Table 4 Organ failures, treatment already engaged, and rationales for WhWd at the time of the decision-making, separating withholding and withdrawal of treatment
Withholding, | Withdrawal, | p | |
|---|---|---|---|
N = 344 | N = 433 | ||
Total SOFA score median (IQR) | 5 (3–9) | 9 (5–13) | <0.01 |
Total SOFA score ≥ 8 | 122 (35.5) | 260 (60.0) | <0.01 |
Total SOFA score ≥ 5 | 198 (57.6) | 367 (84.8) | <0.01 |
Total SOFA score ≥ 3 | 282 (82.0) | 418 (96.5) | <0.01 |
Respiratory failure | 119 (34.6) | 182 (42.0) | 0.03 |
Neurologic failure | 104 (30.2) | 281 (64.9) | <0.01 |
Circulatory failure | 103 (29.9) | 192 (44.3) | <0.01 |
Hepatic failure | 10 (2.9) | 37 (8.5) | <0.01 |
Hematologic failure | 14 (4.1) | 54 (12.5) | <0.01 |
Renal failure | 56 (16.3) | 118 (27.3) | <0.01 |
Treatments already engaged: | |||
Endotracheal ventilation | 213 (61.9) | 375 (86.6) | <0.01 |
Non-invasive ventilation | 50 (27.9) | 35 (17.3) | <0.01 |
Inotrope use | 107 (31.1) | 206 (47.6) | <0.01 |
Renal replacement therapy | 24 (7.2) | 100 (23.6) | <0.01 |
Antibiotics | 158 (45.9) | 256 (59.1) | <0.01 |
Blood product transfusion | 46 (14.9) | 77 (18.6) | 0.11 |
Surgery needed | 22 (6.4) | 47 (10.9) | 0.02 |
Rationales to justify WhWd: | |||
No additional information needed | 246 (78.1) | 356 (90.8) | <0.01 |
Limited subsequent autonomy | 252 (80.3) | 329 (81.4) | 0.34 |
Absence of curative therapy | 199 (61.4) | 360 (86.5) | <0.01 |
Non-responsive to treatment | 180 (56.6) | 336 (83.6) | <0.01 |
End-stage incurable severe disease | 185 (58.4) | 289 (73.5) | <0.01 |
Limited subsequent relational QOL | 177 (57.7) | 265 (68.3) | <0.01 |
Limited autonomy before admission | 184 (55.9) | 133 (33.8) | <0.01 |
Very advanced age | 101 (31.9) | 109 (27.9) | 0.14 |
Excessive treatment felt by relatives | 59 (18.9) | 113 (28.2) | <0.01 |
Patient’s wish to limit treatment | 59 (19.1) | 51 (13.1) | 0.02 |
Awareness of patient’s preferences | 86 (25.0) | 95 (21.9) | 0.31 |
External consultant physician | 142 (41.3) | 214 (49.4) | 0.02 |