| 한국 신경계 중환자실에서 연명의료 중단의 임상적 특성과 결과: 단일 기관 후향 분석 연구 |
| 성준호1, 정혜인1, 정진헌1,2,3, 서정화1,3, 김대현1,3, 조용환3,4, 최재형3,4, 차재관1,3 |
1동아대학교병원 신경과
2동아대학교병원 중환자의학과
3동아대학교병원 부산권역심뇌혈관질환센터
4동아대학교병원 신경외과 |
| Clinical Characteristics and Outcomes of Life-sustaining Treatment Withdrawal in a Korean Neurocritical Care Unit: A Single-center Retrospective Study |
| Junho Seong MD1, Hye-in Chung MD1, Jin-Heon Jeong MD1,2,3, Jung Hwa Seo MD1,3, Dae-Hyun Kim MD1,3, Yong-Hwan Cho MD3,4, Jae Hyung Choi MD3,4, Jae-Kwan Cha MD1,3 |
1Department of Neurology, Dong-A University Hospital, Busan, Korea
2Department of Intensive Care Medicine, Dong-A University Hospital, Busan, Korea
3Busan Regional Cardiocerebrovascular Center, Dong-A University Hospital, Busan, Korea
4Department of Neurosurgery, Dong-A University Hospital, Busan, Korea |
Corresponding Author:
Jin-Heon Jeong ,Tel: +82-51-240-5266, Fax: +82-51-244-8338, Email: jhjeong@dau.ac.kr
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| *These authors contributed equally to this work |
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Received: September 16, 2025 Revised: October 30, 2025 Accepted: November 19, 2025 Published online: February 1, 2026 |
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| Abstract |
Background: The Act on Decisions on Life-Sustaining Treatment (LST) has been implemented in Korea since 2018, yet data on its application in neurocritical care units remain scarce. This study aimed to evaluate the clinical characteristics and outcomes of LST withdrawal or withholding in the neurocritical care unit.
Methods: This study was a retrospective analysis conducted at a tertiary university hospital in Busan, South Korea. Among patients admitted to the neurocritical care unit between February 2018 and August 2023, those with documented decisions for LST withdrawal or withholding were enrolled. Demographic and clinical characteristics, underlying and combined conditions, reasons for LST decisions, measures taken, and time from LST withdrawal to death were extracted from medical records.
Results: A total of 69 patients were included, with a median age of 67 years, and 38 (55%) were male. Cerebrovascular disease (62%) and traumatic brain injury (22%) were the most common underlying diagnoses. The primary reason for LST decisions was irreversible neurological damage (71%), followed by systemic complications (19%). Mechanical ventilation cessation (91%) and extubation (86%) were most frequently used measures for LST withdrawal. The median time from LST withdrawal to death was 22 minutes.
Conclusions: Our study demonstrates that LST decisions in the neurocritical care unit predominantly occur among patients with cerebrovascular disease or traumatic brain injury, mostly triggered by neurological deterioration. Most patients died shortly after withdrawal. These findings provide important insight into current LST withdrawal practices in neurocritical care and may assist clinical and ethical decision making in similar settings. |
| Key Words:
Withholding treatment | Intensive care units | Disease progression |
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