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The Impact of Delirium on Withdrawal of Life-Sustaining Treatment After Intracerebral Hemorrhage

By Currents Editor posted 11-24-2020 13:43

  

Neurology (11/17/20) Vol. 95, No. 20  doi: 10.1212/WNL.0000000000010738
Reznik, Michael E.; Moody, Scott; Murray, Kayleigh; et al.
https://n.neurology.org/content/95/20/e2727

 

Researchers report an association between delirium and withdrawal of life-sustaining treatment (WLST) after intracerebral hemorrhage (ICH). In a single-center cohort study of 311 patients with ICH, 50% had delirium and WLST occurred in 26%. The median time to WLST was 1 day. Patients who developed delirium were more likely to have WLST. Rates of WLST were high among both early and later delirium patients. With an area under the curve (AUC) of 0.902, an ICH score-based model was strongly predictive of WLST. The model’s accuracy increased when a delirium category was added, with an AUC of 0.936. Based on the findings, the researchers recommend additional study on the effects of delirium on clinician and surrogate decision-making.

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