Thursday, September 1, 2011

Removal of life support may occur too early in some cases

There are notable differences in mortality rates after traumatic brain injury from hospital to hospital. The results of a new Canadian study have found that those differences may be attributable to individual hospital practices; specifically, how different hospitals handle the removal of life support from such patients.

. . . In a number of cases of death due to withdrawal of life support, death occurred within the first three days of care. In most cases, life support was removed because the patient had a poor chance of survival, poor long-term neurological prognosis, or a prognosis which was not compatible with his or her wishes.
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Though all are legitimate reasons to cease life-sustaining therapy with a patient, researchers warned that some trauma centers may be making these calls too early. Especially given that many traumatic brain injury cases – often the result of car accidents, assaults, etc. – occur in young people whose chances of recovering from such injury are greater than someone who is older, three days of care may not be enough time to give an accurate prognosis.

The authors admitted several limitations to the study, among which was the reliance on patient medical records which may have led to an underestimation of the frequency of life support withdrawal. However, the results leave us with important things to consider. Researchers encourage doctors to communicate frequently with families of severe brain injury patients if removal of life support or life-sustaining therapy may become necessary. Healthwatch MD

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