Introduction Racial disparities in medical treatment for seriously injured patients across the spectrum of care are well established, but racial disparities in end of life decision-making practices have not been well described. When time from admission to time to withdrawal of life-sustaining treatment (WLST) increases, so does the potential for ineffective care, healthcare resource loss, and patient and family suffering. We sought to determine the existence and extent of racial disparities in late WLST after severe injury. Methods We queried the American College of Surgeons’ (ACS) Trauma Quality Improvement Program (TQIP) (2013 – 2016) for all severely injured patients (injury severity score > 15, age > 16) with a WLST order > 24 hours after admission. We defined late WLST as care withdrawn at a time interval beyond the 75th percentile for the entire cohort. Univariate and multivariate analyses were performed utilizing descriptive statistics, and t-tests and chi-squared tests where appropriate. Multivariable regression analysis was performed with random effects to account for institutional-level clustering using late WLST as the primary outcome, and race as the primary predictor of interest. Results 13,054 patients from 393 centers were included in the analysis. Median time to WLST was 5.4 days (IQR 2.6-10.3). In our unadjusted analysis, African-American patients (10.1% vs 7.1%, p
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2Dl3oxy
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Champion EMS is currently seeking a Communications Center Manager. Champion EMS is based out of Longview, Texas, serving the East Texas area...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
The name of the second author of this article was incorrectly presented as "Riccardo Scarpa Cosimo" this should have been "Co...
-
Abstract Given shifting sex work criminalization and enforcement in Canada, this study examined worrying about workplace inspections by au...
-
Abstract Introduction In recent years, platelet-rich plasma (PRP) has emerged as a promising autologous biological treatment modality fo...
-
Abstract Background Permissive hypotensive resuscitation (PHR) is an advancing concept aiming towards deliberative balanced resuscitation ...
-
from EMS via xlomafota13 on Inoreader http://ift.tt/2sbML2K
-
While the psychiatric disorders are conditions frequently encountered in hospitalized patients, there are little or no data regarding the ch...
-
No abstract available from Emergency Medicine via xlomafota13 on Inoreader https://ift.tt/2Tlj4K7
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου