School of Nursing, The University of Jordan, Amman, Jordan.
Am J Hosp Palliat Care. 2020 Oct;37(10):761-766. doi: 10.1177/1049909120902976. Epub 2020 Jan 29.
Information is presently lacking about the end-of-life care in intensive care unit (ICU). We explored the characteristics, mortality rates, and treatments received in the last few days of life for patients who died in ICU.
This was a retrospective multicenter cohort study. We included patients who died from different medical illnesses between January 2014 and January 2017 in 8 medical ICUs across 3 major health-care systems in Jordan. Of 11 029 patients who were admitted for the study in ICUs, data from 3885 health records were retrieved and analyzed. Pediatric patients aged younger than 18 years and patients admitted to an ICU for less than 4 hours were excluded.
The mean ICU mortality rate was 34.6% (29%-38%), with a slight decline from 2014 through 2016. Most of the patients who died were male (56.6%), transferred from the emergency department (46.8%), and had multiple comorbidities (74%). Cardiopulmonary resuscitation, invasive mechanical ventilation, pharmacological hemodynamic support, and artificial hydration were pursued until death for most patients (91.5%, 80.1%, 78.8%, and 94.1%, respectively).
Aggressive treatment modalities were usually pursued for critically ill patients at the end of their lives. There is a need to explore further the current end-of-life care needs and practices in ICUs in Jordan and to tailor end-of-life care and management suitably to meet the needs of Islamic and Arabic cultures.
目前缺乏关于重症监护病房（ICU）临终关怀的信息。我们探讨了在 ICU 死亡的患者生命最后几天的特征、死亡率和所接受的治疗。
这是一项回顾性多中心队列研究。我们纳入了 2014 年 1 月至 2017 年 1 月期间在约旦 3 大医疗保健系统的 8 家医疗 ICU 中因不同医疗疾病死亡的患者。在纳入 ICU 的 11029 名患者中，我们检索并分析了 3885 份病历的数据。排除了年龄小于 18 岁的儿科患者和 ICU 入住时间少于 4 小时的患者。
ICU 死亡率平均为 34.6%（29%-38%），从 2014 年到 2016 年略有下降。大多数死亡患者为男性（56.6%），从急诊室转入（46.8%），合并多种合并症（74%）。大多数患者（91.5%、80.1%、78.8%和 94.1%）接受心肺复苏、有创机械通气、药物血流动力学支持和人工补液直至死亡。
通常对生命垂危的患者在生命末期采用积极的治疗方式。需要进一步探讨约旦 ICU 目前的临终关怀需求和实践，并根据伊斯兰和阿拉伯文化的需求适当调整临终关怀和管理。
