TY - JOUR T1 - Factors related to limitation of life support within 48h of intensive care unit admission: A multicenter study JO - Medicina Intensiva T2 - AU - Blazquez,V. AU - Rodríguez,A. AU - Sandiumenge,A. AU - Oliver,E. AU - Cancio,B. AU - Ibañez,M. AU - Miró,G. AU - Navas,E. AU - Badía,M. AU - Bosque,M.D. AU - Jurado,M.T. AU - López,M. AU - Llauradó,M. AU - Masnou,N. AU - Pont,T. AU - Bodí,M. SN - 02105691 M3 - 10.1016/j.medin.2018.03.010 DO - 10.1016/j.medin.2018.03.010 UR - https://www.medintensiva.org/es-factors-related-limitation-life-support-articulo-S0210569118301244 AB - ObjectiveTo determine factors related to limitations on life support within 48h of intensive care unit (ICU) admission. Study designProspective multicenter study. SettingEleven ICUs. PatientsAll patients who died and/or had limitations on life support after ICU admission during a four-month period. VariablesPatient characteristics, hospital characteristics, characteristics of limitations on life support. Time-to-first-limitation was classified as early (<48h of admission) or late (≥48h). We performed univariate, multivariate analyses and CHAID (chi-square automatic interaction detection) analysis of variables associated with limitation of life support within 48h of ICU admission. Results3335 patients were admitted; 326 (9.8%) had limitations on life support. A total of 344 patients died; 247 (71.8%) had limitations on life support (range among centers, 58.6%–84.2%). The median (p25–p75) time from admission to initial limitation was 2 (0–7) days. CHAID analysis found that the modified Rankin score was the variable most closely related with early limitations. Among patients with Rankin >2, early limitations were implemented in 71.7% (OR=2.5; 95% CI: 1.5–4.4) and lung disease was the variable most strongly associated with early limitations (OR=12.29; 95% CI: 1.63–255.91). Among patients with Rankin ≤2, 48.8% had early limitations; patients admitted after emergency surgery had the highest rate of early limitations (66.7%; OR=2.4; 95% CI: 1.1–5.5). ConclusionLimitations on life support are common, but the practice varies. Quality of life has the greatest impact on decisions to limit life support within 48h of admission. ER -