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Critical Care
Published in: Critical Care 4/2010

Open Access 01-08-2010 | Research

Retrospective agreement and consent to neurocritical care is influenced by functional outcome

Authors: Ines C Kiphuth, Martin Köhrmann, Joji B Kuramatsu, Christoph Mauer, Lorenz Breuer, Peter D Schellinger, Stefan Schwab, Hagen B Huttner

Published in: Critical Care | Issue 4/2010

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Abstract

Introduction

Only limited data are available on consent and satisfaction of patients receiving specialized neurocritical care. In this study we (i) analyzed the extent of retrospective consent to neurocritical care--given by patients or their relatives--depending on functional outcome one year after hospital stay, and (ii) identified predisposing factors for retrospective agreement to neurocritical care.

Methods

We investigated 704 consecutive patients admitted to a nonsurgical neurocritical care unit over a period of 2 years (2006 through 2007). Demographic and clinical parameters were analyzed, and the patients were grouped according to their diagnosis. Functional outcome, retrospective consent to neurocritical care, and satisfaction with hospital stay was obtained by mailed standardized questionnaires. Logistic regression analyses were calculated to determine independent predictors for consent.

Results

High consent and satisfaction after neurointensive care (91% and 90%, respectively) was observed by those patients who reached an independent life one year after neurointensive care unit (ICU) stay. However, only 19% of surviving patients who were functionally dependent retrospectively agreed to neurocritical care. Unfavorable functional outcome and the diagnosis of stroke were independent predictors for missing retrospective consent.

Conclusions

Retrospective agreement to neurocritical care is influenced by functional outcome. Especially in severely affected stroke patients who cannot communicate their preferences regarding life-sustaining therapy, neurocritical care physicians should balance the expected burdens and benefits of treatment to meet the patients' putative wishes. Efforts should be undertaken to identify predictors for severe disability after neurocritical care.
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Metadata
Title
Retrospective agreement and consent to neurocritical care is influenced by functional outcome
Authors
Ines C Kiphuth
Martin Köhrmann
Joji B Kuramatsu
Christoph Mauer
Lorenz Breuer
Peter D Schellinger
Stefan Schwab
Hagen B Huttner
Publication date
01-08-2010
Publisher
BioMed Central
Published in
Critical Care / Issue 4/2010
Electronic ISSN: 1364-8535
DOI
https://doi.org/10.1186/cc9210

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