Limitations to Assessing Withdrawal of Care in Children

Pediatric traumatic brain injury (TBI) and the decision for withdrawal of life-sustaining therapies are areas that are both understudied and clinically relevant. In the study by Malhotra et al, the authors found that withdrawal of life-sustaining therapies was associated with younger age, firearm injuries, comorbid extracranial injuries, and severe intracranial injuries. They also noted differences in risk-adjusted mortality and withdrawal of life-sustaining therapies between centers. Importantly, the authors highlight that 2.2% of centers were considered outliers with most centers falling within a common range of outcomes (Figure 2). An additional pertinent result worth emphasizing is that insurance coverage, race, and abusive head injury were not associated with a higher rate of withdrawal of life-sustaining therapies.
Source: JAMA Surgery - Category: Sports Medicine Source Type: research