Article Figures & Tables
Tables
Variable No. (%) of cohort* Nursing home
n = 230ECMO
n = 109Age, yr Mean ± SD 72.0 ± 10.6 51.8 ± 15.8 Median (IQR) 73 (64–80) 56 (44–64) Sex, female 103 (44.8) 45 (41.3) Year of admission 2000–2004 5 (2.2) 0 2005–2009 70 (30.4) 8 (7.3) 2010–2014 88 (38.3) 60 (55.0) 2015–2017 67 (29.1) 41 (37.6) Location of residence Urban 77 (70.6) Rural 26 (23.9) Out-of-province or nursing home resident 6 (5.5) Socioeconomic status quintile 1 (lowest income) 29 (28.2) 2 24 (23.3) 3 11 (10.7) 4 17 (16.5) 5 (highest income) 22 (21.4) Category of primary diagnosis at admission Cardiovascular 52 (21.7) 59 (54.1) Infectious 78 (33.9) 26 (23.9) Respiratory 47 (20.4) 23 (21.1) All others 55 (23.9) 1 (0.9) Disease severity APACHE II score, mean ± SD 22.4 ± 6.4 28.5 ± 8.1 APACHE II score, median (IQR) 22 (17–27) 27 (22–35) GCS, mean ± SD 12.0 ± 3.4 8.3 ± 4.6 GCS, median (IQR) 13 (10–15) 7 (3–13) APS, mean ± SD 12.9 ± 4.8 18.7 ± 6.0 APS, median (IQR) 13 (9–16) 18 (14–23) APS-neuro score, mean ± SD 10.1 ± 5.4 12.0 ± 7.1 APS-neuro score, median (IQR) 10 (6–14) 12 (7–17) Elapsed ACP time, d Mean ± SD, 2.9 ± 6.2 9.1 ± 16.3 Median (IQR) 1.0 (1–2) 4.0 (1–13) ECMO type Venovenous with or without arteriovenous 16 (14.7) Arteriovenous only 91 (83.5) Level of care† Resuscitation 56 (24.3) 44 (40.4) Medical 90 (39.1) 6 (5.5) Comfort care 57 (24.8) 45 (41.3) Missing 27 (11.8) 14 (12.8) Hospital length of stay, d Mean ± SD 20.1 ± 33.4 33.8 ± 35.1 Median (IQR) 11 (6–19) 20 (9–48) Hospital death 69 (30.0) 51 (46.8) Note: APACHE = acute physiology and chronic health evaluation, APS = acute physiology score, APS-neuro score = APS score with neurologic component removed, ECMO = extracorporeal membrane oxygenation, elapsed ACP time = elapsed advance care planning time (i.e., interval between ICU admission and first chart documentation of the level of care), GCS = Glasgow Coma Scale, ICU = intensive care unit, IQR = interquartile range, SD = standard deviation.
↵* Unless indicated otherwise.
↵† Least aggressive level of care recorded.
- Table 2:
Quality of end-of-life communication among 2 ICU cohorts, 2000–2017, unadjusted values*
Weighted scores* Nursing home cohort ECMO cohort p value† Composite measure of EOL communication* Mean ± SD 48.5 ± 25.8 49.1 ± 25.9 0.67 Median (IQR) 56.2 (28.4–73.8) 52.2 (27.5–68.9) 0.86 Goals of care communication subscore Mean ± SD 39.9 ± 28.5 44.7 ± 29.1 0.17 Median (IQR) 43.4 (8.2–63.5) 50.0 (15.2–70.5) 0.14 Documentation subscore Mean ± SD 70.9 ± 28.2 60.3 ± 27.1 0.001 Median (IQR) 80.3 (62.6–83.5) 63.8 (42.9–83.5) 0.001 - Table 3:
Median regression results for composite measure of end-of-life communication among 2 ICU cohorts, 2000–2017
Variable Coefficient (95% CI) Cohort Nursing home cohort Reference ECMO cohort −0.56 (−13.15 to 12.02) Age (per year) 0.50 (0.21 to 0.78)* Sex Male Reference Female −2.29 (−12.21 to 7.63) Year of admission (per year) 1.69 (0.54 to 2.84)* Glasgow Coma Scale score (per point) −1.84 (−3.21 to −0.47)* APS-neuro score (per point) 0.72 (−0.18 to 1.63) Category of primary diagnosis at admission Cardiovascular Reference Infectious 0.93 (−9.02 to 10.88) Respiratory −8.56 (−24.16 to 7.05) Other −3.42 (−15.76 to 8.92) Note: APS-neuro score = acute physiologic score with neurologic component removed, CI = confidence interval, ECMO = extracorporeal membrane oxygenation
↵* p value significant after adjustment for multiple comparisons using the 0.05 false discovery rate threshold.