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Many Families Take Patients Off Life Support Too Soon After Head Injury: Study

Many patients who have died from head trauma could have survived and recovered if their families had waited to care for them. excluding respiratory assistanceaccording to a new study.

Researchers from Massachusetts General Hospital, Harvard Medical School and other universities analyzed “potential clinical outcomes” for patients with traumatic brain injury (TBI) who were removed from life support, according to a press release.

The study included 1,392 patients treated at 18 trauma centers in the United States over a period of 7 1/2 years.

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Using a mathematical model, the researchers compared patients for whom life support was removed to similar patients who were kept on life support.

Among the group for whom life support was not withdrawn, more than 40% regained at least some independence, according to a press release.

Many patients who died from head trauma could have survived and recovered if their families had waited until they were taken off life support, a new study suggests. (iStock)

The researchers also found that the notion of remaining in a vegetative state was an “unlikely outcome” six months after an injury.

When designing the study, the team didn’t know what to expect, according to study author Yelena Bodien, PhD, of the Center for Neurotechnology and Neurorecovery in the Department of Neurology at Massachusetts General Hospital.

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“Our anecdotal experience is that some families are told that their loved ones have no chance of recovery, that they will never walk, talk, work or have a meaningful relationship again – and yet, they have chose not to interrupt life support and their loved one made a remarkable recovery” she told Fox News Digital.

“On the other hand, clinicians are under a lot of pressure to make early prognoses and do not want to commit someone to a life that would never be acceptable to them. So it could be that patients who die after removal of the system otherwise, they would have had very significant deficiencies.

“Our anecdotal experience is that some families are told their loved ones have no chance of recovery…but they chose not to interrupt life support and their loved one made a remarkable recovery,” one researcher said. (iStock)

“I think there are two stories here,” Bodien said.

“One is that some head injury patients who died because life support was withdrawn may have recovered, but the other is that many would have died even if life support had been maintained.”

A patient’s prognosis after severe head trauma is very uncertain, she noted. “Sometimes patients with the most devastating injuries survive and significant recoveries“.

“Families can advocate for delaying the decision to terminate life support if it is what they think their loved one would want.”

The problem, Bodien said, is that health care providers don’t have the tools to determine which patients with devastating injuries will recover, how well they will recover — and how long it will take.

A “very important” study

Dr. Marc Siegel, clinical professor of medicine at Langone Medical Center of New York and Fox News medical contributor, was not involved in the research but said it was a “very important” study.

“Previous research shows a high level of recovery after mild head trauma and a significant recovery percentage even with moderate to severe injury,” Siegel told Fox News Digital.

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“After a head injury, the brain can swell, and the use of mannitol and steroids and sometimes even surgery – where the top of the skull is removed – can be used to decrease pressure on the brain and increase the chances of complete recovery,” he said. continued.

Rehabilitation is also crucial, Siegel added.

“All of these tools should have a chance of working in most cases.”

Health care providers don’t have the tools to determine which patients with devastating injuries will recover, how well they will recover and how long it will take, a researcher said. (iStock)

Based on the study results, Bodien recommended that clinicians be “very cautious” with “irreversible decisions” such as removing life support in the following days. traumatic brain injury.

“Families should also be aware of our findings so they can advocate for delaying the decision to withdraw life support if it is what they think their loved one would want,” she added. .

Research limitations

The study had some limitations, Bodien said.

“The study sample size was small, which made it difficult to find an adequate number of participants who had not been interrupted by life support and who were clinically similar, or “matched.” , to those whose life support system had been interrupted,” she told Fox. Digital News.

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Among the participants whose life support was not interrupted, the researchers were not able to follow them all for a period of six months.

Another limitation is that researchers used clinical variables available the day or day after hospitalization – but sometimes the decision to withdraw life support is made several days later.

Based on the findings, study author Yelena Bodien (not pictured) recommended that clinicians be “very careful” with “irreversible decisions” such as removing life support within a few days. head trauma. (iStock)

“There are many considerations that can lead to the decision to terminate life support after head trauma that we were not able to take into account in our analyses,” she continued.

“For example, personal beliefs, religion and advanced directives could all affect decision making but were not considered in our study.

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Bodien also noted that the Harvard study focused on head trauma and could not be generalized to other injuries and illnesses.

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