• Journal of critical care · Feb 2024

    Observational Study

    Prevalence of life-sustaining treatment limitations in Polish very old intensive care patients (VIPs). A post-hoc analysis of two prospective observational studies.

    • Paweł Pasieka, Anna Surówka, Jakub Fronczek, Evan Skwara, Mirosław Czuczwar, Michał Borys, Paweł Krawczyk, Mirosław Ziętkiewicz, Łukasz R Nowak, Maciej Żukowski, Katarzyna Kotfis, Katarzyna Cwyl, Jacek Skowronek, Joanna Solek-Pastuszka, Jowita Biernawska, Paweł Grudzień, Paweł Nasiłowski, Natalia Popek, Waldemar Cyrankiewicz, Katarzyna Sierakowska, Wojciech Mudyna, Szymon Białka, Dorota Studzińska, Szymon Bernas, Mariusz Piechota, Waldemar Machała, Łukasz Sadowski, Jan Stefaniak, Radosław Owczuk, Małgorzata Szymkowiak, Ryszard Gawda, Natalia Kozera, Barbara Adamik, Waldemar Goździk, Agnieszka Wieczorek, Jarosław Janc, Anna Kluzik, Janusz Trzebicki, Paweł Zatorski, Wojciech Gola, Hubert Hymczak, Lukasz J Krzych, Szymon Czajka, Urszula Kościuczuk, Bartosz Kudliński, Hans Flaatten, and Wojciech Szczeklik.
    • Center for Intensive Care and Perioperative Medicine, Jagiellonian University Medical College, Kraków, Poland. Electronic address: pawel.pasieka@doctoral.uj.edu.pl.
    • J Crit Care. 2024 Feb 1; 79: 154439154439.

    PurposeSeveral initiatives have recently focused on raising awareness about limitations of treatment in Poland. We aimed to assess if the propensity to limit LST among elderly patients in 2018-2019 increased compared to 2016-2017.MethodsWe analysed Polish cohorts from studies VIP1 (October 2016 - May 2017) and VIP2 (May 2018 - May 2019) that enrolled critical patients aged >80. We collected data on demographics, clinical features limitations of LST. Primary analysis assessed factors associated with prevalence of limitations of LST, A secondary analysis explored differences between patients with and without limitations of LST.Results601 patients were enrolled. Prevalence of LST limitations was 16.1% in 2016-2017 and 20.5% in 2018-2019. No difference was found in univariate analysis (p = 0.22), multivariable model showed higher propensity towards limiting LST in the 2018-2019 cohort compared to 2016-2017 cohort (OR 1.07;95%CI, 1.01-1.14). There was higher mortality and a longer length of stay of patients with limitations of LST compared to the patients without limitations of LST. (11 vs. 6 days, p = 0.001).ConclusionsThe clinicians in Poland have become more proactive in limiting LST in critically ill patients ≥80 years old over the studied period, however the prevalence of limitations of LST in Poland remains low.Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.

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