Analysis Of Terminally Terminated Treatment For ICU Critical Patients

Objective As the continuous development of modern medicine and the change of disease spectrum,more and more patients and their families realize that even in the ICU with high-tech technical support and accurate monitoring equipment and instruments,many diseases are not expected to be cured,and some patients entering the end-stage period will be affected by the economy.Conditions and physical and mental pain decided to give up life support treatment.Nowadays,in many western countries,there are already relevant operational norms for whether patients with ICU critical end-stage patients give up life support treatment.However,in the cultural background of Chinese Confucianism,"emphasizing life and dying of life",the abandonment of life support treatment is often held.Negative attitudes,lack of normative documents on whether to terminate treatment and terminate treatment.Therefore,this study retrospectively analyzed the clinical data of ICU patients with severe end-stage disease,summarized the status of patients with termination of treatment,and explored the factors affecting patients' adherence to life support treatment(age,condition,payment method,economic status,family education level,etc.)),in turn,how ICU medical staff can provide support to end-stage patients and their families in terms of attitudes,theories,and care programs to improve the quality of death in patients with end-stage disease.Methods From January 2009 to December 2017,5012 patients with ICU admitted to the People's Hospital of Leling City,Shandong Province,retrospectively analyzed the clinical data of 192 patients with end-stage disease who met the study criteria,and the proportion of patients who gave up life support treatment,and automatically discharged from hospital.The signatory of the consent form,the choice to abandon the type of life support treatment,and the abandonment of the patient's outcome after life support treatment.The 192 patients to be included were divided into unsigned and signed groups according to the signed automatic discharge informed consent form.Comparison of two groups of agAcute Pysiology and Chronic Health Evaluation score,SOFA score,gender,occupation,marital status,place of residence,payment method,average total hospitalization expenses,average drug expenses as a percentage of total hospitalization expenses,family education level,and total family monthly income The analysis included the factors in the single factor and the meaningful factors to the multivariate analysis,and the logistic regression analysis was used to investigate the influencing factors of the abandonment of life support treatment in ICU patients with severe end-stage disease.Results(1)Of the 192 patients included in the study,122(63.54%)had a decision to abandon life support treatment,and 121 of them(99.18%)were signed by the family members,and only 1(0.82%)were patients.Individuals signed,no medical staff signed the case.(2)Abandonment of life support treatment The choice of abandonment measures to give up the most(38.52%),followed by only conventional fluids(23.77%);the abandonment of life support treatment outcomes:automatic discharge of 88 cases(72.13%),32 cases(26.23%)died during hospitalization in ICU,and returned to the original ward 2 cases(1.64%).(3)The univariate analysis showed that the age of signature group(>75 years old),the educational level of family members(>junior college),the proportion of family income(<3000 yuan/month)and the proportion of average total hospitalization expenses and average drug expenses in total hospitalization expenses were higher than those of non-signature group(P<0.05).(4)Regression analysis showed that the influencing factors of giving up life support treatment in ICU patients included age,average total hospitalization expenses,average drug expenses in the proportion of total hospitalization expenses,family education level,family monthly total income,etc.Conclusion It is becoming more and more common for patients with severe end-stage ICU to give up life support treatment.In the type of abandonment treatment,the proportion of all abandonment and infusion only conventional fluids is the highest.After giving up treatment,patients are automatically discharged from the hospital,and whether they give up life support treatment.It is not only affected by the patient's age,average total hospitalization expenses,and total monthly family income,but also closely related to the family's family education level and average drug cost to the total hospitalization expenses.However,there is no obvious difference between the patient'Acute Pysiology and Chronic Health Evaluations score,SOFA score and payment method.Correlation,the reason may be that ICU patients with severe end-stage disease are more critical,and the payment method is mostly paid through medical insurance,and the difference between the patient's condition and payment method is small.