Factors associated with Limitation of Life Support: post-ICU mortality case study of a Tertiary Hospital

Background: Life-sustaining treatment limitation (LTSV) is the medical act of withdrawing or not initiating measures that are considered futile in a patient's specific situation. LTSV in critically ill patients remains a difficult topic to study, due to the multitude of factors that condition it. Objective: To determine factors related to LTSV in ICU in cases of post-ICU in-hospital mortality, as well as factors associated with survival after discharge from ICU. Design: Retrospective longitudinal study. Ambit: Intensive care unit of a tertiary hospital. Patients: People who died in the hospitalization ward after ICU treatment between January 2014 and December 2019. Interventions: None. This is an observational study. Variables of interest: Age, sex, probability of death, type of admission, LTSV in ICU, oncological disease, dependence, invasive mechanical ventilation, emergency hemodialysis, transfusion of blood products, nosocomial infection (NI), pre-ICU, intra-ICU and post-ICU stays. Results: Of 114 patients who died outside the ICU, 49 had LTSV registered in the ICU (42.98%). Age and stay prior to ICU admission were positively associated with LTSV (OR 1,03 y 1,08, respectively). Patients without LTSV had a higher post-ICU stay, while it was lower for male patients. Conclusions: Our results support that LTSV established within the ICU can avoid complications commonly associated with unnecessary prolongation of stay, such as NI.