The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study
Objectives: There is little evidence on the factors influencing the decision to withdraw or continue life-sustaining treatment in the setting of severe traumatic brain injury in Japanese institutions. We investigated the factors associated with the withdrawal or withholding of life-sustaining treatm...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-01-01
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| Series: | World Neurosurgery: X |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590139722000291 |
| _version_ | 1811165437609639936 |
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| author | Shinsuke Tanizaki Yasuo Toma Katsuyoshi Miyashita Shigenobu Maeda |
| author_facet | Shinsuke Tanizaki Yasuo Toma Katsuyoshi Miyashita Shigenobu Maeda |
| author_sort | Shinsuke Tanizaki |
| collection | DOAJ |
| description | Objectives: There is little evidence on the factors influencing the decision to withdraw or continue life-sustaining treatment in the setting of severe traumatic brain injury in Japanese institutions. We investigated the factors associated with the withdrawal or withholding of life-sustaining treatment (WLST) for severe traumatic brain injury at a single Japanese institution. Methods: A total of 161 patients with severe traumatic brain injury were retrospectively reviewed. Patient characteristics and injury types were compared between patients with and without the WLST. Results: Of the 161 patients, 87 (54%) died and 52 (32%) decided to undergo WLST. In 98% of the WLST cases, the decision was made within 24 h of admission. The mean duration between WLST and death was 2 days. The predicted probabilities for mortality and unfavorable outcomes were highest in patients with WLST within 24 h. Patients with WLST were older and had a higher frequency of falls on the ground, ischemic heart disease, and acute subdural hemorrhage than those without WLST. Conclusions: The decisions of almost all WLST cases were made within 24 h of admission for severe traumatic brain injury in a Japanese institution because of Japanese patients' religious and cultural backgrounds. |
| first_indexed | 2024-04-10T15:37:08Z |
| format | Article |
| id | doaj.art-dbaaabff10fa44a8ab67589b84e6631b |
| institution | Directory Open Access Journal |
| issn | 2590-1397 |
| language | English |
| last_indexed | 2024-04-10T15:37:08Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Neurosurgery: X |
| spelling | doaj.art-dbaaabff10fa44a8ab67589b84e6631b2023-02-13T04:07:33ZengElsevierWorld Neurosurgery: X2590-13972023-01-0117100144The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional StudyShinsuke Tanizaki0Yasuo Toma1Katsuyoshi Miyashita2Shigenobu Maeda3Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan; To whom correspondence should be addressed: Shinsuke Tanizaki, M.D.Department of Neurosurgery, Fukui Prefectural Hospital, Fukui, JapanDepartment of Neurosurgery, Fukui Prefectural Hospital, Fukui, JapanDepartment of Emergency Medicine, Fukui Prefectural Hospital, Fukui, JapanObjectives: There is little evidence on the factors influencing the decision to withdraw or continue life-sustaining treatment in the setting of severe traumatic brain injury in Japanese institutions. We investigated the factors associated with the withdrawal or withholding of life-sustaining treatment (WLST) for severe traumatic brain injury at a single Japanese institution. Methods: A total of 161 patients with severe traumatic brain injury were retrospectively reviewed. Patient characteristics and injury types were compared between patients with and without the WLST. Results: Of the 161 patients, 87 (54%) died and 52 (32%) decided to undergo WLST. In 98% of the WLST cases, the decision was made within 24 h of admission. The mean duration between WLST and death was 2 days. The predicted probabilities for mortality and unfavorable outcomes were highest in patients with WLST within 24 h. Patients with WLST were older and had a higher frequency of falls on the ground, ischemic heart disease, and acute subdural hemorrhage than those without WLST. Conclusions: The decisions of almost all WLST cases were made within 24 h of admission for severe traumatic brain injury in a Japanese institution because of Japanese patients' religious and cultural backgrounds.http://www.sciencedirect.com/science/article/pii/S2590139722000291ConfucianismSevere traumatic brain injuryWithdrawal or withholding of life-sustaining treatment |
| spellingShingle | Shinsuke Tanizaki Yasuo Toma Katsuyoshi Miyashita Shigenobu Maeda The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study World Neurosurgery: X Confucianism Severe traumatic brain injury Withdrawal or withholding of life-sustaining treatment |
| title | The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study |
| title_full | The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study |
| title_fullStr | The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study |
| title_full_unstemmed | The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study |
| title_short | The Characteristics of Withdrawal or Withholding of Life-Sustaining Treatment in Severe Traumatic Brain Injury: A Single Japanese Institutional Study |
| title_sort | characteristics of withdrawal or withholding of life sustaining treatment in severe traumatic brain injury a single japanese institutional study |
| topic | Confucianism Severe traumatic brain injury Withdrawal or withholding of life-sustaining treatment |
| url | http://www.sciencedirect.com/science/article/pii/S2590139722000291 |
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