BackgroundAlthough the Life-Sustaining Treatment (LST) Decision Act was enforced in 2018 in Korea, data on whether it is well established in actual clinical settings are limited. Hospital-acquired pneumonia (HAP) is a common nosocomial infection with high mortality. However, there are limited data on the end-of-life (EOL) decision of patients with HAP. Therefore, we aimed to examine clinical characteristics and outcomes according to the EOL decision for patients with HAP.MethodsThis multicenter study enrolled patients with HAP at 16 referral hospitals retrospectively from (...) January to December 2019. EOL decisions included do-not-resuscitate (DNR), withholding of LST, and withdrawal of LST. Descriptive and Kaplan–Meier curve analyses for survival were performed.ResultsOf 1,131 patients with HAP, 283 deceased patients with EOL decisions (105 cases of DNR, 108 cases of withholding of LST, and 70 cases of withdrawal of LST) were analyzed. The median age was 74 (IQR 63–81) years. The prevalence of solid malignant tumors was high (32.4% vs. 46.3% vs. 54.3%, P = 0.011), and the ICU admission rate was lower (42.9% vs. 35.2% vs. 24.3%, P = 0.042) in the withdrawal group. The prevalence of multidrug-resistant pathogens, impaired consciousness, and cough was significantly lower in the withdrawal group. Kaplan–Meier curve analysis revealed that 30-day and 60-day survival rates were higher in the withdrawal group than in the DNR and withholding groups (log-rank P = 0.021 and 0.018). The survival of the withdrawal group was markedly decreased after 40 days; thus, the withdrawal decision was made around this time. Among patients aged below 80 years, the rates of EOL decisions were not different (P = 0.430); however, mong patients aged over 80 years, the rate of withdrawal was significantly lower than that of DNR and withholding (P = 0.001).ConclusionsAfter the LST Decision Act was enforced in Korea, a DNR order was still common in EOL decisions. Baseline characteristics and outcomes were similar between the DNR and withholding groups; however, differences were observed in the withdrawal group. Withdrawal decisions seemed to be made at the late stage of dying. Therefore, advance care planning for patients with HAP is needed. (shrink)

« Il faudrait écrire un autre livre pour pouvoir consacrer à ces dossiers toute l'attention qu'il mérite » écrit J.P. Albert dans sa conclusion. Son ouvrage dense, vigoureux, foisonnant d'avancées prometteuses se restreint, en effet, difficilement à l'étude des voies singulières de la sanctification des femmes dans le christianisme romain et le lecteur de subodorer que cette recherche passionnée et passionnante risque fort de déboucher sur deux autres publications, l'une consacrée à un...

1. T'oegye wa Hip'ok'ŭrat'esŭ ka mannagi kkaji -- 2. Taehwa e ch'amyŏ hasin pundŭl -- 3. Che 1-il. 'Kojŏn muksang' : kijon ŭi palgyŏndŭl ŭl ch'ulbalchŏm ŭro samaya -- 4. Che 2-il. 'Chonjaeron': mom an ŭi param ŭn hohŭp, mom pak ŭi param ŭn konggi -- 5. Che 3-il. 'Chŏngsŏ haengdongnon': chari ŭi ch'ai ro inhae sŏro tarŭda -- 6. Che 4-il. 'Kongburon': chonjae haji annŭn ŭisul ŭn ŏpta -- 7. Che 5-il. 'Chihaengnon': maŭm i p'yŏnhaji anŭl ttae nŭn han (...) kŏrŭm kŏrŏra -- 8. Che 6-il. 'Yulliron': kajang hullyunghan ŭihak ŭn ŭihak ŭl p'iryo ro haji ank'e hanŭn kŏt -- 9. Che 7-il. 'Chilli nŭn kat'ŭn kot e': modŭn kŏt ŭi sijak kwa kkŭt ŭn hana ida -- 10. Hip'ok'ŭrat'esŭ myŏngŏndŭl. (shrink)

[1]. Nonmun p'yŏn -- [2-3]. Charyo p'yŏn, 1-2.

1-2. Charyo p'yŏn, 1-2 -- [3]. Nonmun p'yŏn.

언론현상과 제문제를 철학적 관점에서 연구 분석한 논저. 도덕:저널리즘과 윤리 가치론:언론과 가치 등모두 9편을 실었다.

1. Yesul esŏŭi poiji annŭn kŏt -- 2. Mom ŭi chŏngch'i wa munhak ŭi mijongmal.

Che 1-kwŏn. Kodae-kŭndae sasang -- che 2-kwŏn. Hyŏndae sasang.