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SHR Neuro Cancer Cardio Lipid Metab Microb
Saager, L; Hesler, BD; Reynolds, LF; Deogaonkar, A; Dalton, JE; Kurz, A; Turan, A.
The clinical quandary of counseling the moribund critical care patient-a registry analysis of postsurgical outcomes
J CRIT CARE. 2013; 28(4): 421-426.
Doi: 10.1016/j.jcrc.2012.10.068
Web of Science
PubMed
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- Co-authors Med Uni Graz
- Kurz Andrea
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- Abstract:
- Purpose: To provide outcomes data to intensivists and surgeons for counseling patients and family members when considering a surgical intervention in a moribund patient. Materials and Methods: Retrospective analysis of prospectively collected data from the American College of Surgeons National Surgical Quality Improvement Program database in moribund patients undergoing general surgical procedures. Results: Out of 633,262 patients available in the national registry, 2063 (0.3%) were of moribund status. Post-operative mortality was 52.8% for moribund patients. Those who died had higher rates of compromised respiratory, renal and cognitive dysfunction, were older, less independent prior to surgery and had generally longer surgeries. 83% of patients experienced a major complication including mortality and 17% of patients experienced minor complications. Conclusion: The moribund patient is not as grave as once thought and surgery on these patients may not be futile given the 47% survival rate at 30 days. Postoperative complication rates are high. The data presented provide a meaningful tool for the clinicians in counseling patients and families on the expectations when considering a surgical intervention for moribund patients. (C) 2013 Elsevier Inc. All rights reserved.
- Find related publications in this database (Keywords)
- End-of-life care
- Terminal care
- Clinical ethics
- Critical ill
- Mortality