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  1. Private attending physician status and the withdrawal of life-sustaining interventions in a medical intensive care unit population.

    Article - En anglais

    Objective 

    To assess the influence of private attending physician status on the withdrawal of life-sustalning interventions among patients dying within a medical intensive care unit (ICU).

    Design 

    Retrospective cohort analysis.

    Setting 

    An academic tertiary care center.

    Patients 

    One hundred fifty-nine consecutive patient deaths occurring in the medical ICU during a 12-month period. interventions : None.

    Measurements and Main Results 

    Withdrawal of life-sustaining interventions (i.e., mechanical ventilation, dialysis, and/or vasopressors), duration of mechanical ventilation, length of intensive care unit stay, medical care costs, and patient charges were recorded.

    Life-sustaining interventions were actively withdrawn from 69 (43.4%) patients prior to death.

    Patients without a private attending physician were significantly more likely to undergo the withdrawal of life-sustaining interventions compared with patients having a private attending physician (odds ratio=2.5 ; 95% confidence interval=1.8,3.6, respectively ; p=005).

    A correlation was found between the possession of private health insurance and private attending physician status (r2=39, p<. 001).

    Multiple logistic regression analysis was subsequently used to control for demographic factors and severity of illness.

    Three independent predictors for the withdrawal of life-sustaining Interventions were identified in this patient cohort (p<. (...)

    Mots-clés Pascal : Malade, Médecin, Secteur privé, Soin intensif, Réanimation, Assurance maladie, Etude comparative, Analyse coût, Accessibilité, Soin, Urgence, Homme, Durée, Hospitalisation, Système santé, Etats Unis, Amérique du Nord, Amérique

    Mots-clés Pascal anglais : Patient, Physician, Private sector, Intensive care, Resuscitation, Health insurance, Comparative study, Cost analysis, Accessibility, Care, Emergency, Human, Duration, Hospitalization, Health system, United States, North America, America

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0306740

    Code Inist : 002B30A04A. Création : 10/04/1997.