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End-of-Life Decision-Making in Acute Care Setting

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Encyclopedia of Gerontology and Population Aging

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Synonyms

Advance care planning; Advance directives

Definition

Acute care setting refers to hospital facilities with patients being directly admitted from the community to the casualty medicine department. Those patients usually present with acute illnesses including medical diseases (e.g., sepsis, myocardial infarction), surgical diseases (e.g., intestinal obstruction, appendicitis, cholecystitis), and traumas (e.g., accidental fall, road traffic accident) (Hirshon et al. 2013). These acute illnesses are life-threatening and may cause organs failure, which requires patients to be supported by life-sustaining treatments to save their lives. The life-threatening nature of the organ failure from acute illnesses is usually unexpected by the patients and their families.

Life-sustaining treatments (LSTs) include mechanical ventilation, vasopressor infusion, renal replacement therapy, and cardiopulmonary resuscitation for patients suffering from respiratory, cardiovascular, renal system...

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References

  • Brown BA (2003) The history of advance directives. A literature review. J Gerontol Nurs 29(9):4–14

    Article  Google Scholar 

  • Brummel NE, Bell SP, Girard TD, Pandharipande PP, Jackson JC, Morandi A, … Ely EW (2017) Frailty and subsequent disability and mortality among patients with critical illness. Am J Respir Crit Care Med 196(1):64–72. https://doi.org/10.1164/rccm.201605-0939OC

  • Buckley TA, Joynt GM, Tan PY, Cheng CA, Yap FH (2004) Limitation of life support: frequency and practice in a Hong Kong intensive care unit. Crit Care Med 32(2):415–420. https://doi.org/10.1097/01.CCM.0000110675.34569.A9

    Article  Google Scholar 

  • Chu LW, Luk JK, Hui E, Chiu PK, Chan CS, Kwan F, … Woo J (2011) Advance directive and end-of-life care preferences among Chinese nursing home residents in Hong Kong. J Am Med Dir Assoc 12(2):143–152. https://doi.org/10.1016/j.jamda.2010.08.015

  • El-Jawahri A, Mitchell SL, Paasche-Orlow MK, Temel JS, Jackson VA, Rutledge RR, … Volandes AE (2015) A randomized controlled trial of a CPR and intubation video decision support tool for hospitalized patients. J Gen Intern Med 30(8):1071–1080. https://doi.org/10.1007/s11606-015-3200-2

  • Flaatten H, De Lange DW, Morandi A, Andersen FH, Artigas A, Bertolini G, … Guidet B (2017) The impact of frailty on ICU and 30-day mortality and the level of care in very elderly patients (>/= 80 years). Intensive Care Med 43(12):1820–1828. https://doi.org/10.1007/s00134-017-4940-8

  • Grignoli N, Di Bernardo V, Malacrida R (2018) New perspectives on substituted relational autonomy for shared decision-making in critical care. Crit Care 22(1):260. https://doi.org/10.1186/s13054-018-2187-6

    Article  Google Scholar 

  • Guidet B, de Lange DW, Boumendil A, Leaver S, Watson X, Boulanger C, … Flaatten H (2020) The contribution of frailty, cognition, activity of daily life and comorbidities on outcome in acutely admitted patients over 80 years in European ICUs: the VIP2 study. Intensive Care Med 46(1):57–69. https://doi.org/10.1007/s00134-019-05853-1

  • Hirshon JM, Risko N, Calvello EJ, Stewart de Ramirez S, Narayan M, Theodosis C, … Acute Care Research Collaborative at the University of Maryland Global Health Initiative (2013) Health systems and services: the role of acute care. Bull World Health Organ 91(5):386–388. https://doi.org/10.2471/BLT.12.112664

  • Joynt GM, Lipman J, Hartog C, Guidet B, Paruk F, Feldman C, … Sprung CL (2014) The Durban world congress ethics round table IV: health care professional end-of-life decision making. J Crit Care. https://doi.org/10.1016/j.jcrc.2014.10.011

  • Juma S, Taabazuing MM, Montero-Odasso M (2016) Clinical frailty scale in an acute medicine unit: a simple tool that predicts length of stay. Can Geriatr J 19(2):34–39. https://doi.org/10.5770/cgj.19.196

    Article  Google Scholar 

  • Lee HW, Park Y, Jang EJ, Lee YJ (2019) Intensive care unit length of stay is reduced by protocolized family support intervention: a systematic review and meta-analysis. Intensive Care Med. https://doi.org/10.1007/s00134-019-05681-3

  • Lush D (1993) Advance directives and living wills. J R Coll Physicians Lond 27(3):274–277. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5396760/pdf/jrcollphyslond90361-0066.pdf

    Google Scholar 

  • Merino AM, Greiner R, Hartwig K (2017) A randomized controlled trial of a CPR decision support video for patients admitted to the general medicine service. J Hosp Med 12(9):700–704. https://doi.org/10.12788/jhm.2791

    Article  Google Scholar 

  • Montgomery C, Bagshaw SM (2017) Frailty in the age of VIPs (very old intensive care patients). Intensive Care Med 43(12):1887–1888. https://doi.org/10.1007/s00134-017-4974-y

    Article  Google Scholar 

  • Noble C, Grealish L, Teodorczuk A, Shanahan B, Hiremagular B, Morris J, Yardley S (2018) How can end of life care excellence be normalized in hospitals? Lessons from a qualitative framework study. BMC Palliat Care 17(1):100. https://doi.org/10.1186/s12904-018-0353-x

    Article  Google Scholar 

  • Ofori-Asenso R, Chin KL, Mazidi M, Zomer E, Ilomaki J, Zullo AR, … Liew D (2019) Global incidence of frailty and prefrailty among community-dwelling older adults: a systematic review and meta-analysis. JAMA Netw Open 2(8):e198398. https://doi.org/10.1001/jamanetworkopen.2019.8398

  • Phua J, Joynt GM, Nishimura M, Deng Y, Myatra SN, Chan YH, … the Asian Critical Care Clinical Trials Group (2015) Withholding and withdrawal of life-sustaining treatments in intensive care units in Asia. JAMA Intern Med. https://doi.org/10.1001/jamainternmed.2014.7386

  • Reignier J, Feral-Pierssens AL, Boulain T, Carpentier F, Le Borgne P, Del Nista D, … French Intensive Care Society (2019) Withholding and withdrawing life-support in adults in emergency care: joint position paper from the French Intensive Care Society and French Society of Emergency Medicine. Ann Intensive Care 9(1):105. https://doi.org/10.1186/s13613-019-0579-7

  • Sprung CL, Cohen SL, Sjokvist P, Baras M, Bulow HH, Hovilehto S, … Ethicus Study Group (2003) End-of-life practices in European intensive care units: the Ethicus study. JAMA 290(6):790–797. https://doi.org/10.1001/jama.290.6.790

  • Wendler D (2017) The theory and practice of surrogate decision-making. Hast Cent Rep 47(1):29–31. https://doi.org/10.1002/hast.671

    Article  Google Scholar 

  • White DB, Angus DC, Shields AM, Buddadhumaruk P, Pidro C, Paner C, … PARTNER Investigators (2018) A randomized trial of a family-support intervention in intensive care units. N Engl J Med 378(25):2365–2375. https://doi.org/10.1056/NEJMoa1802637

  • Wong WT, Joynt GM (2016) End-of-life care. In: Guidet B, Valentin A, Flaatten H (eds) Quality management in intensive care. Cambridge University Press, Cambridge, UK/New York, pp 85–91

    Chapter  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Anaesthesia and Intensive Care, The Chinese University of Hong Kong, Hong Kong, China

    Wai-Tat Wong

Authors
  1. Wai-Tat Wong
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Corresponding author

Correspondence to Wai-Tat Wong .

Editor information

Editors and Affiliations

  1. Population Division, UN Dept of Economic Social Affairs Population Division, New York, NY, USA

    Danan Gu

  2. Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA

    Matthew E. Dupre

Section Editor information

  1. Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong

    Amy Yin Man Chow Ph.D., RSW, FT

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Wong, WT. (2020). End-of-Life Decision-Making in Acute Care Setting. In: Gu, D., Dupre, M. (eds) Encyclopedia of Gerontology and Population Aging. Springer, Cham. https://doi.org/10.1007/978-3-319-69892-2_1025-1

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  • DOI: https://doi.org/10.1007/978-3-319-69892-2_1025-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-69892-2

  • Online ISBN: 978-3-319-69892-2

  • eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences

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