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Table 3 Impact of the LWAT file on end-of-life management

From: Formal procedure to facilitate the decision to withhold or withdraw life-sustaining interventions in a neonatal intensive care unit: a seven-year retrospective study

  Cohort 1 with meeting (n = 25) Cohort 2 Meeting + file (n = 52) p value
Age at death, mean (+/− SD), median (IQR) (days) 28.3 (36.4)
14 (36)
21.7 (25.6)
11 (17.5)
0.556
Death < 1 week, n (%) 8 (32) 17 (32.7) 0.952
Birth context, n (%)
 Severe hypoxic-ischemic encephalopathy 4 (16) 9 (17.3) 0.445
 Congenital anomaly 5 (20) 5 (9.6)
 Premature 7 (28) 11 (21.2)
 Weight less than 1000 g 9 (36) 27 (51.9)
Verhagen classification, n (%)
 Class 1 0 1 (1.9) 0.654
 Class 2 1 (4) 3 (5.8)
 Class 3 7 (28) 9 (17.3)
 Class 4 17 (68) 39 (75)
 Parental opinion before meeting 4 (16.7) 25 (48.1) 0.009
Pathology prompting the meeting, n (%)
 Severe hypoxic-ischemic encephalopathy 5 (20) 8 (15.4) 0.742
 Other neurological disease 12 (48) 30 (57.7)
 Sepsis 1 (4) 3 (5.8)
 Congenital anomaly 3 (12) 6 (11.5)
 Acute respiratory disease 1 (4) 1 (1.9)
 Other 3 (12) 4 (7.5)
Cause of death, n (%)
 Severe hypoxic-ischemic encephalopathy 4 (16) 9 (17.3) 0.774
 Other neurological injury 13 (52) 27 (51.9)
 Sepsis 1 (4) 2 (3.8)
 Hemodynamic failure 2 (8) 7 (13.5)
 Congenital anomaly 4 (16) 6 (11.5)
 Respiratory failure 1 (4) 1 (1.9)
Lifetime according to pathology, median (IQR)
 Severe hypoxic-ischemic encephalopathy 13 (14.5) 11 (5.5) 0.337
 Congenital anomaly 20 (112.5) 31 (41)
 Premature 15 (37) 11 (21)
 Weight < 1000 g 11 (54.5) 9 (17)
 Understanding of end-of -life conditions, n (%) 21 (84) 51 (98.1) 0.019
Decision at the end of the meeting, n (%)
 Continue treatment 1 0 0.318
 Withhold treatment 7 14 (26.9)
 Withdraw treatment 16 38 (73.1)
 Sedation, n (%) 24 (96) 49 (94.2) 0.743
 Hypnotics 5 (20) 25 (48.1) 0.018
 Morphine 23 (92) 48 (92.3) 0.962
Ventilation support at time of death, n (%) 6 (24) 12 (23.1) 0.929
 Mechanical ventilation 5 (20) 11 (21.2) 0.864
 CPAP 1 (4) 1 (1.9)
 High flow nasal canulea 0 0
  1. Verhagen classification: class 1: children who died despite cardiopulmonary resuscitation (CPR) (no withholding nor withdrawing of LSIs), class 2: children who died while the ventilator, without CPR (no withdrawing of LSIs, but CPR withheld), class 3: children who died after LSIs were withdrawn or class 4: LSIs were withheld