Machine learning determination of motivators of terminal extubation during the transition to end-of-life care in intensive care unit
The result's identifiers
Result code in IS VaVaI
<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F23%3A43925142" target="_blank" >RIV/00064173:_____/23:43925142 - isvavai.cz</a>
Alternative codes found
RIV/00216208:11120/23:43925142
Result on the web
<a href="https://doi.org/10.1038/s41598-023-29042-9" target="_blank" >https://doi.org/10.1038/s41598-023-29042-9</a>
DOI - Digital Object Identifier
<a href="http://dx.doi.org/10.1038/s41598-023-29042-9" target="_blank" >10.1038/s41598-023-29042-9</a>
Alternative languages
Result language
angličtina
Original language name
Machine learning determination of motivators of terminal extubation during the transition to end-of-life care in intensive care unit
Original language description
Procedural aspects of compassionate care such as the terminal extubation are understudied. We used machine learning methods to determine factors associated with the decision to extubate the critically ill patient at the end of life, and whether the terminal extubation shortens the dying process. We performed a secondary data analysis of a large, prospective, multicentre, cohort study, death prediction and physiology after removal of therapy (DePPaRT), which collected baseline data as well as ECG, pulse oximeter and arterial waveforms from WLST until 30 min after death. We analysed a priori defined factors associated with the decision to perform terminal extubation in WLST using the random forest method and logistic regression. Cox regression was used to analyse the effect of terminal extubation on time from WLST to death. A total of 616 patients were included into the analysis, out of which 396 (64.3%) were terminally extubated. The study centre, low or no vasopressor support, and good respiratory function were factors significantly associated with the decision to extubate. Unadjusted time to death did not differ between patients with and without extubation (median survival time extubated vs. not extubated: 60 [95% CI: 46; 76] vs. 58 [95% CI: 45; 75] min). In contrast, after adjustment for confounders, time to death of extubated patients was significantly shorter (49 [95% CI: 40; 62] vs. 85 [95% CI: 61; 115] min). The decision to terminally extubate is associated with specific centres and less respiratory and/or vasopressor support. In this context, terminal extubation was associated with a shorter time to death.
Czech name
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Czech description
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Classification
Type
J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database
CEP classification
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OECD FORD branch
30221 - Critical care medicine and Emergency medicine
Result continuities
Project
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Continuities
I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace
Others
Publication year
2023
Confidentiality
S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů
Data specific for result type
Name of the periodical
Scientific Reports
ISSN
2045-2322
e-ISSN
2045-2322
Volume of the periodical
13
Issue of the periodical within the volume
February
Country of publishing house
GB - UNITED KINGDOM
Number of pages
10
Pages from-to
2632
UT code for WoS article
001100562500015
EID of the result in the Scopus database
2-s2.0-85148081876