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Factors associated with an ICU withholding decision were the presence of advanced cognitive impairment (26% of limitation decisions), dependency (Katz scale ≤4; 22.9%), high comorbidities and age (86.9 vs 82.8 years; p = 0.002).
Rather than ratifying a foretold death, the intention of the withholding decision was in some circumstances to let nature take its course toward death or life while avoiding non-beneficial and burdening therapies.
We recorded treatment limitations at ICU admission in three categories: withdrawing (decision to stop life-sustaining intervention), withholding (decision not to start or increase life-sustaining intervention when there is a need), or advance withholding (no escalation of treatment before this need arises) [21].
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The themes included collaborative issues, changing of withholding decisions which were already made, and unnecessary postponement of withdrawing therapy decisions.
However, no differences were found regarding the elapsed time from admission to the ER until the first medical contact or the time since the recognition of sepsis and antibiotic administration, although the group with withholding decisions had less specimens collected for microbiology: blood cultures (68% vs. 91%, P < 0.001) or other specimens (58% vs. 96%, P < 0.001).
Internal medicine physicians were asked to report any ICU withholds decision for their patients.
Of 109 deaths over a 3-month period, 50 were preceded by a decision to forgo life support: 46 by a withdrawal decision and just four by a withhold decision.
Reformers argue that by withholding its decision until 10 days before the election, the council is hoping to damage reformers' chances to campaign effectively.
But the Obama campaign, citing its preference for a debate before the primary in Pennsylvania on April 22, is still withholding a decision.
In 60.4% (58 of 96 patients) of cases withholding ICU decision was taken by the attending physician, alone.
New York City, which buys Glock handguns for its police officers, has withheld a decision.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com