Study Suggests Waiting Longer Before Withdrawing Life Support

Decisions regarding the withdrawal of life support for patients with traumatic brain injury are often pressured by hospitals around the 72-hour mark, though research suggests this may be too soon. A study by Mass General Brigham, published in the Journal of Neurotrauma, indicates that some patients might recover a degree of independence within months if given more time. The unpredictability of recovery makes it challenging for families to make informed decisions about life-sustaining treatment soon after an injury.

The study analyzed over seven years of data from 1,392 patients in U.S. trauma centers, focusing on those who required life support. By comparing matched pairs of patients—one group who had life support withdrawn and another who continued—researchers found that many who had life support withdrawn might have died regardless. However, a significant proportion could have achieved some level of independence within six months if life support had not been withdrawn. The study also noted that remaining in a vegetative state was an unlikely outcome six months post-injury, suggesting that early withdrawal might prematurely end recoverable lives.

Demographic analysis of the study revealed that patients who had life support withdrawn were typically older and less likely to be Black or Hispanic. The findings highlight the importance of delaying life support decisions to better predict patient outcomes and avoid a self-fulfilling prophecy where poor prognosis leads to withdrawal, increasing poor outcomes. Despite its small sample size, the study’s insights are considered valuable. Experts like Dr. Walter Koroshetz stress that longer waiting periods allow for better understanding of recovery potential, emphasizing the need for cautious decision-making in life support withdrawal.

For more information see Gina Kolata “Study Suggests Waiting Longer Before Withdrawing Life Support“, The New York Times, May 17, 2024. 

Special thanks to Lewis Saret (Attorney, Washington, D.C.) for bringing this article to my attention.