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Study urges caution when making decisions regarding traumatic brain injury

A new study of traumatic brain injuries indicates that many decisions to withdraw life support are made within three days of admission to an intensive care unit.

Are some of these decisions too hasty? That's what will debated in Wisconsin and elsewhere in the wake of the new Canadian study.

Most of those studied sustained their severe brain injuries in car accidents (55 percent), followed by people who were injured in falls (30 percent) and in assaults (7.5 percent).

The study found that decisions about withdrawal of life support measures from traumatic brain injury (TBI) victims varied widely from hospital to hospital. Researchers said the results may indicate that the decisions might sometimes depend too heavily on a doctor's philosophy and "practice patterns."

The researchers found that 64 percent of the TBI patients who died within three days of being admitted to an ICU had life support withdrawn.

That might be too soon for doctors to be able to make accurate predictions of how the injured person might respond to life-sustaining therapy.

"Caution is warranted regarding prognostication and early withdrawal of life-sustaining therapy following severe traumatic brain injury before accurate and clinically useful prognostic tests and models are available," researchers wrote.

They also wrote that doctors vary in their prognosis evaluations, meaning that while one doctor might advise a family that their loved one has no chance of recovery, another one might advise the family to hang in there and see how the loved one's brain responds to efforts to restore brain function.

The study is certainly food for thought. None of us knows who might someday have to deal with the painful and difficult decision to withdraw medical life support meaures from a loved one hurt in a motor vehicle accident, fall or other serious mishap.

Source: Medscape.com: "Caution Urged on Withdrawal of Life-Support After Brain Injury" by Kate Johnson: Sept. 1, 2011

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