Study Suggests Waiting Longer Before Withdrawing Life Support
The New York Times
A review of a limited number of cases of unresponsive patients with severe traumatic brain injuries raised questions about a custom of making a decision within 72 hours.
When a patient with a severe traumatic brain injury is comatose, in intensive care, unresponsive and hooked up to a ventilator, but not brain-dead, when is the time to withdraw life support? A small study on the fates of people in such situations suggests that doctors and patients’ families may make better decisions if they wait even a few days longer than usual.
Often, a doctor sits down with family members within 72 hours of the patient’s admission to intensive care to discuss the patient’s prognosis, and whether they want to keep their loved one alive, or to remove life support.
Experts say that many doctors would describe the outlook as grim — most likely death or severe disability. Reported outcomes of patients who had severe traumatic brain injuries show that most times the decision is to remove life support. The patient dies.
The researchers behind the new study say that their limited data suggests that doctors’ predictions so soon after the injury frequently are wrong.
The study, published Monday in Journal of Neurotrauma, used a national database that included 1,392 traumatic brain injury patients.
Sifting through the data, they ended up comparing 80 patients with severe injuries who died after life support was withdrawn, with 80 similar patients whose life support was not withdrawn.
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