Withholding of Life-sustaining Treatment and Quality of Life After Severe Acute Brain Injury: Qualitative Analysis and Ethical Issues

Centre Hospitalier Universitaire de Saint Etienne

Status: Enrolling

Conditions: Brain Injuries; Quality of Life; Post ICU

Treatments: Other: Recording data from the ICU stay and the post-ICU follow-up.

Study type: Observational

Funder types: Other

Identifiers

NCT06523127

IRBN672024/CHUSTE

Details and patient eligibility

About

Withdrawal of life-sustaining treatment affects 10-15% of ICU patients, including those with severe acute brain injury, whose care appears futile in terms of prognosis based on clinical and paraclinical data, expected quality of life, patient preferences, age, or reduced quality of life.

There are few studies on withholding treatment compared with withdrawing treatment, and even fewer on survivors after a decision to withhold treatment.

Quality of life is defined by WHO as "an individual's perception of his or her position in life in the context of the culture and value systems in which he or she lives and in relation to his or her goals, expectations, standards and concerns". The relationship between quality of life and neurological outcome after severe acute brain injury is controversial and therefore difficult to predict.

That's why the investigators question the legitimacy of making decisions to withhold treatment from patients with severe acute brain injury based on their expected quality of life, when this prediction is uncertain.

Enrollment: 14 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

Patients:

• with severe acute brain injury (TBI, stroke, central nervous system infection).
• admitted in the neurocritical care unit in 2022.
• followed up 24 months after ICU between 15th April 2024 and 31st August 2024.

Exclusion criteria

Patients:

• death in 2024,
• refusal by patient or relative.

Trial design

14 participants in 2 patient groups

Patients with severe acute brain injury and with withholding of life-sustaining treatment

Description:

Assessment of quality of life in patients with severe acute brain injury based on the audio recording during post-ICU follow-up.

Treatment:

Other: Recording data from the ICU stay and the post-ICU follow-up.

Patients with severe acute brain injury and without withholding of life-sustaining treatment

Description:

Assessment of quality of life in patients with severe acute brain injury based on the audio recording during post-ICU follow-up.

Treatment:

Other: Recording data from the ICU stay and the post-ICU follow-up.