Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage

<i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs i...
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Autor*in:	Felix Lehmann [verfasserIn] Matthias Schneider [verfasserIn] Joshua D. Bernstock [verfasserIn] Christian Bode [verfasserIn] Valeri Borger [verfasserIn] Stefan Felix Ehrentraut [verfasserIn] Florian Gessler [verfasserIn] Anna-Laura Potthoff [verfasserIn] Christian Putensen [verfasserIn] Lorena M. Schenk [verfasserIn] Julian Zimmermann [verfasserIn] Hartmut Vatter [verfasserIn] Patrick Schuss [verfasserIn] Alexis Hadjiathanasiou [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2022

Schlagwörter:	intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility

Übergeordnetes Werk:	In: Medicina - MDPI AG, 2016, 58(2022), 8, p 989
Übergeordnetes Werk:	volume:58 ; year:2022 ; number:8, p 989

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc Journal toc

DOI / URN:	10.3390/medicina58080989

Katalog-ID:	DOAJ036303089

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allfields	10.3390/medicina58080989 doi (DE-627)DOAJ036303089 (DE-599)DOAJ6f1b14f3f8fc4578bc5ee6fcc47c75aa DE-627 ger DE-627 rakwb eng R5-920 Felix Lehmann verfasserin aut Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families. intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General) Matthias Schneider verfasserin aut Joshua D. Bernstock verfasserin aut Christian Bode verfasserin aut Valeri Borger verfasserin aut Stefan Felix Ehrentraut verfasserin aut Florian Gessler verfasserin aut Anna-Laura Potthoff verfasserin aut Christian Putensen verfasserin aut Lorena M. Schenk verfasserin aut Julian Zimmermann verfasserin aut Hartmut Vatter verfasserin aut Patrick Schuss verfasserin aut Alexis Hadjiathanasiou verfasserin aut In Medicina MDPI AG, 2016 58(2022), 8, p 989 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:8, p 989 https://doi.org/10.3390/medicina58080989 kostenfrei https://doaj.org/article/6f1b14f3f8fc4578bc5ee6fcc47c75aa kostenfrei https://www.mdpi.com/1648-9144/58/8/989 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 8, p 989
spelling	10.3390/medicina58080989 doi (DE-627)DOAJ036303089 (DE-599)DOAJ6f1b14f3f8fc4578bc5ee6fcc47c75aa DE-627 ger DE-627 rakwb eng R5-920 Felix Lehmann verfasserin aut Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families. intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General) Matthias Schneider verfasserin aut Joshua D. Bernstock verfasserin aut Christian Bode verfasserin aut Valeri Borger verfasserin aut Stefan Felix Ehrentraut verfasserin aut Florian Gessler verfasserin aut Anna-Laura Potthoff verfasserin aut Christian Putensen verfasserin aut Lorena M. Schenk verfasserin aut Julian Zimmermann verfasserin aut Hartmut Vatter verfasserin aut Patrick Schuss verfasserin aut Alexis Hadjiathanasiou verfasserin aut In Medicina MDPI AG, 2016 58(2022), 8, p 989 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:8, p 989 https://doi.org/10.3390/medicina58080989 kostenfrei https://doaj.org/article/6f1b14f3f8fc4578bc5ee6fcc47c75aa kostenfrei https://www.mdpi.com/1648-9144/58/8/989 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 8, p 989
allfields_unstemmed	10.3390/medicina58080989 doi (DE-627)DOAJ036303089 (DE-599)DOAJ6f1b14f3f8fc4578bc5ee6fcc47c75aa DE-627 ger DE-627 rakwb eng R5-920 Felix Lehmann verfasserin aut Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families. intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General) Matthias Schneider verfasserin aut Joshua D. Bernstock verfasserin aut Christian Bode verfasserin aut Valeri Borger verfasserin aut Stefan Felix Ehrentraut verfasserin aut Florian Gessler verfasserin aut Anna-Laura Potthoff verfasserin aut Christian Putensen verfasserin aut Lorena M. Schenk verfasserin aut Julian Zimmermann verfasserin aut Hartmut Vatter verfasserin aut Patrick Schuss verfasserin aut Alexis Hadjiathanasiou verfasserin aut In Medicina MDPI AG, 2016 58(2022), 8, p 989 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:8, p 989 https://doi.org/10.3390/medicina58080989 kostenfrei https://doaj.org/article/6f1b14f3f8fc4578bc5ee6fcc47c75aa kostenfrei https://www.mdpi.com/1648-9144/58/8/989 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 8, p 989
allfieldsGer	10.3390/medicina58080989 doi (DE-627)DOAJ036303089 (DE-599)DOAJ6f1b14f3f8fc4578bc5ee6fcc47c75aa DE-627 ger DE-627 rakwb eng R5-920 Felix Lehmann verfasserin aut Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families. intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General) Matthias Schneider verfasserin aut Joshua D. Bernstock verfasserin aut Christian Bode verfasserin aut Valeri Borger verfasserin aut Stefan Felix Ehrentraut verfasserin aut Florian Gessler verfasserin aut Anna-Laura Potthoff verfasserin aut Christian Putensen verfasserin aut Lorena M. Schenk verfasserin aut Julian Zimmermann verfasserin aut Hartmut Vatter verfasserin aut Patrick Schuss verfasserin aut Alexis Hadjiathanasiou verfasserin aut In Medicina MDPI AG, 2016 58(2022), 8, p 989 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:8, p 989 https://doi.org/10.3390/medicina58080989 kostenfrei https://doaj.org/article/6f1b14f3f8fc4578bc5ee6fcc47c75aa kostenfrei https://www.mdpi.com/1648-9144/58/8/989 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 8, p 989
allfieldsSound	10.3390/medicina58080989 doi (DE-627)DOAJ036303089 (DE-599)DOAJ6f1b14f3f8fc4578bc5ee6fcc47c75aa DE-627 ger DE-627 rakwb eng R5-920 Felix Lehmann verfasserin aut Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage 2022 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier <i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families. intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General) Matthias Schneider verfasserin aut Joshua D. Bernstock verfasserin aut Christian Bode verfasserin aut Valeri Borger verfasserin aut Stefan Felix Ehrentraut verfasserin aut Florian Gessler verfasserin aut Anna-Laura Potthoff verfasserin aut Christian Putensen verfasserin aut Lorena M. Schenk verfasserin aut Julian Zimmermann verfasserin aut Hartmut Vatter verfasserin aut Patrick Schuss verfasserin aut Alexis Hadjiathanasiou verfasserin aut In Medicina MDPI AG, 2016 58(2022), 8, p 989 (DE-627)354543296 (DE-600)2088820-X 16489144 nnns volume:58 year:2022 number:8, p 989 https://doi.org/10.3390/medicina58080989 kostenfrei https://doaj.org/article/6f1b14f3f8fc4578bc5ee6fcc47c75aa kostenfrei https://www.mdpi.com/1648-9144/58/8/989 kostenfrei https://doaj.org/toc/1010-660X Journal toc kostenfrei https://doaj.org/toc/1648-9144 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 58 2022 8, p 989
language	English
source	In Medicina 58(2022), 8, p 989 volume:58 year:2022 number:8, p 989
sourceStr	In Medicina 58(2022), 8, p 989 volume:58 year:2022 number:8, p 989
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility Medicine (General)
isfreeaccess_bool	true
container_title	Medicina
authorswithroles_txt_mv	Felix Lehmann @@aut@@ Matthias Schneider @@aut@@ Joshua D. Bernstock @@aut@@ Christian Bode @@aut@@ Valeri Borger @@aut@@ Stefan Felix Ehrentraut @@aut@@ Florian Gessler @@aut@@ Anna-Laura Potthoff @@aut@@ Christian Putensen @@aut@@ Lorena M. Schenk @@aut@@ Julian Zimmermann @@aut@@ Hartmut Vatter @@aut@@ Patrick Schuss @@aut@@ Alexis Hadjiathanasiou @@aut@@
publishDateDaySort_date	2022-01-01T00:00:00Z
hierarchy_top_id	354543296
id	DOAJ036303089
language_de	englisch
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callnumber-first	R - Medicine
author	Felix Lehmann
spellingShingle	Felix Lehmann misc R5-920 misc intracerebral hemorrhage (ICH) misc treatment-limiting decisions (TLD) misc advanced directives misc treatment futility misc Medicine (General) Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage
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topic_title	R5-920 Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage intracerebral hemorrhage (ICH) treatment-limiting decisions (TLD) advanced directives treatment futility
topic	misc R5-920 misc intracerebral hemorrhage (ICH) misc treatment-limiting decisions (TLD) misc advanced directives misc treatment futility misc Medicine (General)
topic_unstemmed	misc R5-920 misc intracerebral hemorrhage (ICH) misc treatment-limiting decisions (TLD) misc advanced directives misc treatment futility misc Medicine (General)
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title	Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage
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title_full	Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage
author_sort	Felix Lehmann
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author_browse	Felix Lehmann Matthias Schneider Joshua D. Bernstock Christian Bode Valeri Borger Stefan Felix Ehrentraut Florian Gessler Anna-Laura Potthoff Christian Putensen Lorena M. Schenk Julian Zimmermann Hartmut Vatter Patrick Schuss Alexis Hadjiathanasiou
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title_sort	treatment-limiting decisions in patients with spontaneous intracerebral hemorrhage
callnumber	R5-920
title_auth	Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage
abstract	<i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families.
abstractGer	<i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families.
abstract_unstemmed	<i<Background and Objectives</i<: Treatment-limiting decisions (TLDs) are employed to actively withhold treatment/invasive interventions from patients in whom clinicians feel they would derive little to no benefit and/or suffer detrimental effects. Data regarding the employment of TLDs in patients with spontaneous intracerebral hemorrhage (ICH) remain sparse. Accordingly, this study sought to investigate both the prevalence of TLDs and factors driving TLDs in patients suffering from spontaneous ICH. <i<Materials and Methods:</i< This was a retrospective study of 249 consecutive patients with ICH treated from 2018–2019 at the Neurovascular Center of the University Hospital Bonn. Reasons deemed critical in the decision-making process with regard to TLD were ultimately extracted/examined via chart review of qualifying patients. <i<Results</i<: A total of 249 patients with ICH were included within the final analyses. During the time period examined, 49 patients (20%) had advanced directives in place, whereas in 53 patients (21%) consultation with relatives or acquaintances was employed before further treatment decisions. Overall, TLD ultimately manifested in 104 patients (42%). TLD was reached within 6 h after admission in 52 patients (50%). Congruent with severity of injury and expected outcomes, TLDs were more likely in patients with signs of cerebral herniation and an ICH score < 3 (<i<p</i< < 0.001). <i<Conclusions</i<: The present study examines details associated with TLDs in patients with spontaneous ICH. These data provide insight into key decisional processes and reinforce the need for further structured investigations in an effort to help guide patients and their families.
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title_short	Treatment-Limiting Decisions in Patients with Spontaneous Intracerebral Hemorrhage
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author2	Matthias Schneider Joshua D. Bernstock Christian Bode Valeri Borger Stefan Felix Ehrentraut Florian Gessler Anna-Laura Potthoff Christian Putensen Lorena M. Schenk Julian Zimmermann Hartmut Vatter Patrick Schuss Alexis Hadjiathanasiou
author2Str	Matthias Schneider Joshua D. Bernstock Christian Bode Valeri Borger Stefan Felix Ehrentraut Florian Gessler Anna-Laura Potthoff Christian Putensen Lorena M. Schenk Julian Zimmermann Hartmut Vatter Patrick Schuss Alexis Hadjiathanasiou
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up_date	2024-07-03T19:49:29.424Z
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