Article
Author: Krzych, Lukasz J ; Białka, Szymon ; Sierakowska, Katarzyna ; Szymkowiak, Małgorzata ; Flaatten, Hans ; Czajka, Szymon ; Szczeklik, Wojciech ; Kudliński, Bartosz ; Machała, Waldemar ; Pasieka, Paweł ; Żukowski, Maciej ; Cyrankiewicz, Waldemar ; Sadowski, Łukasz ; Solek-Pastuszka, Joanna ; Surówka, Anna ; Kościuczuk, Urszula ; Studzińska, Dorota ; Biernawska, Jowita ; Nowak, Łukasz R ; Popek, Natalia ; Janc, Jarosław ; Gawda, Ryszard ; Owczuk, Radosław ; Hymczak, Hubert ; Bernas, Szymon ; Mudyna, Wojciech ; Nasiłowski, Paweł ; Gola, Wojciech ; Zatorski, Paweł ; Trzebicki, Janusz ; Goździk, Waldemar ; Borys, Michał ; Piechota, Mariusz ; Czuczwar, Mirosław ; Skwara, Evan ; Fronczek, Jakub ; Kluzik, Anna ; Adamik, Barbara ; Kozera, Natalia ; Skowronek, Jacek ; Grudzień, Paweł ; Wieczorek, Agnieszka ; Cwyl, Katarzyna ; Kotfis, Katarzyna ; Ziętkiewicz, Mirosław ; Stefaniak, Jan ; Krawczyk, Paweł
PURPOSE:Several 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.
METHODS:We 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.
RESULTS:601 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).
CONCLUSIONS:The 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.