0000000000123405

AUTHOR

Lawton T.

0000-0003-1351-8127

showing 5 related works from this author

Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit

2018

PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU len…

Malemedicine.medical_treatmentHSJ UCICritical Care and Intensive Care Medicinelaw.inventionLife sustaining treatment0302 clinical medicineElderlylaw80 and overMedicine030212 general & internal medicineProspective StudiesProspective cohort studyAged 80 and overeducation.field_of_studyWithholding Treatmentddc:617[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontologyWithholdingIntensive care unit3. Good healthEuropeagedIntensive Care UnitsWithdrawalSOFA scoreHumanmedicine.medical_specialtyethical aspectsPopulationIntensive Care UnitDecision MakingElderly; Ethics; Intensive care; Life sustaining treatment; Withdrawal; Withholding;life-sustaining therapyNO03 medical and health sciencesIntensive careAnesthesiologyHumansEthiceducationMechanical ventilationEthicsbusiness.industry030208 emergency & critical care medicineElderly; Ethics; Intensive care; Life sustaining treatment; Withdrawal; Withholdingcritical careLife Support CareProspective StudieWithholding TreatmentIntensive careEmergency medicineElderly; Ethics; Intensive care; Life sustaining treatment; Withdrawal; Withholding; Aged 80 and over; Decision Making; Europe; Humans; Intensive Care Units; Male; Prospective Studies; Life Support Care; Withholding Treatmentbusiness
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Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre…

2021

BackgroundRespiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity.MethodsPRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of…

Pulmonary and Respiratory Medicinemedicine.medical_treatmentPopulationNO03 medical and health sciences0302 clinical medicineCPAPAbdomenSettore MED/41 - ANESTESIOLOGIAIntubation IntratrachealmedicineHumansIntubation030212 general & internal medicineContinuous positive airway pressureAdverse effecteducationeducation.field_of_studyContinuous Positive Airway Pressurebusiness.industryrespiratory complications; continuous positive airway pressure; major abdominal surgeryPneumoniaMiddle Agedmedicine.diseaserespiratory tract diseasesIntratrachealPneumoniaTreatment Outcome030228 respiratory systemRespiratory failureAnesthesiaVomitingmedicine.symptomRespiratory InsufficiencyIntubationbusinessAbdominal surgery
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Sepsis at ICU admission does not decrease 30-day survival in very old patients : a post-hoc analysis of the VIP1 multinational cohort study

2020

AbstractBackgroundThe number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival.ResultsThis prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admi…

INTENSIVE-CARE-UNITSurvivalHSJ UCICritical Care and Intensive Care Medicinesurvival analysislaw.inventionsepsisSeverity of illne0302 clinical medicineLONG-TERM OUTCOMESoverlevingsanalyselawMedicine and Health SciencesEPIDEMIOLOGYIntensive care; Mortality; Outcome; Sepsis; Severity of illness; Survival; Very old030212 general & internal medicineProspective cohort studyELDERLY-PATIENTSOutcomeddc:617PATIENTS AGED 80lcsh:Medical emergencies. Critical care. Intensive care. First aidVery OldIntensive care unitSOFA scoremedicine.symptomCRITICALLY-ILL PATIENTSWITHDRAWALhormones hormone substitutes and hormone antagonistsmedicine.medical_specialtySepsiVery oldelderly patientsSeverity of illnessNOSepsis03 medical and health sciencessterfteSepsisInternal medicineIntensive careSeverity of illnessmedicineMortalityFRAILTYbusiness.industrySeptic shockResearchSEPTIC SHOCKOrgan dysfunctionIntensive Care030208 emergency & critical care medicinelcsh:RC86-88.9oudere patiëntenmedicine.diseaseIntensive carebusiness
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Cumulative Prognostic Score Predicting Mortality in Patients Older Than 80 Years Admitted to the ICU

2019

OBJECTIVES To develop a scoring system model that predicts mortality within 30 days of admission of patients older than 80 years admitted to intensive care units (ICUs). DESIGN Prospective cohort study. SETTING A total of 306 ICUs from 24 European countries. PARTICIPANTS Older adults admitted to European ICUs (N = 3730; median age = 84 years [interquartile range = 81‐87 y]; 51.8% male). MEASUREMENTS Overall, 24 variables available during ICU admission were included as potential predictive variables. Multivariable logistic regression was used to identify independent predictors of 30‐day mortality. Model sensitivity, specificity, and accuracy were evaluated with receiver operating characteris…

MaleINTENSIVE-CARE-UNITOrgan Dysfunction Scoresmedicine.medical_treatmentPrognosis.MedizinDECISION-MAKINGLogistic regressionlaw.inventionolder adult0302 clinical medicinePHYSICIANSInterquartile rangelaw80 and overMedicine and Health Sciences030212 general & internal medicineHospital MortalityProspective StudiesProspective cohort studyolder adultsAged 80 and overpredictddc:617Respiration[SDV.MHEP.GEG]Life Sciences [q-bio]/Human health and pathology/Geriatry and gerontologyBrief ReportPrognosisIntensive care unitADMISSION3. Good healthEuropeHospitalizationIntensive Care UnitsBrier scoreOlder adultsArtificialFemaleprognosimedicine.medical_specialtycritical care; model; older adults; predict; prognosis; Aged 80 and over; Europe; Female; Hospital Mortality; Hospitalization; Humans; Intensive Care Units; Male; Prospective Studies; Respiration Artificial; Organ Dysfunction Scores; Prognosis03 medical and health sciencesIntensive caremedicineJournal ArticleHumansILL ELDERLY-PATIENTSRenal replacement therapyAgedmodelReceiver operating characteristicbusiness.industry030208 emergency & critical care medicineRespiration Artificialcritical careEmergency medicine[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologieBrief ReportsprognosisGeriatrics and Gerontologybusiness
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Correction to: Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit (Intensive Care…

2018

In the original publication Dr Patrick Meybohm of the Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy, Frankfurt University Hospital, Frankfurt, Germany was inadvertently omitted from the list of investigators.

End of lifeICUwithdrawing
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