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Table 4 Organ failures, treatment already engaged, and rationales for WhWd at the time of the decision-making, separating withholding and withdrawal of treatment

From: Withholding or withdrawal of treatment under French rules: a study performed in 43 intensive care units

 

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

  1. Values are represented as number (%), unless stated otherwise.
  2. SOFA sequential organ failure assessment, WhWd withhold or withdraw treatment, QOL quality of life. By convention, a SOFA organ sub-score of 3 or more was considered as organ failure