Time to death after compassionate extubation in medical and neuroscience intensive care units
•Medical ICU (MICU) MICU patients dying after compassionate extubation died of infection or cancer, compared with Neuroscience ICU (NSICU) patients who had intracranial hemorrhage or ischemic stroke.•Patients dying after compassionate extubation in the NSICU underwent CE after shorter time in the IC...
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description | •Medical ICU (MICU) MICU patients dying after compassionate extubation died of infection or cancer, compared with Neuroscience ICU (NSICU) patients who had intracranial hemorrhage or ischemic stroke.•Patients dying after compassionate extubation in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards compared with MICU patients•Patients dying after compassionate extubation in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.
Medical ICU (MICU) and neuroscience ICU (NSICU) populations undergoing compassionate extubation (CE) may have different characteristics that affect post-procedure outcomes.
To contrast clinical characteristics and evaluate time to death (TTD) following CE in MICU and NSICU populations.
Single-center retrospective cohort study of patients who completed CE in a MICU or NSICU in 2021. Data were obtained by manual chart abstraction. A Mann-Whitney U test was used to compare characteristics between the clinical units.
Fifty patients were included in the study, 27 were in the MICU and 23 in the NSICU. Median age was 68 years. Patients in the MICU had a longer LOS before CE than those in the NSICU (10.0 vs. 3.0 days, p=0.001). Patients in the MICU experienced a shorter median TTD after CE than those in the NSICU (25 vs. 195 mins, p=0.004). MICU patients had a higher pre-hospital burden of illness (median CCI 6 vs 3, p=0.003), and a higher degree of organ failure at CE (median SOFA 12 vs 6, p |
doi_str_mv | 10.1016/j.hrtlng.2024.10.005 |
format | Article |
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Medical ICU (MICU) and neuroscience ICU (NSICU) populations undergoing compassionate extubation (CE) may have different characteristics that affect post-procedure outcomes.
To contrast clinical characteristics and evaluate time to death (TTD) following CE in MICU and NSICU populations.
Single-center retrospective cohort study of patients who completed CE in a MICU or NSICU in 2021. Data were obtained by manual chart abstraction. A Mann-Whitney U test was used to compare characteristics between the clinical units.
Fifty patients were included in the study, 27 were in the MICU and 23 in the NSICU. Median age was 68 years. Patients in the MICU had a longer LOS before CE than those in the NSICU (10.0 vs. 3.0 days, p=0.001). Patients in the MICU experienced a shorter median TTD after CE than those in the NSICU (25 vs. 195 mins, p=0.004). MICU patients had a higher pre-hospital burden of illness (median CCI 6 vs 3, p=0.003), and a higher degree of organ failure at CE (median SOFA 12 vs 6, p<0.001), with more severe hypoxemia (PaO2/FiO2 ratio of 149 vs 360, p<0.001). Most MICU patients died of infection or cancer, compared with NSICU patients who had intracranial hemorrhage or ischemic stroke.
Patients in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards than MICU patients. Patients in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.</description><identifier>ISSN: 0147-9563</identifier><identifier>ISSN: 1527-3288</identifier><identifier>EISSN: 1527-3288</identifier><identifier>DOI: 10.1016/j.hrtlng.2024.10.005</identifier><identifier>PMID: 39486140</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Compassionate extubation ; ICU end-of-life care ; Palliative ventilator withdrawal ; Prognostication</subject><ispartof>Heart & lung, 2025-01, Vol.69, p.185-191</ispartof><rights>2024</rights><rights>Copyright © 2024. Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c241t-4080ab60fac395bf1e1547e7dec4a578371ae24c27da8bc0310f7704aeae5eb93</cites><orcidid>0000-0001-5746-7785</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S014795632400195X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39486140$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Elaine</creatorcontrib><creatorcontrib>Kosinski, Nicholas</creatorcontrib><creatorcontrib>Kaur, Ramandeep</creatorcontrib><title>Time to death after compassionate extubation in medical and neuroscience intensive care units</title><title>Heart & lung</title><addtitle>Heart Lung</addtitle><description>•Medical ICU (MICU) MICU patients dying after compassionate extubation died of infection or cancer, compared with Neuroscience ICU (NSICU) patients who had intracranial hemorrhage or ischemic stroke.•Patients dying after compassionate extubation in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards compared with MICU patients•Patients dying after compassionate extubation in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.
Medical ICU (MICU) and neuroscience ICU (NSICU) populations undergoing compassionate extubation (CE) may have different characteristics that affect post-procedure outcomes.
To contrast clinical characteristics and evaluate time to death (TTD) following CE in MICU and NSICU populations.
Single-center retrospective cohort study of patients who completed CE in a MICU or NSICU in 2021. Data were obtained by manual chart abstraction. A Mann-Whitney U test was used to compare characteristics between the clinical units.
Fifty patients were included in the study, 27 were in the MICU and 23 in the NSICU. Median age was 68 years. Patients in the MICU had a longer LOS before CE than those in the NSICU (10.0 vs. 3.0 days, p=0.001). Patients in the MICU experienced a shorter median TTD after CE than those in the NSICU (25 vs. 195 mins, p=0.004). MICU patients had a higher pre-hospital burden of illness (median CCI 6 vs 3, p=0.003), and a higher degree of organ failure at CE (median SOFA 12 vs 6, p<0.001), with more severe hypoxemia (PaO2/FiO2 ratio of 149 vs 360, p<0.001). Most MICU patients died of infection or cancer, compared with NSICU patients who had intracranial hemorrhage or ischemic stroke.
Patients in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards than MICU patients. Patients in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.</description><subject>Compassionate extubation</subject><subject>ICU end-of-life care</subject><subject>Palliative ventilator withdrawal</subject><subject>Prognostication</subject><issn>0147-9563</issn><issn>1527-3288</issn><issn>1527-3288</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2025</creationdate><recordtype>article</recordtype><recordid>eNp9kE1PwzAMhiMEYmPwDxDKkUtH0qRNd0FCiC9pEhc4oshNXcjUpiNJJ_j3ZNrgiC-W7ddfDyHnnM054-XVav7hY-fe5znLZUrNGSsOyJQXucpEXlWHZMq4VNmiKMWEnISwYslEqY7JRCxkVXLJpuTtxfZI40AbhPhBoY3oqRn6NYRgBwcRKX7FsYaYImod7bGxBjoKrqEORz8EY9EZTLWILtgNUgMe6ehsDKfkqIUu4Nnez8jr_d3L7WO2fH54ur1ZZiaXPGaSVQzqkrVgxKKoW468kApVg0ZCoSqhOGAuTa4aqGrDBGetUkwCAhZYL8SMXO7mrv3wOWKIurfBYNeBw2EMWvBcFLJSadSMyJ3UpNODx1avve3Bf2vO9BasXukdWL0Fu80msKntYr9hrBOCv6ZfkklwvRNg-nNj0es9mMZ6NFE3g_1_ww99Z40s</recordid><startdate>20250101</startdate><enddate>20250101</enddate><creator>Chen, Elaine</creator><creator>Kosinski, Nicholas</creator><creator>Kaur, Ramandeep</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5746-7785</orcidid></search><sort><creationdate>20250101</creationdate><title>Time to death after compassionate extubation in medical and neuroscience intensive care units</title><author>Chen, Elaine ; Kosinski, Nicholas ; Kaur, Ramandeep</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c241t-4080ab60fac395bf1e1547e7dec4a578371ae24c27da8bc0310f7704aeae5eb93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2025</creationdate><topic>Compassionate extubation</topic><topic>ICU end-of-life care</topic><topic>Palliative ventilator withdrawal</topic><topic>Prognostication</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Elaine</creatorcontrib><creatorcontrib>Kosinski, Nicholas</creatorcontrib><creatorcontrib>Kaur, Ramandeep</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Heart & lung</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Elaine</au><au>Kosinski, Nicholas</au><au>Kaur, Ramandeep</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Time to death after compassionate extubation in medical and neuroscience intensive care units</atitle><jtitle>Heart & lung</jtitle><addtitle>Heart Lung</addtitle><date>2025-01-01</date><risdate>2025</risdate><volume>69</volume><spage>185</spage><epage>191</epage><pages>185-191</pages><issn>0147-9563</issn><issn>1527-3288</issn><eissn>1527-3288</eissn><abstract>•Medical ICU (MICU) MICU patients dying after compassionate extubation died of infection or cancer, compared with Neuroscience ICU (NSICU) patients who had intracranial hemorrhage or ischemic stroke.•Patients dying after compassionate extubation in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards compared with MICU patients•Patients dying after compassionate extubation in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.
Medical ICU (MICU) and neuroscience ICU (NSICU) populations undergoing compassionate extubation (CE) may have different characteristics that affect post-procedure outcomes.
To contrast clinical characteristics and evaluate time to death (TTD) following CE in MICU and NSICU populations.
Single-center retrospective cohort study of patients who completed CE in a MICU or NSICU in 2021. Data were obtained by manual chart abstraction. A Mann-Whitney U test was used to compare characteristics between the clinical units.
Fifty patients were included in the study, 27 were in the MICU and 23 in the NSICU. Median age was 68 years. Patients in the MICU had a longer LOS before CE than those in the NSICU (10.0 vs. 3.0 days, p=0.001). Patients in the MICU experienced a shorter median TTD after CE than those in the NSICU (25 vs. 195 mins, p=0.004). MICU patients had a higher pre-hospital burden of illness (median CCI 6 vs 3, p=0.003), and a higher degree of organ failure at CE (median SOFA 12 vs 6, p<0.001), with more severe hypoxemia (PaO2/FiO2 ratio of 149 vs 360, p<0.001). Most MICU patients died of infection or cancer, compared with NSICU patients who had intracranial hemorrhage or ischemic stroke.
Patients in the NSICU underwent CE after shorter time in the ICU and survived longer afterwards than MICU patients. Patients in the MICU have a higher pre-hospital severity of illness and a higher level of organ failure at the time of CE compared with NSICU patients.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>39486140</pmid><doi>10.1016/j.hrtlng.2024.10.005</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5746-7785</orcidid></addata></record> |
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subjects | Compassionate extubation ICU end-of-life care Palliative ventilator withdrawal Prognostication |
title | Time to death after compassionate extubation in medical and neuroscience intensive care units |
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