tailieunhanh - Báo cáo y học: "Retrospective agreement and consent to neurocritical care is influenced by functional outcome"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Retrospective agreement and consent to neurocritical care is influenced by functional outcome. | Kiphuth et al. Critical Care 2010 14 R144 http content 14 4 R144 c CRITICAL CARE RESEARCH Open Access Retrospective agreement and consent to neurocritical care is influenced by functional outcome Ines C Kiphuth Martin Kohrmann Joji B Kuramatsu Christoph Mauer Lorenz Breuer Peter D Schellinger Stefan Schwab Hagen B Huttner Abstract Introduction Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we i analyzed the extent of retrospective consent to neurocritical care-given by patients or their relatives-depending on functional outcome one year after hospital stay and ii identified predisposing factors for retrospective agreement to neurocritical care. Methods We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years 2006 through 2007 . Demographic and clinical parameters were analyzed and the patients were grouped according to their diagnosis. Functional outcome retrospective consent to neurocritical care and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent. Results High consent and satisfaction after neurointensive care 91 and 90 respectively was observed by those patients who reached an independent life one year after neurointensive care unit ICU stay. However only 19 of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent. Conclusions Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy neurocritical care physicians should balance the expected burdens and benefits of treatment to .