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Published (Version of Record)CC BY V4.0, Open Access
Journal article
Access to reliable information about long-term prognosis influences clinical opinion on use of lifesaving intervention
PLoS ONE, Vol.7(2), e32375
2012
Abstract
Background
Decompressive craniectomy has been traditionally used as a lifesaving rescue treatment in severe traumatic brain injury (TBI). This study assessed whether objective information on long-term prognosis would influence healthcare workers' opinion about using decompressive craniectomy as a lifesaving procedure for patients with severe TBI.
Method
A two-part structured interview was used to assess the participants' opinion to perform decompressive craniectomy for three patients who had very severe TBI. Their opinion was assessed before and after knowing the predicted and observed risks of an unfavourable long-term neurological outcome in various scenarios.
Results
Five hundred healthcare workers with a wide variety of clinical backgrounds participated. The participants were significantly more likely to recommend decompressive craniectomy for their patients than for themselves (mean difference in visual analogue scale [VAS] −1.5, 95% confidence interval −1.3 to −1.6), especially when the next of kin of the patients requested intervention. Patients' preferences were more similar to patients who had advance directives. The participants' preferences to perform the procedure for themselves and their patients both significantly reduced after knowing the predicted risks of unfavourable outcomes, and the changes in attitude were consistent across different specialties, amount of experience in caring for similar patients, religious backgrounds, and positions in the specialty of the participants.
Conclusions
Access to objective information on risk of an unfavourable long-term outcome influenced healthcare workers' decision to recommend decompressive craniectomy, considered as a lifesaving procedure, for patients with very severe TBI.
Details
- Title
- Access to reliable information about long-term prognosis influences clinical opinion on use of lifesaving intervention
- Authors/Creators
- E.W. Steyerberg (Author/Creator)S. Honeybul (Author/Creator) - Sir Charles Gairdner HospitalK.M. Ho (Author/Creator) - The University of Western AustraliaS. O'Hanlon (Author/Creator) - Sir Charles Gairdner Hospital
- Publication Details
- PLoS ONE, Vol.7(2), e32375
- Publisher
- Public Library of Science
- Identifiers
- 991005541397807891
- Copyright
- © 2012 Honeybul et al
- Murdoch Affiliation
- Murdoch University
- Language
- English
- Resource Type
- Journal article
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Source: InCites
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- Collaboration types
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.134 Trauma & Emergency Surgery
- 1.134.286 Traumatic Brain Injury
- Web Of Science research areas
- Clinical Neurology
- ESI research areas
- Clinical Medicine