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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Patients with severe acute brain injury and with withholding of life-sustaining treatment | Assessment of quality of life in patients with severe acute brain injury based on the audio recording during post-ICU follow-up. |
| |
| Patients with severe acute brain injury and without withholding of life-sustaining treatment | Assessment of quality of life in patients with severe acute brain injury based on the audio recording during post-ICU follow-up. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Recording data from the ICU stay and the post-ICU follow-up. | Other | Record analysis of the post-ICU follow-up with the Interpretative Phenomenological Analysis |
|
| Measure | Description | Time Frame |
|---|---|---|
| Interpretative Phenomenological Analysis | Qualitative analysis of the quality of life in patients with severe acute brain injury and with withholding of life-sustaining treatment | 24 months after ICU discharge |
| Measure | Description | Time Frame |
|---|---|---|
| International survey among neurointensivists from ANARLF network - questionnaires | Comparison of the number of decisions of withholding treatment in the clinical cases versus real life | Month : 3 |
| International survey among neurointensivists from ANARLF network - follow-up |
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Inclusion Criteria:
Patients:
Exclusion Criteria:
Patients:
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Patients with acute brain injury admitted to intensive care in 2022 will be included.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Marie DAKENG, resident | Contact | (0)4 77 82 83 29 | +33 | mcgperret@gmail.com |
| Nory ELHADJENE, MD | Contact | (0)4 77 82 83 29 | +33 | Nory.ELHADJENE@chu-st-etienne.fr |
| Name | Affiliation | Role |
|---|---|---|
| Marie DAKENG, resident | Centre Hospitalier Universitaire de Saint Etienne | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier Universitaire de Saint Etienne | Recruiting | Saint-Etienne | 42055 | France |
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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. |
| Month : 3 |
| ID | Term |
|---|---|
| D001930 | Brain Injuries |
| ID | Term |
|---|---|
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D006259 | Craniocerebral Trauma |
| D020196 | Trauma, Nervous System |
| D014947 | Wounds and Injuries |
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