Prevalence of life-sustaining treatment limitations in Polish very old intensive care patients (VIPs). A post-hoc analysis of two prospective observational studies

Purpose: Several initiatives have recently focused on raising awareness about limitations of treatment in Poland. We aimed to assess if the propensity to limit LST among elderly patients in 2018-2019 increased compared to 2016-2017.Methods: We analysed Polish cohorts from studies VIP1 (October 2016 -May 2017) and VIP2 (May 2018 -May 2019) that enrolled critical patients aged >80. We collected data on demographics, clinical features limitations of LST. Primary analysis assessed factors associated with prevalence of limitations of LST, A secondary analysis explored differences between patients with and without limitations of LST.Results: 601 patients were enrolled. Prevalence of LST limitations was 16.1% in 2016-2017 and 20.5% in 2018-2019. No difference was found in univariate analysis (p = 0.22), multivariable model showed higher propensity towards limiting LST in the 2018-2019 cohort compared to 2016-2017 cohort (OR 1.07;95%CI, 1.01-1.14). There was higher mortality and a longer length of stay of patients with limitations of LST compared to the patients without limitations of LST. (11 vs. 6 days, p = 0.001).Conclusions: The clinicians in Poland have become more proactive in limiting LST in critically ill patients >= 80 years old over the studied period, however the prevalence of limitations of LST in Poland remains low.

Automated summary

The study aims to evaluate whether there is an increased propensity to limit life-sustaining treatment (LST) among elderly patients in Poland from 2018-2019 compared to 2016-2017. The results show that clinicians in Poland have become more proactive in limiting LST in critically ill patients aged 80 and above during the studied period, although the prevalence of LST limitations in Poland remains low.