-- Robert Preidt
MONDAY, Aug. 29 (HealthDay News) -- Caution is required when
deciding whether to stop life support for patients with traumatic
brain injuries, a new study suggests.
Researchers examined death rates after life support was halted
for 720 patients over age 16 with severe traumatic brain injury in
six trauma centers in the Canadian provinces of Ontario, Quebec and
Overall, about one-third of the patients died in hospital, but
the rate varied from 11 to 44 percent -- depending on the different
trauma centers, according to the study published Aug. 29 in the
Canadian Medical Association Journal.
"We saw that most deaths after severe traumatic brain injury occurred after withdrawal of life-sustaining therapy and that the rate of withdrawal of life-sustaining therapy varied significantly across level-one trauma centers," wrote Dr. Alexis Turgeon of Laval University in Quebec, and coauthors.
Seventy percent of the deaths (a range of 64 percent to 76
percent among centers) were associated with the withdrawal of life
support, and about half of these deaths occurred within three days,
the authors noted in a journal news release.
The team also found "considerable variability" in the death rate
between the hospitals, even after adjusting for various risk
factors. "This raises the concern that differences in mortality
between centers may be partly due to variation in physicians'
perceptions of long-term prognosis and physicians' practice
patterns for recommending withdrawal of life-sustaining therapy,"
the team stated.
Therefore, until accurate diagnostic tools are available,
caution is required when estimating prognoses for patients with
severe traumatic brain injuries and when recommending the
withdrawal of life support, the researchers concluded.
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