@article{ref1,
title="Risk factors for withdrawal of life-sustaining treatment in severe traumatic brain injury",
journal="American surgeon",
year="2020",
author="Gambhir, Sahil and Grigorian, Areg and Ramakrishnan, Divya and Kuza, Catherine M. and Sheehan, Brian and Maithel, Shelley and Nahmias, Jeff",
volume="86",
number="1",
pages="8-14",
abstract="Studies demonstrate a significant variation in decision-making regarding withdrawal of life-sustaining treatment (WLST) practices for patients with severe traumatic brain injury (TBI). We investigated risk factors associated with WLST in severe TBI. We hypothesized age ≥65 years would be an independent risk factor. In addition, we compared survivors with patients who died in hospital after WLST to identify potential factors associated with in-hospital mortality. The Trauma Quality Improvement Program (2010-2016) was queried for patients with severe TBI of the head. Patients were compared by age (age < 65 and age ≥ 65 years) and survival after WLST (survivors <i>versus</i> non-survivors) at hospitalization discharge. A multivariable logistic regression model was used for analysis. From 1,403,466 trauma admissions, 328,588 (23.4%) patients had severe TBI. Age ≥ 65 years was associated with increased WLST (odds ratio: 1.76, confidence interval: 1.59-1.94, <i>P</i> < 0.001), whereas nonwhite race was associated with decreased WLST (odds ratio: 0.60, confidence interval: 0.55-0.65, <i>P</i> < 0.001). Compared with non-survivors of WLST, survivors were older (74 <i>vs</i> 61 years, <i>P</i> < 0.001) and more likely to have comorbidities such as hypertension (57% <i>vs</i> 38.5%, <i>P</i> < 0.001). Age ≥ 65 years was an independent risk factor for WLST, and nonwhite race was associated with decreased WLST. Patients surviving until discharge after WLST decision were older (≥74 years) and had multiple comorbidities.<p /> <p>Language: en</p>",
language="en",
issn="0003-1348",
doi="",
url="http://dx.doi.org/"
}