcontrib>Mertens, Mayli</creatorcontrib><creatorcontrib>Boenink, Marianne</creatorcontrib><creatorcontrib>Groothuis-Oudshoorn, Catherina</creatorcontrib><creatorcontrib>Hofmeijer, Jeannette</creatorcontrib><title>Prognostication of patients in coma after cardiac arrest: Public perspectives</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America.
A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for differences between countries.
In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37–54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p < 0.001) or the Netherlands (OR = 1.74, p < 0.001) and preferring to stay alive in a conscious state with severe physical and cognitive impairments more than respondents from Italy (OR = 3.76, p < 0.001), Germany (OR = 2.21, p < 0.001), or the Netherlands (OR = 2.39, p < 0.001).
Over one-third of the respondents considered WLST unacceptable when there is any remaining prognostic uncertainty. Respondents had a more positive perspective on acceptable quality of life after coma than what is currently considered acceptable in medical literature. This indicates a need for a closer look at the practice of WLST based on prognostic information, to ensure responsible use of novel prognostic tests.</description><subject>Adult</subject><subject>Coma - epidemiology</subject><subject>Coma - etiology</subject><subject>End-of-life decisions</subject><subject>Heart Arrest - epidemiology</subject><subject>Heart Arrest - therapy</subject><subject>Humans</subject><subject>Post-anoxic coma</subject><subject>Prognosis</subject><subject>Prognostic tests</subject><subject>Public perspective</subject><subject>Quality of Life</subject><subject>Withdrawal of life support</subject><subject>Withholding Treatment</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkE1r3DAQhkVJaDYffyEIesnF25FkW972VJZtWkhJDslZ6GNUtKwtR7ID-ffVdreF3HKagXnnfWceQj4xWDJg7eftMmGesw2TnkIclhw4K5MlAP9AFqyTomKNhBOyAAFQrRrJz8h5zlsAEM1KfiRnom5FLZpuQX49pPh7iHkK9q8bjZ6OpcNhyjQM1MZeU-0nTNTq5IK2VKeSP32hD7PZBUtHTHlEO4UXzJfk1OtdxqtjvSBP3zeP6x_V3f3tz_W3u8qKhvFKyE5yZgxn3IM34GyD1jOJnjHhDAjDfc3lqgYJvjZNyzvjoJXcCO-4M-KC3Bx8xxSf53KN6kO2uNvpAeOcFW86xrtartoi_XqQ2hRzTujVmEKv06tioPY81Va94an2PPfDwrNsXx-DZtOj-7_7D2ARbA4CLO--BEyqGOFg0YVUoCgXw7uC_gA3R49j</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>van Til, Janine</creator><creator>Bouwers-Beens, Eline</creator><creator>Mertens, Mayli</creator><creator>Boenink, Marianne</creator><creator>Groothuis-Oudshoorn, Catherina</creator><creator>Hofmeijer, Jeannette</creator><general>Elsevier B.V</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202112</creationdate><title>Prognostication of patients in coma after cardiac arrest: Public perspectives</title><author>van Til, Janine ; Bouwers-Beens, Eline ; Mertens, Mayli ; Boenink, Marianne ; Groothuis-Oudshoorn, Catherina ; Hofmeijer, Jeannette</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3512-378721bb212f0fb0dc5ecf17ef113db03b2f42794070f4b5628bd0672b3fd2db3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Coma - epidemiology</topic><topic>Coma - etiology</topic><topic>End-of-life decisions</topic><topic>Heart Arrest - epidemiology</topic><topic>Heart Arrest - therapy</topic><topic>Humans</topic><topic>Post-anoxic coma</topic><topic>Prognosis</topic><topic>Prognostic tests</topic><topic>Public perspective</topic><topic>Quality of Life</topic><topic>Withdrawal of life support</topic><topic>Withholding Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>van Til, Janine</creatorcontrib><creatorcontrib>Bouwers-Beens, Eline</creatorcontrib><creatorcontrib>Mertens, Mayli</creatorcontrib><creatorcontrib>Boenink, Marianne</creatorcontrib><creatorcontrib>Groothuis-Oudshoorn, Catherina</creatorcontrib><creatorcontrib>Hofmeijer, Jeannette</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>van Til, Janine</au><au>Bouwers-Beens, Eline</au><au>Mertens, Mayli</au><au>Boenink, Marianne</au><au>Groothuis-Oudshoorn, Catherina</au><au>Hofmeijer, Jeannette</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostication of patients in coma after cardiac arrest: Public perspectives</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2021-12</date><risdate>2021</risdate><volume>169</volume><spage>4</spage><epage>10</epage><pages>4-10</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><abstract>To elicit preferences for prognostic information, attitudes towards withdrawal of life-sustaining treatment (WLST) and perspectives on acceptable quality of life after post-anoxic coma within the adult general population of Germany, Italy, the Netherlands and the United States of America.
A web-based survey, consisting of questions on respondent characteristics, perspectives on quality of life, communication of prognostic information, and withdrawal of life-sustaining treatment, was taken by adult respondents recruited from four countries. Statistical analysis included descriptive analysis and chi2-tests for differences between countries.
In total, 2012 respondents completed the survey. In each country, at least 84% indicated they would prefer to receive early prognostic information. If a poor outcome was predicted with some uncertainty, 37–54% of the respondents indicated that WLST was not to be allowed. A conscious state with severe physical and cognitive impairments was perceived as acceptable quality of life by 17–44% of the respondents. Clear differences between countries exist, including respondents from the U.S. being more likely to allow WLST than respondents from Germany (OR = 1.99, p < 0.001) or the Netherlands (OR = 1.74, p < 0.001) and preferring to stay alive in a conscious state with severe physical and cognitive impairments more than respondents from Italy (OR = 3.76, p < 0.001), Germany (OR = 2.21, p < 0.001), or the Netherlands (OR = 2.39, p < 0.001).
Over one-third of the respondents considered WLST unacceptable when there is any remaining prognostic uncertainty. Respondents had a more positive perspective on acceptable quality of life after coma than what is currently considered acceptable in medical literature. This indicates a need for a closer look at the practice of WLST based on prognostic information, to ensure responsible use of novel prognostic tests.</abstract><cop>Ireland</cop><pub>Elsevier B.V</pub><pmid>34634358</pmid><doi>10.1016/j.resuscitation.2021.10.002</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Coma - epidemiology Coma - etiology End-of-life decisions Heart Arrest - epidemiology Heart Arrest - therapy Humans Post-anoxic coma Prognosis Prognostic tests Public perspective Quality of Life Withdrawal of life support Withholding Treatment |
| title | Prognostication of patients in coma after cardiac arrest: Public perspectives |
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