Brain Injuries, Post ICU, Quality of Life
Conditions
Keywords
Quality of life, Withholding of life-sustaining treatments, Withdrawal of life-sustaining treatment, Severe acute brain injury
Brief summary
Withdrawal of life-sustaining treatment affects 10-15% of ICU patients, including those with severe acute brain injury, whose care appears futile in terms of prognosis based on clinical and paraclinical data, expected quality of life, patient preferences, age, or reduced quality of life. There are few studies on withholding treatment compared with withdrawing treatment, and even fewer on survivors after a decision to withhold treatment. Quality of life is defined by WHO as an individual's perception of his or her position in life in the context of the culture and value systems in which he or she lives and in relation to his or her goals, expectations, standards and concerns. The relationship between quality of life and neurological outcome after severe acute brain injury is controversial and therefore difficult to predict. That's why the investigators question the legitimacy of making decisions to withhold treatment from patients with severe acute brain injury based on their expected quality of life, when this prediction is uncertain.
Interventions
OTHERRecording data from the ICU stay and the post-ICU follow-up.
Record analysis of the post-ICU follow-up with the Interpretative Phenomenological Analysis
Sponsors
Centre Hospitalier Universitaire de Saint Etienne
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients: * with severe acute brain injury (TBI, stroke, central nervous system infection). * admitted in the neurocritical care unit in 2022. * followed up 24 months after ICU between 15th April 2024 and 31st August 2024.
Exclusion criteria
Patients: * death in 2024, * refusal by patient or relative.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Interpretative Phenomenological Analysis | 24 months after ICU discharge | Qualitative analysis of the quality of life in patients with severe acute brain injury and with withholding of life-sustaining treatment |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| International survey among neurointensivists from ANARLF network - questionnaires | Month : 3 | Comparison of the number of decisions of withholding treatment in the clinical cases versus real life |
| International survey among neurointensivists from ANARLF network - follow-up | Month : 3 | Comparison of the predicted neurological outcome and quality of life by neurointensivists versus the real neurological outcome and quality of life assessed at the post-ICU follow-up. |
Countries
France
Contacts
Primary ContactMarie DAKENG, resident
Backup ContactNory ELHADJENE, MD
Outcome results
None listed