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

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

Recruiting
18 years and older
All
Phase N/A

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Overview

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.

Eligibility

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.

Study details
    Quality of Life
    Brain Injuries
    Post ICU

NCT06523127

Centre Hospitalier Universitaire de Saint Etienne

21 October 2025

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